Diabetes is a disease currently affecting more than one million people across Australia, and this number is only rising. However, although diabetes is so widespread, many of us don’t have a good understanding of the disease or how to manage it.
Even if you don’t have diabetes yourself, it’s likely you know someone who does, and it’s always good to be familiar with the basics. This two-part guide explains the basics of diabetes and diabetes management.
What is diabetes?
The diabetic condition is one in which the body doesn’t produce or properly use insulin (a hormone allowing the body to use glucose/sugar for energy), and therefore cannot allow glucose (converted from carbohydrates) into your cells to provide you with energy.
Carbohydrates are the body’s primary source of energy. Although the body can use protein, fats and carbohydrates for energy, carbohydrates trigger a more dramatic insulin release and response. Here’s what happens to carbohydrates in your body if you don’t have diabetes:
- When you eat a food containing carbohydrates, the carbohydrates are converted to glucose, and then released into your bloodstream.
- The glucose then wants to get into your body’s cells to give them energy. However, the glucose can’t just enter the cells – it needs a “key” to unlock the cell “door”, and insulin acts as that key.
- Therefore, when glucose levels in the bloodstream get high enough, the pancreas releases some insulin to go and unlock the cells so that the glucose can get in and give energy to the cells.
If you do have diabetes, the process fails at one of two points.
- In Type 1 diabetes, the pancreas does not produce enough insulin, so the “key” cannot unlock the cell “doors” to provide them with energy.
- In Type 2 diabetes, the cell’s keyholes are not the right shape for the insulin keys.
Either way, glucose cannot enter the cells and so remains in the blood stream.
What is hyperglycaemia?
When glucose remains in the blood stream, glucose levels can get too high. This is called hyperglycaemia – also known as high blood glucose (blood sugar).
The body tries to combat hyperglycaemia by pulling water out of the body’s cells and sending it into the bloodstream. Once in the bloodstream, the water dilutes the high concentration of glucose, and then excretes excess glucose through the urine. This results in symptoms of frequent urination, continual thirst, and tiredness. At the same time, the cells remain starving for glucose, so they send signals to the body to eat more food. People with diabetes are often very hungry as a result.
Checking your blood sugar count regularly, and treating high blood glucose levels early can help you detect and avoid hyperglycaemia.
If you don’t treat hyperglycaemia quickly, a serious condition called ketoacidosis can occur. This means your body does not have enough insulin, so attempts to break down fats into glucose to get more insulin. However, this produces waste products called ketones. Your body cannot tolerate large amounts of ketones, so tries to remove them through your urine. Unfortunately your body can’t remove all of the ketones effectively in this way, and they can build up in your blood. This excess of ketones in your blood can lead to ketoacidosis, a life-threatening condition which needs to be treated immediately.
What health problems occur as a result of diabetes?
Many health problems can occur as a result of diabetes.
In the short-term, you may experience ketone damage, extreme thirst, exhaustion, nausea, and slow healing of wounds.
If diabetes remains untreated and your blood glucose levels remain high for many years, this can result in damage to nerves and blood vessels. This, in turn, leads to more serious complications associated with diabetes such as:
- High blood pressure
- High cholesterol
- Blood clotting
- Heart failure
- Eye diseases, including diabetic retinopathy, glaucoma, cataracts
- Foot ulcers leading to amputations
- Renal disease
What is the difference between Type 1 and Type 2 diabetes?
The most important difference between Type 1 and Type 2 diabetes is that Type 2 diabetes is preventable. Although it has a genetic basis, Type 2 diabetes is largely dependent on environmental factors. The misshapen “key holes” in Type 2 diabetes which stop insulin from entering the cells are almost always caused by excess fat or a sedentary lifestyle; in fact 90% of people with Type 2 diabetes are overweight or obese. Losing weight, eating healthily and increasing physical activity can help treat or prevent Type 2 diabetes in most cases.
Type 1 diabetes, on the other hand, is a hereditary condition where the problem is the lack of insulin produced by the body. Type 1 diabetes must be managed through insulin injections, as well as carefully-monitored eating and regular exercise. Although the causes of Type 1 and 2 diabetes are different, both forms of the disease are equally serious and can have equally serious consequences if left untreated.
There is also a third type of diabetes called gestational diabetes. Gestational diabetes occurs during pregnancy, but with proper management the condition usually resolves itself after the baby is born. Gestational diabetes occurs in about 8% of pregnancies.
