Diabetes
Diabetes occurs when there is too much glucose in the blood. Insulin is a hormone made in the pancreas that allows glucose to move from the blood into the cells, where it is used to produce energy. In diabetes, either the pancreas stops producing insulin (type 1 diabetes) or the pancreas does not produce enough insulin and the body does not respond properly to insulin (type 2 diabetes).
Type 1 diabetes
(Previously called insulin-dependent diabetes mellitus or juvenile diabetes.)
* The body’s immune system destroys the insulin-producing cells in the pancreas.
* It usually starts suddenly and the exact cause is unknown.
* People with type 1 diabetes need insulin injections to survive.
Type 2 diabetes
(Previously called non-insulin-dependent diabetes mellitus or mature-onset diabetes.)
* The most common form of diabetes.
* People with type 2 diabetes are more likely to have high blood pressure and cholesterol and be overweight.
* Develops gradually.
* Can often be controlled with diet and exercise but sometimes tablets and then later, insulin may be required.
Signs and symptoms
These may include:
* Passing more urine
* Increased thirst and/or hunger
* Tiredness - loss of energy
* Weight loss (type 1)
* Itching and skin infections (e.g., thrush)
* Blurred vision
* Slow-healing wounds
* Tingling and numbness in the feet.
People with type 2 diabetes may only notice symptoms after their blood glucose levels have been high for many years.
If you are at risk of type 2 diabetes, don’t rely on the presence of symptoms to know if diabetes has developed. Be tested annually in order to detect diabetes early. You may have diabetes without feeling any symptoms.
Risk factors for diabetes
More than 500,000 Australians have type 2 diabetes and do not know it. Ask yourself these questions and if you answer ‘yes’to one or more of them then you are at risk of diabetes and you should see your doctor and ask to be tested.
Am I over 45 and have high blood pressure?
Am I over 45 and overweight?
Am I over 45 and have a family member with diabetes?
Am I over 55?
Do I have heart disease or have had a heart attack?
Did I have high blood sugar levels while I was pregnant?
Have I had a borderline high blood sugar test?
Do I have polycystic ovary syndrome and am overweight?
Am I over 35 and am an Aboriginal or Torres Strait Islander, a Pacific Islander, of Chinese cultural origin or from the Indian sub-continent?
Effects of diabetes
If diabetes is not well controlled, blood vessels, nerves and other body organs may be damaged. This may cause complications such as:
* Loss of eyesight
* Kidney damage
* Heart disease, stroke
* Foot problems and leg ulcers.
* Poor blood flow
* Infections
* Impotence in men
Managing diabetes
The aim of diabetes management is to maintain blood glucose levels as close to normal as possible (4-8mmol/L).
A good management plan is important. Your doctor, diabetes educator, dietitian and pharmacist will help you.
* Regular testing of blood glucose levels at home can monitor diabetes control. There is a variety of blood glucose monitors available.
* Home blood-ketone testing for type 1 diabetics during times of illness or stress can signal an impending ketoacidosis emergency. Blood testing is more accurate than urine testing.
* Some medicines can affect control of blood glucose. Always check with a doctor or pharmacist before taking anything new.
Self care
* Learn about diabetes and how to manage it.
* Monitor blood-glucose levels regularly.
* Follow your diet and medicine plan.
* Eat regular, healthy meals.
* Limit food high in fat or sugar.
* Control weight.
* Exercise regularly (at least 30 minutes on most days).
* Limit alcohol intake.
* Have blood pressure checked at each doctor’s visit.
* Have regular long-term blood glucose, kidney, cholesterol and liver tests.
* Always carry some jelly beans in case of hypoglycaemia.
* Have feet examined regularly by a doctor or a podiatrist and wear shoes that fit well.
* Have an eye examination every year.
* Smokers should quit - ask a pharmacist.
* Join Diabetes Australia for information and support.
* Wear a MedicAlert bracelet.
Hypoglycaemia
People may experience hypoglycaemia if insulin or certain diabetes tablets cause the blood-glucose level to fall below about 3.5mmol/L. Symptoms include:
* Sweating, chills
* Shaking, weakness, dizziness
* Racing heart
* Tingling around the mouth
* Hunger
* Unusual behaviour (irritable, anxious, poor concentration)
* Drowsiness.
If the blood glucose is low the patient needs to:
* Take a ready source of glucose, e.g., fruit juice, jelly beans, honey
* Eat a sandwich or dried fruit after the glucose
* Check blood-glucose levels.
If the patient is unconscious do not give them anything by mouth. Turn them on their side and follow first-aid procedures. Get medical help.
Internet sites
International Diabetes Institute - www.diabetes.com.au
Diabetes Australia - www.diabetesaustralia.com.au (includes multilingual information)
Eyes on Diabetes - www.eyesondiabetes.org.au
Abbott Diabetes Care - www.medisense.com.au (information on blood-glucose meters).
Contact
A doctor - listed under ‘Medical Practitioners’ in the Yellow Pages.
Diabetes Australia - listed under ‘D’ in the White Pages.
A Self Care pharmacy - to locate telephone 1300 369 772 and ask for the Pharmacy Self Care Field Officer.
In case of poisoning, telephone the Poisons Information Centre on 131 126 from anywhere in Australia.
Pharmacists are medicines experts. Ask a pharmacist for advice when choosing a medicine.
