DIABETES

The information on diabetes on this website is not designed to provide medical or professional advice. It is designed to provide information only and if you have any health questions or problems please consult a medical doctor.

Diabetes is now an epidemic and it's now one of the biggest challenges confronting Australia's health system. There is around 1.7 million Australians with diabetes and this number includes 1.2 million known and registered people with diabetes as well as 500 000 people who have diabetes but are unaware or do not know they have diabetes.

What is diabetes?

It is a very serious condition which requires regular and life-long care and if complications develop, diabetes can destroy your quality of life and cause premature death. At present there is no cure for diabetes that we know of, but even though there is no cure, you can still have diabetes and live a normal life by learning about your diabetes and managing it effectively with support from your family and health professionals.
When you have diabetes, it means your body cannot maintain normal levels of sugar called glucose in the blood. This glucose is a form of sugar which your body uses to generate energy that your body needs to function and survive. For your body to work well and properly you need to change or convert sugar from food that you eat to energy. When you eat food, it is broken down and eventually most of it gets converted to glucose. This glucose is then carried by your blood to the rest of the body to be used to produce energy. The tissues and cells that make your body needs to extract this glucose from the blood and to do so, your body needs a hormone called insulin which is produced by an organ called the pancreas. When glucose combines with insulin in the blood vessels, the glucose is driven or pushed into the cells. When glucose enters the cells, it is then used to produce energy that your body needs to keep you healthy and alive. If you have diabetes, it means your pancreas no longer produces insulin at all or if it does produce insulin, it does not produce the insulin in sufficient amounts or the little insulin that it produces does not work effectively or the cells of the body do not respond to insulin effectively.
Therefore if you have diabetes and you eat food or have a meal, for example bread, the glucose from the bread that you absorb remains locked in the blood vessels and cannot be pushed out into the cells or organs of the body where it is required and needed. That means glucose stays in the blood resulting in high blood glucose levels with the cells of the body starving of glucose.

Types of diabetes

There are 3 main different types of diabetes called type 1 diabetes, type 2 diabetes and gestational diabetes and all types are increasing in prevalence.
1. Type 1 diabetes accounts for 10 percent of all diabetes and occurs mainly in children.
2. Type 2 diabetes accounts for 85 percent of all diabetes and occurs mainly in adults and we are now seeing it in younger people as well.
3. Gestational diabetes occurs in pregnancy.

Type 2 diabetes

Type 2 diabetes is the most common form of diabetes, and is largely preventable by maintaining a healthy lifestyle. Type 2 diabetes is a progressive condition in which your body becomes resistant to the normal effects of insulin and or gradually loses the capacity to produce enough insulin in the pancreas, that is, there is reduced insulin production or the insulin does not work effectively or there is insulin resistance. During insulin resistance, the insulin is increasingly ineffective at managing the blood glucose levels and as a result the pancreas responds by producing a lot of insulin to try and control blood glucose levels. Over time the cells in the pancreas that produce insulin wear themselves out or burn out, so that by the time you are told that you  have type 2 diabetes, you would  have lost about 50-70 percent of  cells that produce insulin in the pancreas.
Type 2 diabetes represents about 85-90 percent of all cases of diabetes and normally develops in adults over the age of 45 years but we now know that it is increasingly occurring in younger age groups including children, adolescents and young adults. Type 2 diabetes runs in families, that is, it is more likely to develop in people with a family history of type 2 diabetes or from particular ethnic backgrounds.

Complications of diabetes

If not managed well diabetes can causes all sorts of problems and complications which include;
1. blindness, 
2. kidney failure and dialysis,
3. Increased risk of heart attacks and strokes,
4. limb amputations,
5. nerve damage,
6. sexual dysfunction,
7. mouth diseases,
8. hearing loss, sleep apnoea,
9. high or low sugar levels (hyperglycaemia & hypoglycaemia),
10. at least 30 percent of diabetics have depression, anxiety and distress.

It is therefore crucial to diagnose diabetes early so that optimal treatment and effective support and management can be provided to reduce the risk of complications and premature death.

What causes type 2 diabetes?

There is no single cause of type 2 diabetes but we know that it runs in families, that is, if you have a family member with diabetes, you have a genetic disposition to have diabetes, that is, you are more likely to develop type 2 diabetes. This family predisposition is increased when it is associated with lifestyle factors such as high blood pressure, overweight or obesity, insufficient physical activity, poor diet and carrying extra weight around the waist. Some other risk factors that puts you at a higher risk of developing type 2 diabetes include:
1. being over 55 years of age,
2. being over 45 years of age and overweight,
3. being over 45 years of age and having high blood pressure,
4. being over 35 years of age and you are from an Aboriginal or Torres Strait Islander background, Pacific Island, Indian subcontinent or Chinese cultural background,
5. being a woman who has given birth to a child over 4.5kgs (9 lbs),
6. if you had gestational diabetes when pregnant,
7. if you have certain medical conditions such as Polycystic Ovarian Syndrome.