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Who can get diabetes?
Type 1 diabetes is mostly genetic, and usually occurs in children or young adults. Researchers believe that in Type 1 diabetes, the body’s immune system is somehow triggered by the environment, causing it to destroy the cells in the pancreas that produce insulin. But we have yet to understand why this happens or what triggers this response.
Overweight and inactive adults are most likely to develop Type 2 diabetes. Possessing any of the following characteristics are common factors in people predisposed to the disease: obesity, a family history of diabetes, aged over 55 years, high blood pressure, a previous diagnosis of gestational diabetes, delivery of a baby over 4.5 kg, and pre-diabetes (see the section ‘What is pre-diabetes?’ on the next page). Those aged over 35 years and of Aboriginal, Torres Strait Islander, Pacific Islands, Indian subcontinent or Chinese cultural background also have an increased risk of Type 2 diabetes.
How do I know if I have diabetes?
Diabetes is first diagnosed by the appearance of symptoms. Urine tests and blood tests are then used to confirm a diagnosis. Symptoms can develop suddenly in healthy children or adults, or gradually over several years in overweight adults. If you have any of the following symptoms you should see your doctor for testing:
- Increased thirst
- Unusually frequent hunger
- Frequent urination
- Unusual fatigue
- Blurred vision
- Cramps or burning sensations in your feet and/or legs
- Unexplained weight loss
- Nausea or vomiting
- Sores that take an excessively long time to heal
You should see your doctor for a blood glucose test at least once every three years.
What is pre-diabetes?
Pre-diabetes, also called glucose intolerance, is a condition in which a person’s blood glucose levels are higher than normal, but not high enough for a diagnosis of Type 2 diabetes. It is estimated that 1 in 4 Australians have pre-diabetes or diabetes.
Left unmanaged, pre-diabetes can develop into Type 2 diabetes. Lifestyle improvements, including adopting a better diet and exercising more regularly, can prevent pre-diabetes from turning into a more serious condition.
What is silent diabetes?
For everyone who has been diagnosed with diabetes, there is also someone who has the condition but remains undiagnosed – in Australia alone, that’s over 500,000 undiagnosed cases.
This is because many of the symptoms of diabetes can initially be very mild or easily ignored. It’s also possible to have very high blood glucose levels causing damage to the body, yet not feel unwell. This is called silent diabetes. It is still important to treat these cases, as research shows that good control of blood glucose levels prevents or lessens the likelihood of the complications of diabetes, so early intervention is critical. Therefore, it’s important to have your blood glucose level checked by your doctor every three years.
Prevention is the best cure for Type 2 diabetes; this can’t be emphasised enough. Diabetes Australia recommends a balanced diet and regular exercise to greatly reduce your risk of pre-diabetes and Type 2 diabetes. Remember – it’s in your hands. Don’t just sit around waiting for diabetes to happen, take action before it does.
Of course, for many people, making the change to eating more healthily and exercising often can be difficult. If you know you need to make changes to your current lifestyle, but are struggling with motivation and support, talk to a health professional – support and guidance makes the transition much easier and more manageable. A dietitian, doctor or diabetes educator can help you to get on track with healthy living, to prevent your chances of developing Type 2 diabetes.
If you haven’t done so already, take a good look around Food.com.au for plenty of information, ideas, support and tools for effective weight control. Talk to existing members in our Community Forums to find out how Food.com.au has helped them make important lifestyle changes.
Please note: This article is for informational purposes only and is not intended to replace professional medical advice. Please see your doctor immediately if any of the following occurs:
- Your blood glucose level is consistently high or low, even though you are taking your insulin/medications correctly.
- Your symptoms worsen
- You experience chest pain, vision problems, sweatiness or numbness
This article was compiled in consultation with Food.com.au experts and in reference to the following sources:
Diabetes Australia, ‘General Diabetes Fact Sheet’, www.diabetesaustralia.com.au/fact_sheets
Diabetes Australia, ‘What is Diabetes?’, www.diabetesaustralia.com.au/fact_sheets
Diabetes Australia, ‘Pre Diabetes’, www.diabetesaustralia.com.au/fact_sheets
Diabetes Australia, ‘Type 1 Diabetes’, www.diabetesaustralia.com.au/fact_sheets
Diabetes Australia, ‘Type 2 Diabetes’, www.diabetesaustralia.com.au/fact_sheets