Diabetes

Diabetes is a chronic (long-term) health condition that affects the level of sugar in your blood, which is normally controlled by a hormone called insulin.

• Type 1 diabetes - the immune system attacks the cells that produce insulin, reducing your ability to manage blood sugar. It is inherited and cannot be caused by an unhealthy lifestyle.
• Type 2 diabetes - the body doesn't produce enough insulin or the cells are less sensitive to insulin than normal. It can be caused by a number of factors, including lifestyle choices and tends to develop later in life.

Diabetes is a progressive condition, which means it gets worse over time as the body becomes resistant to the effects of insulin, or loses the ability to produce enough insulin in the pancreas.

This page will focus on type 2 diabetes, which is the most common form of the condition and represents 85-90% of all cases. It is important to manage type 2 diabetes properly to prevent health complications.

• Untreated diabetes can lead to heart disease, stroke, kidney disease, nerve damage, foot problems, sexual dysfunction, miscarriage and stillbirth.

Around 1.2 million Australian adults (6% of the population) have diabetes, according to the Australian Bureau of Statistics 2014-15 survey. This includes all types of diabetes, but is thought to underestimate the true number of diabetics in the country; many people are living with diabetes but haven't been diagnosed yet.

Even so the data suggests a continual increase; statistics show that the prevalence of diabetes tripled from 1989-90 to 2014-15 (1.5% to 4.7% of population).

In 2014-15, a greater percentage of Australian men (7%) had diabetes than women (5%). The rate of diabetes increased significantly with age, as rates among 65-74-year-olds (17%) were three times as high as 45-54-year-olds (5%).

The prevalence of diabetes is also influenced by socioeconomic factors. In Australia, the rate for the lowest socioeconomic group (10% of men and 7% of women) was double that of the highest socioeconomic group (4% for men and women).

There is also a huge discrepancy in diabetes rates between Indigenous Australians and non-Indigenous Australians. The former are four times as likely to have diabetes compared to the latter (18% to 5%).

The scale of the problem should not be underestimated. In 2014-15 there were 1 million hospitalisations associated with diabetes. This makes up 10% of all hospitalisations in Australia that year.

Another important point is that 1 in 10 deaths had diabetes as an underlying and/or associated cause of death in 2014.

Symptoms of type 2 diabetes can include:

• Increased thirst
• Weight loss
• Fatigue
• Itchy genitals
• Frequent urination
• Infections or cuts that are slow to heal
• Thrush
• Boils/warts
• Blurred vision

There is no single cause of type 2 diabetes. In fact scientists do not know why the condition develops. However the following factors can increase the likelihood of diagnosis:

• Genetics – if one parent has type 2 diabetes, their child has a 1 in 3 chance of developing the condition
• Age – type 2 diabetes usually develops in adults aged 40 and over
• Obesity – being overweight is a major risk factor
• Ethnicity – people with Caribbean or African heritage are 3 times more likely to develop diabetes than Caucasians. This rises to 6 times for those of South Asian heritage.

Type 2 diabetes is a progressive condition that develops over a long period of time.

There is often no sign that you are suffering type 2 diabetes until you suffer a complication. This can include something as serious as a heart attack or a relatively minor symptom that could have a number of causes such as blurry vision or a foot ulcer.

If you experience any of the symptoms of diabetes, it is important to visit your doctor as soon as possible. During your appointment, you will be asked about the symptoms and may be given blood and urine tests.

Doctors will test to see if your urine contains glucose. In a healthy body there would be no glucose in urine, but in diabetics, it may be present. This is because your body tries to expel excess glucose through the urine.

If it is discovered that you do have glucose in your urine, you will be given a specialised blood test call glycated haemoglobin (HbA1c) to see if you have diabetes.

In the event of a positive diagnosis your doctor will advise on appropriate treatment. Most people will be expected to make lifestyle changes, but there are prescription medications available in severe or advanced cases.

At first you may not need to take any medication for type 2 diabetes. A healthy lifestyle and careful monitoring of blood sugar levels may be enough to maintain good health.

However the condition is progressive, and you may need to take medication at some point. A medication called biguanides are commonly used to treat type 2 diabetes, as are a number of other medications. Your doctor or diabetes specialist will be able to recommend the best treatment for your specific case.

It is important to remember that these medicines are not a magic solution that will cure diabetes. You will have to make certain lifestyle changes at the same time to make sure that your diabetes is properly managed.

If you have been diagnosed with type 2 diabetes, lifestyle changes are incredibly important. For anyone who wants to avoid serious health complications, the following actions can help:

Eat a healthy diet

You should eat a low-fat, low-sugar diet that is high in fibre. It is particularly important to cut down on saturated fat.

Fibre is found in foods such as wholegrain bread and cereals, beans and lentils, and fruit and vegetables. Try swapping out fatty foods like butter for low-fat spreads and vegetable oil.

Aim to buy skimmed or semi-skimmed milk and low-fat yoghurts rather than full-fat versions. Make your dishes with fish and lean meat rather than fatty or processed meat.

Try not to fry or roast your food, but grill, poach, bake or steam it instead. Swap unhealthy cakes and biscuits for healthier snacks such as fruit and unsalted nuts.

This will help you maintain a healthy weight.

Exercise

Physical activity is key if you want to maintain a healthy weight. If you are overweight, you need to burn more energy than you are consuming as calories.

No one is suggesting that you start training for a marathon, at least not straight away. Exercising can be simple things that you build into your daily routine, such as using stairs instead of the lift or getting off the bus a stop early to walk home.

Obesity is measured using Body Mass Index (BMI). You should aim for a BMI between 18.5 and 24.9. Obese people have a BMI of more than 30. If you fall in this population then you should aim to lose 5-10% of your body weight in one year.

Cut down on alcohol

Many alcoholic drinks contain a lot of sugar, as well as a lot of calories. As a result, it is recommended that you minimise your alcohol intake as much as possible. This will help you to control your blood sugar levels and maintain a healthy weight.

Stop smoking

Smoking affects your body in lots of different ways. The combination of diabetes and smoking raises the risk of suffering cardiovascular emergencies such as heart attack or stroke. Cutting out smoking will lower this risk and bring a lot of other benefits.

All of these factors are important in maintaining a healthy body. It is important that you keep monitoring your blood sugar levels and maintain good communication with your doctor.

Your medical team will also be able to recommend support services for diabetics. There may be local diabetes groups or online forums, where you can talk to other people with the condition. This can help motivate you and provide support if you are feeling low about living with diabetes.