Diabetes is the fastest-growing chronic condition in Australia, with one Australian developing the disease every five minutes. It’s a serious condition that affects the body in many ways. Without correct management, diabetes can lead to serious health complications.

What is diabetes?

Diabetes (diabetes mellitus) is a condition that causes high levels of glucose (sugar) in the blood because the body can’t process it effectively.

Glucose and insulin

Glucose, which comes from the food we eat, is a key source of energy for the body. During digestion, glucose is converted into energy with the help of a hormone called insulin, which is produced by the pancreas (a gland located behind the stomach).

When you eat, your body releases insulin to help move glucose from the bloodstream into your cells for energy. As blood glucose levels drop, insulin production also decreases.

For someone with diabetes, this process doesn’t work properly. They may produce too little insulin, none at all, or their body may not respond to it effectively. This results in high blood sugar levels, a condition known as hyperglycaemia.

Types of diabetes

Type 1 diabetes is an autoimmune condition where the immune system attacks and destroys the insulin-producing cells in the pancreas. It accounts for around 10% of all diabetes cases. Type 1 diabetes cannot be prevented and currently has no cure. Management requires daily insulin injections or the use of an insulin pump to regulate blood glucose levels.

Type 2 diabetes is a progressive condition that usually occurs later in life. The pancreas still produces insulin, but the body becomes resistant to its normal effects. Eventually, the pancreas is not able to produce enough insulin. Insulin resistance or not enough insulin causes blood sugar levels to remain high. Type 2 diabetes accounts for 85-90% of all cases.

Gestational diabetes is a form of diabetes that can occur during pregnancy as a result of hormonal changes. The condition usually disappears once the baby is born. However, women who develop gestational diabetes are at greater risk of developing type 2 diabetes later on.

What causes type 2 diabetes?

There is no single cause of type 2 diabetes. Instead, there are several risk factors – some you can prevent, and some you can’t.

Risk factors you can’t prevent⁴:

• Family history of diabetes

• Age – the risk increases as you get older

• Ethnicity – Aboriginal and Torres Strait Islander peoples, Pacific Islanders, and people from the Indian subcontinent, or Chinese cultural backgrounds, have a higher risk⁵

• Being a woman who:

  • Gave birth to a child over 4.5kg

  • Had gestational diabetes

  • Has Polycystic Ovarian Syndrome

Risk factors you can change:

• Weight – the risk increases if you are overweight

• Inactivity – the less active you are, the higher the risk

• Blood pressure – high blood pressure increases your risk

• Cholesterol levels – low levels of ‘good’ (HDL) cholesterol increase your risk, while high levels of Triglycerides (fats) also increase your risk

• Smoking– the risk increases if you are a smoker. While not all cases of diabetes can be prevented, research shows that type 2 diabetes can be prevented or delayed in up to 58% of cases by maintaining a healthy weight, following a healthy eating plan, and being physically active.

Signs and symptoms of type 2 diabetes

Diabetes has many symptoms. Some people with diabetes notice several symptoms, while others may notice none.

Typical symptoms include:

• Excessive thirst

• Passing more urine (usually as a result of drinking more)

• Tiredness and lethargy

• Unexplained hunger

• Cuts that are slow to heal

• Itchy skin or skin infections

• Deteriorating vision

• Gradual weight gain

• Mood swings

• Leg cramps

Complications of type 2 diabetes

Diabetes can lead to long-term complications that can potentially be life-threatening. The longer you’ve had diabetes and the less controlled your blood sugar levels are, the higher the risk of complications.

These may include:

• Cardiovascular disease, including heart attack and stroke

• Kidney damage and kidney failure

• Vision problems and blindness

• Nerve damage, which can lead to digestive problems, erectile dysfunction, poor blood flow, and amputation

How to manage your type 2 diabetes

Complications of diabetes are related to how well you control your blood sugar levels. This means that it’s important to manage your diabetes and keep your blood sugar levels as close to your target range as possible.

Your doctor will advise what levels you should aim for. However, Diabetes Australia recommends the following as a general guide:

Positive lifestyle changes

You can manage your diabetes by making changes to a healthier lifestyle.

These include:

• Eating a healthy diet, in particular following the Australian Dietary Guidelines

• Participating in regular physical activity

• Quitting smoking

• Monitoring your blood pressure and cholesterol levels

• Monitoring your blood glucose levels

In some cases, or as the disease progresses, lifestyle changes may not be enough to keep your blood sugar levels within the recommended range.

This is when you may need to take medication or insulin, as prescribed by your doctor.

Can you still live a normal life with diabetes?

Diabetes is a long-term condition, but with the right care, you can live a long and healthy life. Managing diabetes is important to reduce the risk of diabetes complications and the risk of developing other health conditions linked to diabetes.

Management involves monitoring and controlling blood glucose levels through healthy eating, regular exercise, and in some cases, medication.

It’s important to work with your health practitioner if you have diabetes.

Holistic management

Diabetes is associated with several serious complications, including:

• Blindness

• Lower limb amputation

• Heart disease

• Kidney disease

• Depression, anxiety and stress

For this reason, it’s important to maintain regular health checks with a multidisciplinary team. Your team includes your GP, diabetes educator, podiatrist, optometrist, endocrinologist, Pharmacist, and others there to support you.

Health checks for people with type 2 diabetes, include:

• HbA1c – a blood test that reflects your average blood glucose over the past 10-12 weeks

• Blood pressure – checked by your GP or nurse at each visit, or at least every six months

• Foot health – to look for changes in blood supply and sensation

• Eyes – to check for damage to small vessels that can occur without us realising it

• Kidneys – urine and blood tests to check kidney function and health

• Blood fats – a blood test determines levels of healthy fats, which help reduce diabetes-related complications

I don’t have diabetes. How can I manage my risk?

The first step is to manage your risk factors through lifestyle changes. You can also book a Health Check to get an overall idea of your health and well-being. This includes checking your weight, waist and BMI, blood pressure, cholesterol and random glucose levels.

Managing your diabetes is important to reduce the risk of complications. Our pharmacists are here to support you in managing your health. We can help you manage it with our Diabetes Medication Review, where one of our Pharmacists will review your medication and discuss the best ways to manage your condition. If you have type 2 diabetes, book your Diabetes Medication Review with us today.

General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.

Sources

1 Diabetes Australia, Diabetes in Australia, https://www.diabetesaustralia.com.au/diabetes-in-australia
2 Diabetes Australia, What is diabetes, https://www.diabetesaustralia.com.au/what-is-diabetes
3 Mayo Clinic, Diabetes, https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
4 Diabetes Australia, Type 2 Diabetes, https://www.diabetesaustralia.com.au/type-2-diabetes
5 Diabetes Australia, Prevention, https://www.diabetesaustralia.com.au/prevention
6 Mayo Clinic, Diabetes, https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
7 Diabetes Australia, Gestational Diabetes, https://static.diabetesaustralia.com.au/s/fileassets/diabetes-australia/9a6615de-20d7-4b09-b98d-b661b3bebb88.pdf
8 Diabetes Australia, Diabetes in Australia, https://www.diabetesaustralia.com.au/about-diabetes/diabetes-in-australia/
9 National Diabetes Services Scheme, Your diabetes annual cycle of care, https://www.ndss.com.au/wp-content/uploads/fact-sheets/fact-sheet-your-diabetes-annual-cycle-of-care.pdf
10 Diabetes Australia, Managing diabetes, https://www.diabetesaustralia.com.au/managing-diabetes/
11 Healthdirect, HbA1c test, https://www.healthdirect.gov.au/hba1c-test