Hervey Bay Local Health News

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?
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Gout is a common and very painful type of arthritis that occurs when uric acid crystals form in and around a joint. It more commonly affects men, especially after the age of 40. Gout can usually be well controlled with medicines and changes to diet.

Uric acid (urate) is one of the body’s waste products. If uric acid builds up in the bloodstream, it can settle in and around joints as crystals. Uric acid crystals irritate the joint, causing the inflammation and pain of a gout attack.

People who get gout usually have a high level of uric acid in their blood. Gout commonly affects one joint at a time, most often the big toe joint, but can affect knee, ankle, foot, hand, wrist, and elbow joints.

Signs and symptoms
A gout attack usually comes on suddenly, often overnight. Common symptoms include:
*    Joint inflammation, with swelling, redness and heat
*    An extremely tender and painful joint, which is sensitive to touch - sometimes even the weight of a bed sheet can cause severe pain.

If a fever is also present, it is important to consult a doctor as soon as possible.

Without treatment, a gout attack usually lasts about one week. After having one gout attack, more attacks are likely. The time between gout attacks can be days, weeks, months or years.

If gout is not managed correctly, the time between attacks may get shorter, attacks may last longer and more joints may be affected. A joint can be permanently damaged by repeated gout attacks and kidney problems can also develop.

Contributing factors include:
*   A family history of gout
*    Drinking too much alcohol
*    Being overweight or overeating
*    Joint injury or surgery
*    Certain medical conditions
*    Certain medicines (e.g\, some fluid tablets)
*    Crash dieting or fasting
*    Not drinking enough fluids.

Some foods may also increase the level of uric acid in the blood.

Reducing or eliminating some or all of these factors may reduce the risk of future gout attacks and the need for long-term gout medicine.

Foods that can increase uric acid levels:
Foods high in proteins and purines can increase uric acid levels. For example:
*    Large amounts of meat
*    Sardines, herrings, anchovies, shellfish
*    Liver, kidney, brains, sweetbreads
*    Meat extracts (e.g., Bonox, Bovril, gravies)
*    Baker’s and brewer’s yeast
*    Vegemite, Marmite, Promite
*    Dried beans and peas
*    Asparagus and mushrooms.

Self care
*   At the first sign of a gout attack, it is best to consult a doctor and start ‘gout reliever’ medicine promptly.
*   Avoid vigorous exercise during a gout attack, but keep your joints mobile with regular moderate intensity exercise.
*   Limit alcohol consumption. Try light beer and low-alcohol wines and avoid drinking a lot of alcohol at one time (binge drinking) as this may bring on an attack.
*   Drink at least two litres (eight glasses) of water every day (unless your fluid intake has been restricted by your doctor).
*   Reduce your dietary salt intake.
*   Eat a healthy diet and avoid foods that can increase uric acid levels.
*   Keep to a healthy weight.

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