Diabetes, a disease describing abnormally high levels of glucose in the body, has been described as being at pandemic levels in Australia, with around 1.1 million of us having been diagnosed with type 1 or type 2 diabetes, and 280 new cases diagnosed each day. Type 2 diabetes is currently the fastest growing chronic condition in Australia, with the number of sufferers expected to triple over the next twenty years. Millions more are pre-diabetic. Experts explain the rise in this chronic disease is mostly due to increasing levels of obesity, dietary changes, insufficient exercise and an ageing population.
Diabetes Australia states there is an “urgent and growing need to promote the issues surrounding this [disease]”. This guide will explain the ins and outs of type 2 diabetes, the disease estimated to cost Australians around $14.6 billion every year.
SO, WHAT IS DIABETES?
In effect, a diabetic’s body has either stopped producing insulin, or insulin is produced in insufficient amounts. Insulin is a hormone produced by the pancreas to convert glucose to energy. Even if we have an abundant supply of glucose in our bodies, a lack of insulin will mean that the individual cells in our bodies will not be able to use that glucose. Insulin resistance occurs when the cells cannot effectively use the insulin that is produced. It’s like trying to watch television without an aerial, or building flat-pack furniture without the instructions – it’s a feat no man can achieve. The glucose which is not converted to energy stays in the blood, which is why people with diabetes have a higher blood glucose level. Having a high level of glucose in the blood can be dangerous over a period of time, if not properly controlled.
Why glucose? Glucose is our primary energy source, and without a proper conversion system, the cells in our body can’t do what they need to do in order to keep us alive. Glucose is the only energy source used by the brain. This is why people who cannot convert glucose to energy appear confused, almost drunk and can faint without proper medical intervention.
The most common types of diabetes are type 1 and type 2; however, there are other conditions that you may have not heard of, including gestational diabetes and pre-diabetes.
TYPE 1 DIABETES
To understand type 2 diabetes, it’s important to understand the different types of diabetes, starting with type 1. Type 1 diabetes is an auto-immune disease in which the body attacks the insulin-producing beta cells in the pancreas. The onset of symptoms usually begins in childhood or adolescence, lending itself the alternative label “juvenile diabetes”, although it’s not uncommon for a diagnosis up to the age of 30. Unfortunately for type 1 sufferers, researchers are yet to find a preventative or a cure. Type 1 is not triggered by lifestyle factors, although once diagnosed, good habits will be recommended in order to control the condition.
Type 1 diabetes describes a complete absence of insulin in the body, and the sufferer must rely on insulin injections in order to process glucose. Failure to reintroduce insulin to the body results in the body breaking down fat to obtain energy, resulting in a toxic build-up of by-products called ketoacidosis. This effect is not often seen in other types of diabetes, and it is potentially life-threatening if insulin is not provided quickly. Ketone toxicity can also cause major organ damage. Ketoacidosis may present as decreased awareness, rapid respiration, flushed complexion, dryness in the mouth, extreme thirst, increased urination, headache, sweet-smelling breath, nausea, vomiting and pain, particularly in the abdomen. If some of these symptoms become apparent, emergency medical treatment is required without delay.
TYPE 2 DIABETES
Type 2 diabetes is more prevalent in Australia than type 1. Type 2 describes inadequate secretions of insulin, with or without insulin-resistance, resulting in abnormally high glucose levels. 85-90% percent of all diabetes sufferers have type 2. The onset of symptoms typically occur after the age of 40, but increasingly, predisposed individuals with high risk factors such as obesity, lack of exercise and poor dietary choices are receiving diagnoses well before this age. Type 2 can be managed in a variety of ways, from a change in lifestyle to include regular exercise and a dietary plan, oral medication, and finally, insulin injections. If the disease progresses, medical management of the associated conditions of diabetes will likely form a major part of the care plan.
The best news about type 2 diabetes is that most cases are completely preventable. Weight control alone could prevent around 60% of cases. Your Body Mass Index (or BMI) is just one predictor of developing type 2 diabetes. Assessing and restricting your intake of carbohydrate-heavy foods (especially the ones that spike glucose levels) by understanding the affect that the glycemic index has on your body may go some way in preventing the development of type 2, even if you’re already pre-diabetic. Exercise assists in regulating these effects, and an early adherence to a regular exercise plan is important.
Pre-diabetes describes higher-than-normal glucose levels in the body, but not high enough to qualify as full diabetes. It may also be described as borderline diabetes, or impaired glucose metabolism. Left untreated, however, pre-diabetes will develop full within five to ten years. At this stage, there is still an excellent opportunity to stop the progression through significant diet and lifestyle changes, with or without medications. You can assess your risk factors here.
Gestational diabetes refers to a mostly-transient condition that appears during pregnancy in the second or third trimester in 3-8% of women. Blood glucose levels usually return to normal after the birth of the child, but the mother has a higher predisposition for the development of type 2 at a later stage. Risk factors include a genetic predisposition, obesity, poor nutrition, being over the age of thirty, and having certain ethnic backgrounds.
SYMPTOMS TO WATCH OUT FOR
Be aware of any unusual bodily changes. These include an excessive thirst and hunger, extreme fatigue, dizzy spells, blurry vision, disorientation, dry mouth, headaches and increased urination. These are all a sign of diabetes and should not be ignored. At the first presentation of these indicators, have yourself checked out by your medical doctor.
