Diabetes

Diabetes is a condition where the level of sugar (glucose) in the blood is too high. A hormone called insulin, which is produced by the pancreas, regulates blood glucose levels. You can get diabetes if the pancreas does not produce enough insulin or if your body doesn’t use the insulin that is produced properly. Around 5-7% of the Australian population has Diabetes.

Common Symptoms

• Some diabetics can have no symptoms at all

• Increased thirst

• Increased urination

• Fatigue and feeling tired all the time

• Blurred vision

• Weight loss

• Mood swings

• Itching

Diagnosis

A simple fasting blood test can give the diagnosis. It is done after waking up in the morning. After waking up, you can have some water but you can’t eat or drink anything else until your blood is taken.

Types of Diabetes

1. Pre-Diabetes or Borderline Diabetes

This essentially means that the blood sugar levels are higher than normal but it is not high enough to be classed as diabetic. Usually, there will be no symptoms.
It is important to take note of this diagnosis because about a third of this group develops Type 2 Diabetes if nothing is done. Weight loss, cessation of smoking, blood pressure control, increasing exercise, modifying diet and controlling cholesterol levels will help to make sure it does not develop into Type 2 Diabetes. Regular blood tests will be needed to assess progress.

2. Type 1 Diabetes (Insulin Dependent Diabetes)

About 10% of people with diabetes fall into this category. In Type 1 Diabetes, the pancreas does not produce Insulin anymore. This happens because the body destroys the insulin making cells in the pancreas.
It is usually diagnosed in the under 30-age group and can happen in young children as well. There is no known cure at this stage.
This condition can be managed well with Insulin injections. Your doctor will need to monitor you on a regular basis.

3. Type 2 Diabetes (Non Insulin Dependent Diabetes)

This is the commonest type of diabetes and accounts for 85% of all diabetics. It happens because the cells in the body do not respond to insulin in the proper manner.
It usually affects people over 40. It is becoming a major issue in Australia and is a “lifestyle” disease. It happens mainly in people who are overweight and inactive.
Type 2 Diabetes can be stopped or delayed with lifestyle modifications. The condition can be treated with oral medication and lifestyle changes.

4. Diabetes Insipidus and Gestational Diabetes

These forms of diabetes are not discussed in this blog. Gestational Diabetes will be discussed in another blog at a later date.

Complications

1. Heart Disease such as angina and heart attacks

2. Strokes

3. Eye damage- can reduce vision

4. Kidney damage- can progress to kidney failure

5. Neuropathy- altered or decreased sensation in hands and feet

6. Poor wound healing

7. Increased incidence of infections

8. Foot and leg ulceration

9. Sexual issues- mainly with erections in a man.

Treatment

The main aim of treatment is not to cure diabetes, as we do not know how to do that yet, but to manage the blood glucose levels. This will in turn, help to prevent complications and allow you to live a full and comfortable life.

1. Lifestyle changes
   Weight loss- in particular decreasing the waistline.
   Diet- avoid foods high in fat, sugar and salt. Also avoid foods low in fibre. Smaller food portions are better.Increasing activity to at least 30 minutes a day or more.
   Cutting down or stopping smoking

2. Medications
   Oral diabetic medication- used in Type 2 Diabetes.
   Insulin Injections- used in Type 1 Diabetes and also very infrequently in certain cases of Type 2 Diabetes.

3. Blood Pressure and Cholesterol
   These should be monitored and treated as needed to prevent complications. This may mean further medications too.

4. Self Monitoring of Blood Glucose levels
   This is done by a finger prick test at home with a small machine and gives you a reading of your glucose levels. Also involves keeping a diary of these readings.

5. Regular reviews 3 monthly or 6 monthly by your doctor.
   This will include bloods tests, review of your blood glucose diary, monitoring for complications and arranging for allied health visits if needed.

6. Referrals
   The doctor may refer you to the following Health Professionals as needed
   Diabetic Educators- for the newly diagnosed and poorly controlled diabetics
   Optometrist- all diabetics need regular eye checks
   Podiatrist- to manage foot care in established diabetics
   Dietician- to help with eating well
   Exercise Physiologist- to help with activities and promote healthy lifestyle
   Diabetic Specialist (Endocrinologist)- usually reserved for complications or issues with controlling blood sugar levels