Of all the diabetes types, type 2 diabetes is increasing at the fastest rate. We also know that there is a lot of people with diabetes but are unaware and their health is being ruined. We also know that there is about 2 million Australians who are at high risk of developing type 2 diabetes.

Symptoms of type 2 diabetes

With type 2 diabetes particularly in the early stages, you may feel well with no symptoms at all and as a result by the time your symptoms are noticed, complications of diabetes may already be present but in any event here are some of the symptoms to look for:

• Being more thirsty than usual, passing more urine,
• Feeling tired and lethargic, always feeling hungry,
• Having cuts that heal slowly, itching, skin infections,
• Blurred vision, putting on weight, 
• Mood swings, headaches,
• Feeling dizzy, leg cramps, tingly and numbness in the feet.

Facts about diabetes in Australia

Diabetes is the fastest growing chronic condition in Australia and more than 100 000 Australians develop diabetes every year and this means that 280 Australians develop diabetes every day which translates to one person every five minutes. In Australia there is about 1.7 million people with diabetes (about 1.2 million people are known and registered to have diabetes and about 500 000 have diabetes but they are unaware they have it). We also know that for every person diagnosed with diabetes there is usually a family member or carer who also has do deal with diabetes every day in a supporting role. This means that an estimated 2.4 million Australians are affected by diabetes every day. There is about 2 million Australians who are at high risk of developing type 2 diabetes. Type 2 diabetes can be delayed or prevented in 58 percent of cases.

Managing Type 2 Diabetes

We know that at present there is no cure for type 2 diabetes but at the same time it can be managed effectively through lifestyle changes and medication to prevent complications and premature demise.  Initially type 2 diabetes can be managed through lifestyle changes which include:
1. a healthy diet,
2. regular exercise,
3. monitoring your blood glucose levels.

Type 2 diabetes is a progressive condition and eventually healthy eating and exercise will become inadequate to keep the blood glucose levels down. When this happens medications are then prescribed to control blood glucose levels. There is a whole range of different medications including tablets and injections on the market and the list is growing. As time goes on your body will completely fail to produce insulin. When this happens you will start to use insulin injections or pumps to control blood glucose levels. Sometimes tablets may be continued in addition to insulin. It is very important to understand that tablets or injections are intended to be used together with healthy eating and regular physical activity, not as a substitute to control diabetes.

Are you at risk at of developing Type 2 diabetes?

We know that there is a no single cause of type 2 diabetes but we also know that there are well-established risk factors. Some risk factors can be controlled and others you are born with.  We know that there is about 2 million Australians who are at high risk of developing type 2 diabetes. Diabetes Australia has developed a Risk Calculator based on the Australian type 2 diabetes risk test called (AUSDRISK). This is a very simple and easy way to assess your risk of developing type 2 diabetes and it can be found on https://www.diabetesaustralia.com.au/risk-calculator and I encourage you to use the calculator and bring forward the results to a medical doctor and urge your friends and family to do the same as well.

Help

You are able to get help if you have diabetes from various professionals and organizations such as:
1. Doctor
2. Endocrinologist, Ophthalmologist, Dentist
3. Optometrist, Podiatrist, Dietician, Diabetic Educator
4. Diabetes Australia: Tel 1300 136 588 (https://www.diabetesaustralia.com.au) and States organizations.

Summary

• Diabetes is serious and complex and should not be taken lightly. It requires daily and life-long care. If not well managed, diabetes is fatal. Anyone can develop diabetes and it does not discriminate.
• Diabetes complications include permanent organ damage such as (heart)-heart attack, (brain)-stroke, (eye)-blindness, (kidney)-kidney failure and dialysis, (feet)-nerve damage and amputation, sexual dysfunction, skin and mouth infections, mental health and premature death.
• Type 2 diabetes may be prevented and reversed with proper care and treatment if detected early.
• The aim of good diabetes management is to keep blood glucose levels as close to the target range to prevent both short-term and long-term complications.  It is also important to keep your waist measurement, weight, blood pressure, physical activity and cholesterol within recommended ranges.
• It is very important that you cease smoking and reduce alcohol intake if you have diabetes.