The potential consequences of having a progressive or unmanaged case of type 2 diabetes are serious. Even in well-managed cases, complications can occur, and sufferers should be aware of the signs so treatment can be sought without delay. The long-terms effects from frequent high glucose levels can be significant and permanent, and include, but are not limited to, the following:
In Australia, the primary cause of blindness for people under 60 is diabetic retinopathy. The high glucose levels in the blood lead to damage of the tiny blood vessels that supply the retina, resulting in various degrees of impaired vision. The risk increases with the length of time the diabetes has been present, but it can be reduced by strictly monitoring and controlling blood glucose levels. With regular eye checks, diabetics can monitor for any early signs of eye disease.
Around 30% of diabetics will develop complications of the kidneys, a condition referred to as nephropathy. The kidneys play an enormous role in regulating and filtering the content of the blood as they form urine, and excess glucose can compromise this process leading to kidney disease. Many diabetics who develop complications in the kidneys will go on to receive dialysis and will ultimately require a transplant. The symptoms won’t present until the damage is quite extensive, but regular blood and urine tests can identify any unusual changes much earlier.
Peripheral neuropathy and peripheral vascular disease.
Neuropathy is characterised by a lack of sensation or numbness, in this case within the lower extremities, and is associated strongly with long-term diabetes. Feet are particularly affected. With both the nerves and the vascular system in the lower legs struggling to communicate with the rest of thDe body, the sufferer is vulnerable to sores, ulcers and inadequate circulation, all of which can lead to amputation. By checking your legs and feet each day, and attending regular podiatry appointments, you can significantly reduce your risk of complications.
Vascular problems caused by diabetes can lead to erectile trouble in men due to a reduced blood flow and potentially some local nerve damage. There are a range of treatment options available.
Heart disease and stroke.
People with diabetes tend to have higher blood pressure and levels of cholesterol and triglycerides, as well as blood glucose levels, combining to place them at an increased risk of cardiovascular events like heart attacks and strokes. In addition to consulting with an appropriate professional to control these levels, diabetics and those around them should be aware of the first signs of a serious event. At this point, emergency services should be contacted without delay.
If you have a family history of diabetes and carry excess weight around your midsection, you are probably a prime candidate to develop the disease, and if you’re over 45 years of age, your susceptibility once again increases. The real tragedy is that type 2 diabetes is a largely preventable disease, and despite occasionally being genetically unavoidable, most of us can make lifestyle changes that reduce the likelihood of developing the condition.
There is no single recommended diet for people living with diabetes. There are types of foods that assist in regulating blood sugar levels, and they tend to be the foods that should be a part of a normal, healthy diet for everyone. For a diabetic, however, special attention should be paid to the amount of carbohydrates, particularly simple carbohydrates like refined sugars. This is because carbohydrates, as opposed to fats and proteins, have the greatest effect on blood glucose levels. That being said, limiting intake of fats and proteins in order to avoid excess calories is also important.
Choosing foods that have a low glycemic index (or GI) will reduce the impact of blood sugar spikes after you eat. Those who eat a diet based on mainly low GI foods tend to have much lower levels of total body fat, so this change in diet can assist in disease control as well as weight control. In contrast, those who consume mainly high GI foods have more body fat and more significant blood sugar spikes after eating, making this kind of diet a poor choice for diabetics. A diabetes educator is well-placed to provide some solid education around selecting the best foods for your individual case and palate.
Diabetics should always be cautious when it comes to alcohol consumption. Alcohol is processed by the body in a way that is similar to fat, with almost as many calories. Alcohol should only be consumed in modest quantities in diabetics whose blood glucose levels are well-controlled. Your doctor will be able to give you clear guidelines based on your current state of health.
The most significant things we can do to immediately lower our risk are to lose excess belly fat, particularly that which protrudes out from the body, and begin a daily exercise regime. Exercise, especially the kind that builds muscle, is an effective way to control pre-diabetes and low-level diabetes, but it’s also a promising preventative. Understanding the relationship between our muscles and glucose uptake is fascinating in general, but in diabetics, this level of understanding becomes a useful management tool.
Because diabetics are also prone to high blood pressure and heart disease, exercise that targets the cardiovascular system is also important. For some, this may mean regular moderately-paced walking for short spurts. For more able-bodied diabetics, a tougher workout may be feasible, and can include running, dancing and cross-training. Having a plan and a routine is always going to be more successful than an ad-hoc approach, so consult your doctor as well as a trainer or sports scientist, and select a program that you’re comfortable with and can reasonable expect to stick to.
Taking care of yourself through your dietary and lifestyle choices is an essential way to reduce your likelihood of developing chronic illnesses like type 2 diabetes. Negotiating the world of hospitals and medical specialists can be daunting and frustrating, but you can take matters into your own hands to a point. Having an appropriate level of health insurance, should you require specialist medical attention, provides comfort and allows you to have greater control over your treatment. If you don’t currently have good cover, take note: it might be too late to get the right coverage once you develop a condition, so it’s important you take a preventative approach. Compare providers today to ensure that you have the best possible care when you need it most.