DIABETES

Did you know?

• More than 300 Australians develop diabetes every day. That’s one person every 5 minutes.
• Almost 120,000 Australians have developed diabetes in the past year
• Diabetes is the seventh most common cause of death by disease in Australia

What is diabetes?

Diabetes is a chronic medical condition where the body either cannot produce enough insulin (type 1 diabetes) or cannot properly use the insulin it produces (type 2 diabetes). Insulin is a hormone that regulates blood sugar (glucose) levels. When insulin is ineffective or insufficient, blood sugar levels can become too high, leading to various health complications over time.

The are three main types of diabetes; all types are complex and serious:

Type 1 Diabetes

Type 1 diabetes is an autoimmune condition where the body’s own immune system is activated to destroy the beta cells in the pancreas which produce insulini. We do not know what causes this autoimmune reaction however environmental factors are thought to set off the process. Type 1 diabetes is not linked to modifiable lifestyle factors. Currently there is no cure and it is lifelong.

• Occurs when the pancreas does not produce insulin
• Represents around 10 per cent of all cases of diabetes and is one of the most common chronic childhood conditions
• In children, onset is usually abrupt and the symptoms obvious
• In adults, onset is slower
• Symptoms can include excessive thirst and urination, unexplained weight loss, weakness and fatigue and blurred vision
• Is managed with insulin injections several times a day or the use of an insulin pump

Type 2 Diabetes

Type 2 diabetes is a condition in which the body becomes resistant to the normal effects of insulin and gradually loses the capacity to produce enough insulin in the pancreas. The condition has strong genetic and family-related (non-modifiable) risk factors and is also often associated with modifiable lifestyle risk factors. We do not know the exact genetic causes of type 2 diabetes. People may be able to significantly slow or even stop the progression of the condition through changes to diet and increasing the amount of physical activity they do.

• Is diagnosed when blood glucose levels are high due to insulin produced by the pancreas not working effectively and/or the cells of the body do not respond to insulin effectively (known as insulin resistance), over time the condition progresses and the pancreas does not produce enough insulin (reduced insulin production)
• Represents 85–90 percent of all cases of diabetes
• Usually develops in adults over the age of 45 years but is increasingly occurring in younger age groups including children, adolescents, and young adults
• Is more likely in people with a family history of type 2 diabetes or from particular ethnic backgrounds
• For some, the first sign may be a complication of diabetes such as a heart attack, vision problems or a wound that does not heal well
• Is managed with a combination of regular physical activity, healthy eating, and weight reduction. As type 2 diabetes can be progressive, many people will need oral medications and/or insulin injections in addition to lifestyle changes over time

Gestational Diabetes

Gestational diabetes mellitus (sometimes referred to as GDM) is a type of diabetes that occurs during pregnancy.

Women with gestational diabetes can still have a healthy baby but it is important that gestational diabetesis managed to reduce the risk of developing complications during pregnancy.

Gestational diabetes will not lead to your baby being born with diabetes, however, can increase the risk of your baby developing type 2 diabetes later in life.

Gestational diabetes is diagnosed when higher than normal blood glucose levels first appear during pregnancy. Most women with gestational diabetes will no longer have diabetes after the baby is born. However, some women will continue to have high blood glucose levels after delivery.

Gestational diabetes is the fastest growing type of diabetes in Australia, affecting thousands of pregnant women. Between five and 10 per cent of pregnant women will develop gestational diabetes. All pregnant women should be tested for gestational diabetes at 24-28 weeks of pregnancy (except those women who already have diabetes). Women who have risk factors for gestational diabetes should be tested earlier in their pregnancy.

Diabetes affects the body in several ways due to high blood sugar levels over time:

1. Cardiovascular System: It increases the risk of heart disease, stroke, and high blood pressure by damaging blood vessels and the heart.
2. Kidneys: Diabetes can lead to kidney damage (nephropathy) or even failure over time.
3. Nerves: Nerve damage (neuropathy) can cause tingling, pain, or numbness, especially in the feet and hands.
4. Eyes: It can lead to vision problems and even blindness (diabetic retinopathy).
5. Skin: Diabetes increases the risk of skin infections and conditions like acanthosis nigricans (darkened patches of skin).
6. Feet: Poor blood circulation and nerve damage can lead to foot problems, sometimes severe enough to require amputation.
7. Immune System: Diabetes can weaken the immune system, making it harder to fight infections.

Managing diabetes through medication, diet, exercise, and regular check-ups is crucial to reduce these risks and complications.

There are several common signs and symptoms that may indicate diabetes:

1. Frequent urination: You may find yourself urinating more often than usual, particularly at night.
2. Increased thirst: Feeling constantly thirsty, even after drinking fluids.
3. Extreme hunger: Despite eating, you may still feel very hungry.
4. Unexplained weight loss: Losing weight without trying could be a sign, especially in type 1 diabetes.
5. Fatigue: Feeling tired and lethargic, even with adequate rest.
6. Blurred vision: Changes in vision may occur due to high blood sugar levels.
7. Slow-healing sores or frequent infections: High blood sugar impairs the body’s ability to heal and fight infections.

If you experience these symptoms, especially if they are persistent or severe, it’s important to consult your doctor for proper evaluation and diagnosis. They may perform blood tests to measure your blood sugar levels and determine if you have diabetes or another condition. Early diagnosis and treatment are crucial for managing diabetes effectively and preventing complications.

Managing diabetes effectively requires a comprehensive approach known as a chronic disease management plan. Here are key components:

A GPMP (General Practice Management Plan) is a document prepared by your general practitioner (GP) for patients with chronic or complex medical conditions. It outlines coordinated healthcare management strategies tailored to the patient’s needs. Key features of a GPMP include:

1. Comprehensive Assessment: A thorough assessment of the patient’s medical condition, including their health goals and current health status.
2. Goal Setting: Establishing realistic and achievable health goals in collaboration with the patient.
3. Care Coordination: Coordinating healthcare services and professionals involved in the patient’s care, ensuring continuity and effectiveness of treatment.
4. Multidisciplinary Care: Involving allied health professionals such as dietitians, physiotherapists, and psychologists as needed.
5. Education and Support: Providing education about the patient’s condition and self-management strategies to improve health outcomes.
6. Regular Review: Periodic reviews to assess progress towards goals, adjust management strategies as needed, and address any emerging issues.

GPMPs are designed to enhance the quality of care for patients with chronic conditions like diabetes, asthma, cardiovascular disease, or mental health disorders. They aim to improve patient outcomes through structured and coordinated healthcare planning.

Individuals with diabetes should work closely with their doctor to personalise their management plan based on factors like age, health status, and personal goals. Consistent adherence to these components can significantly reduce the risk of complications and improve overall quality of life.

*The information provided here is for information purposes only and should not be considered medical advice. Managing diabetes requires individualised care and guidance from your healthcare professional. If you or someone you know is dealing with diabetes, it’s essential to consult your doctors for proper diagnosis, treatment, and management tailored to specific needs and circumstances.