At a glance:
- Diabetes is the name given to a number of conditions that leave people unable to properly regulate blood glucose levels
- A high blood sugar (glucose) level is known as hyperglycemia
- Insulin is a hormone that regulates blood sugar levels
- Type 1 Diabetes is an autoimmune disease that prevents the body from producing insulin
- Type 2 Diabetes is a genetic disorder of insulin resistance, but with a strong lifestyle component
- Around 2 million Australians are classified as pre-diabetic. Somewhere between 6-8% of the adult population have type 2 diabetes
- Both type 1 and type 2 diabetes can greatly increase the chances of heart attack, stroke and other serious complications
What is Diabetes?
Diabetes is the name given to a number of conditions that lead the body to be unable to properly regulate the levels of glucose (a kind of sugar) in the blood. Glucose is meant to be transformed from sugar to energy, but people with diabetes can’t do this efficiently, leading to high blood sugar levels known as hyperglycemia.
The pancreas produces a number of hormones, the best known & central one being insulin. This hormone regulates blood sugar (glucose) levels. Type 2 diabetes occurs when the body becomes resistant to insulin and type 1 diabetes, when the pancreas cannot produce enough insulin to regulate the higher levels of blood sugar.
There are multiple forms of diabetes:
- Type 1 Diabetes - is caused by an autoimmune disease that attacks the cells in the pancreas responsible for creating insulin. Type 1 diabetes leaves people unable to produce insulin. As a result, people with type 1 diabetes must rely on injections or pumps to survive. Although the disease can appear at any age, it typically presents in children, adolescents and young adults. Type 1 diabetes is sometimes referred to as “Juvenile Onset Diabetes or Insulin Dependent Diabetes”.
- Type 2 Diabetes - associated with both genetic and lifestyle factors, such as diet, weight gain and lack of physical activity, type 2 diabetes can be controlled through medications and changes in lifestyle. Some cases of type 2 diabetes require insulin injections to control blood sugar levels.
- Gestational Diabetes - as the name suggests, gestational diabetes may affect some pregnant women. While most cases of gestational diabetes rectify themselves after the birth of the child, there does seem to be an elevated risk of these women developing type 2 diabetes later in life. As with type 2 diabetes, many cases of gestational diabetes can be controlled through lifestyle changes and medication, but some cases require insulin injections to regulate blood sugar.
- Pre-Diabetes - when blood glucose levels are high but not elevated enough to be classified as type 2 diabetes, this condition is referred to as pre-diabetes. The condition itself has no symptoms but greatly increases the risk of developing type 2 diabetes if diet and lifestyle changes are not undertaken. According to Diabetes Australia, around two million Australians are classified as pre-diabetic. Without lifestyle changes, around one in three people with pre-diabetes will develop type 2 diabetes.
Symptoms of Diabetes
Many people with all types of diabetes have minimal outward symptoms, or symptoms mild enough to go unnoticed, but both type 1 and type 2 diabetes have a number of common symptoms, including:
- Blurred vision
- Cramps - especially in the legs
- Excessive thirst - people with type 1 and type 2 diabetes often find themselves thirsty
- Fatigue or lethargy
- Frequent urination
- Increased, persistent hunger
- Itching, skin infections
- Mood swings
- Slow healing of even minor wounds - people with diabetes often display slow healing of cuts and abrasions
- Unexplained weight loss - people with type 1 diabetes can lose weight unexpectedly
- Weight gain - people with type 2 diabetes are more likely to slowly gain weight
In addition to common symptoms, men with either type 1 or type 2 diabetes may also experience a reduced sex drive or erectile dysfunction. Women with type 1 or type 2 diabetes may also experience increased instances of yeast infections or urinary tract infections.
Both gestational diabetes and pre-diabetes are typically asymptomatic.
Complications Associated With Diabetes
In addition to standard symptoms, both type 1 and type 2 diabetes can increase the chances of people living with the conditions to develop other diseases or complications, including:
- Heart Attack and Stroke - people with diabetes are four times more likely than the average Australian to suffer a heart attack or stroke.
- Blindness - diabetes can lead to Diabetic Retinopathy as well as increasing the risk of developing Glaucoma or Age Related Macular Degeneration (AMD).
- Kidney and Bladder Issues - diabetes can damage the kidneys and bladder, leading to increased risk of infection, failure and even dialysis.
- High Blood Pressure - high blood pressure is common in people with diabetes. This is one of the major factors leading to increased risk of heart attack, stroke, eye problems, kidney disease and nerve damage.
- Foot Ulcers - diabetes increases the risk of developing food ulcers These can lead to amputation. Amputations are 15 times more common amongst people with diabetes than the general public.
