Diabetes is a complex condition that can affect the entire body. The peak advocacy group for the disease, Diabetes Australia, is calling for a new national diabetes strategy amidst concerns that the incidence of Type 2 diabetes - which is largely preventable - is continuing to increase with the combination of people living longer with busy and less healthy lifestyles.
Diabetes Australia says you probably know someone close to you with diabetes because it has reached "epidemic proportions" in Australia and globally.
Last week, Accredited Practising Dietitian Kerryn Boogaard wrote about why the Mediterranean diet is a good one to follow and what the practical differences are between it and the 'average' diet of many Australians. This week, we speak with Dr Ian Boyd from Medibank 24/7 Health Line who gives us some plain-English answers to readers' questions.
1. What should people be concerned about with diabetes?
Diabetes is divided into two main types, 1 and 2. Type 1 accounts for 87% and Type 2 just over 10% of all cases. A less common, but still very important, type affects some pregnant women and is called Gestational Diabetes.
On a national level we should be concerned as around one million Australians have diabetes and many more have pre-diabetes. Worryingly, 1 in 20 pregnancies are affected by diabetes. These figures are astounding, especially when you consider that around 40% of all admissions to hospitals involve people who have diabetes and around 30% of all prescription medications are prescribed for managing diabetes or complications.
2. How are people tested?
Diabetes should be diagnosed by your doctor using a specific blood test. Some types of diabetes have no symptoms and can go undiagnosed, but there are some common symptoms like increased thirst, urination and tiredness as well as slow healing wounds or reoccurring infections. A health screening tool like a random finger prick or urine test is not enough to make an initial diagnosis for diabetes but these can be used to identify a potential problem or to help confirmed diabetics monitor their own blood sugar levels.
3. What happens if you have diabetes?
A hormone called 'insulin' is produced by the pancreas and helps regulate the amount of sugar in the blood. In Type 1 diabetes, the body's immune system attacks and destroys the cells that produce insulin, whilst in Type 2 diabetes the pancreas does not produce enough insulin or the body can’t use the insulin it produces. Gestational diabetes occurs in pregnancy when some women are unable to produce enough insulin and while this may return to normal after the pregnancy the mother may be at risk of developing diabetes.
When there is too much sugar in the blood over a prolonged period there may be complications, such as:
- Damage to organs like Kidneys or Eyes,
- Nerve damage in parts of the body,
- Heart disease and circulation problems, and
- Skin ulcers or infections, especially the feet, resulting from circulation problems and nerve damage.
Whist there is no current cure for diabetes, there is treatment aimed at preventing complications by controlling blood glucose levels.
4. What if someone develops type 2 diabetes and they don't do anything about addressing lifestyle factors?
When people don’t manage their disease they are at an increased risk of complications. Already we know that 3 in 5 of people with diabetes also have cardiovascular disease, over 10% of people with diabetes are experiencing vision loss, and there are other complications like foot ulcers. When lifestyle factors are not managed, it increases the risk of complications.
Addressing the lifestyle factors and managing the blood sugar level decreases the risk of complications and when managed properly, diabetes complications can be prevented or delayed.
5. How come some people can be overweight and not have diabetes?
Over half of Australian adults are overweight or obese, which puts them at greater risk for diabetes, particularly Type 2. However, being overweight is not the only risk factor for developing diabetes – for example, family history and ageing are other important risk factors. Weight also plays a far lesser role in development of Type 1 and gestational diabetes.
6. How come there are people who are not overweight and lead a fairly healthy lifestyle can have diabetes? Are they supposed to lead a healthier lifestyle?
Being overweight is not the only risk factor for developing diabetes as there are other risk factors too that include:
- Age
- Having diabetes when you were pregnant
- Family History
- Ethnic Background
- Elevated cholesterol levels
- Other medical problems, such as polycystic ovarian syndrome.
We all need to lead a healthier lifestyle and that includes diet and exercise. Knowing the risk factors in developing diabetes will help early diagnosis and better management to reduce or delay complications.
7. If healthy, normal weight people can get it, how do you know lifestyle is the key factor?
Weight and lifestyle are key factors in developing insulin resistance and diabetes, but are not the only ones. Unlike age or family history, lifestyle issues like diet, exercise and weight are risk factors that you can control. Research continues into diabetes and our understanding of the disease continues to grow.
8. Can children get type 2 diabetes, and if so, at what age?
In Type 2 diabetes the pancreas does not produce enough insulin or the body can’t use the insulin – also called insulin resistance. Children may have the risk factors for type 2 diabetes, such as family history and ethnicity, but when this is mixed with lifestyle factors, such as poor diet, obesity and lack of exercise they can develop Type 2 diabetes.
Type 2 diabetes used to be associated solely with middle age or older adults. However, with the rise of overweight and obesity in children, it is now being increasingly diagnosed in children and adolescents, particularly those of Aboriginal and Torres Strait Islander and non- European backgrounds.
* * *
For further information on diabetes visit Diabetes Australia.
Listen to Professor Stephen Colagiuri on the need for a national diabetes strategy.
__small.png)