- Influenza Complications - people living with diabetes are at high risk of developing serious flu complications.
- Ketoacidosis - a common complication of type 1 diabetes (and rarely with type 2 diabetes), ketoacidosis is caused when the blood glucose levels are high but a lack of insulin causes the body to burn fats for energy leading to the release of ketones (acids) in the blood.
- Hypoglycemia - when someone’s blood sugar drops too low they can experience a number of adverse symptoms, including slurred speech, weakness, dizziness, sweating, shaking and even fits and seizures or unconsciousness. Overuse of insulin or diabetic medications, skipping meals, and drinking alcohol may all increase the chance of hypoglycemia in people with diabetes.
What Causes Diabetes?
Although all forms of diabetes involve issues with the regulation of blood glucose levels, type 1 and 2 diabetes, as well as gestational diabetes all have different underlying causes.
Type 1 Diabetes
In type 1 diabetes, the body’s own immune system destroys the cells in the pancreas (an organ located behind the stomach) that produces insulin. Without the ability to produce insulin, people with diabetes cannot convert glucose in the blood into energy, so have to rely on alternative sources of insulin (injections or pumps) for survival.
Without insulin to convert the glucose, the body burns fat for energy, leading to the release of acid chemicals known as ketones in the blood. This can cause harm or even death. The condition is known as ketoacidosis.
The exact cause of type 1 diabetes is unknown, but it is felt there are genetic predispositions to the condition. Type 1 diabetes cannot be prevented by lifestyle and diet changes but, lifestyle and diet changes are important for helping to control type 1 diabetes.
Type 2 Diabetes
Type 2 diabetes is caused by underlying insulin resistance. This resistance increases over a long period of time as the pancreas steadily has to produce more and more insulin to regulate blood sugar levels.
After, at times, decades of elevated levels of insulin, the cells in the pancreas responsible for the development of insulin progressively lose function. Typically the pancreas of people diagnosed with type 2 diabetes has lost over 50% of its insulin production capability.
Type 2 diabetes has a strong genetic factor, with people with a family history of diabetes having a higher risk of developing the condition, but it is also strongly connected with lifestyle factors and diet. People who maintain an unhealthy diet, are inactive or overweight or obese have a much higher risk of developing type 2 diabetes.
High blood pressure, abdominal obesity and poor eating habits may exacerbate insulin resistance and eventually lead to type 2 diabetes. The condition may develop at any age but is more common in people over 40.
During pregnancy, the placenta creates hormones that help the baby grow and thrive, but these hormones also limit the effectiveness of the mother’s insulin. In women without an underlying insulin resistance, the pancreas can make up for this reduction in insulin effectiveness easily. If the mother also has insulin resistance, the lowered insulin effectiveness can lead to high blood sugar levels, leading to a diagnosis of gestational diabetes.
Typically the blood sugar levels in women with gestational diabetes return to normal after pregnancy.
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Management Of and Living With Diabetes
Different medications and lifestyle changes need to be used to manage type 1 and type 2 diabetes.
Type 1 Diabetes
As the pancreas can no longer create insulin, all people with type 1 diabetes must rely on alternative sources of insulin for survival. Maintaining healthy blood sugar levels requires frequent testing of blood sugar as well as monitoring diet and exercise.
Depending on the severity of type 1 diabetes, a person living with the condition may inject themselves with insulin when needed, but in severe cases, insulin pumps that monitor blood sugar and automatically administer insulin injections are used.
A carefully balanced diet (planned with your doctor or a diabetes specialist) as well as regular exercise can help maintain a healthy blood sugar level limiting the chance of complications, hyperglycemia or hypoglycemia.
Type 1 diabetes is a lifelong condition that requires constant attention. There is no cure.
Type 2 Diabetes
Due to the fact that people with type 2 diabetes still have the ability to produce insulin, albeit in a reduced capacity, some people with the condition can manage their disease through a carefully balanced diet and exercise.
Other people may need to take a variety of medications available that help increase the effectiveness of insulin, delaying the intestine’s ability to absorb glucose and reducing the amount of glucose made by the liver or increase the glucose output through the kidneys. Type 2 diabetes is referred to as a progressive condition.
Management should include intensive diet and other lifestyle changes & often the variety of medications mentioned above. Type 2 diabetics may also require insulin injections as the disease progresses.
Gestational diabetes is typically managed through the monitoring of blood glucose levels, diet and exercise. Around 10% - 20% of women require insulin injections during pregnancy to manage their gestational diabetes, but the need for injections typically cease after pregnancy.
Lifestyle changes, such as losing weight, having regular exercise and eating a healthy diet will assist in lowering blood glucose to regular levels before the condition progresses to become type 2 diabetes.
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