I have worked in diabetes for just over 5 years now. Although 280 Australians develop diabetes everyday (BTW, this is MASSIVE), I feel that the general knowledge of diabetes in the community is pretty poor. Never have I come across a condition that comes with so much stigma and so many myths. I get it, I totally do...diabetes is one complex condition that often gets over simplified. What people often don't realise is:
- Pre-diabetes and type 2 diabetes aren't as innocent as 'a touch of sugar.'
- Nobody has 'mild diabetes.'
- There is no 'good' or 'bad' type of diabetes.
- You don't have to be overweight to get type 2 diabetes.
- You don't have to be old to get type 2 diabetes.
- Many people are at risk of type 2 diabetes and don't realise it.
- You can get type 1 diabetes at any age.
- Eating sugar doesn't cause diabetes.
- Diabetes is a challenging condition to manage and requires 24/7 attention - it is hard work!
So being National Diabetes Week, I think its a good idea to take some time out to really understand what diabetes is. It may help you understand what a person with diabetes may be going through each day or teach you the differences between type 1 and type 2 diabetes. It may also help you learn if you are unexpectedly at risk of type 2 diabetes. This post will form part of a series of posts over this important week.
First of all..
To understand what diabetes is, it's good to get a handle on the role of insulin and what happens in a person WITHOUT diabetes.
Glucose (AKA sugar) is the main source of energy that our body uses to function. The cells throughout our body get glucose from the digestion of all carbohydrate foods (not just table sugar), or from stores in our liver that are released when needed (for example, when blood glucose levels drop between meals or overnight, or in response to hormones such as adrenaline, growth hormone and cortisol, which may be released during exercise or when stressed, sick or excited).
Important point no. 1 - its not just food that affects blood glucose levels.
When blood glucose levels rise, insulin allows glucose to move from the blood stream into the cells in our muscles and tissues. Here, glucose can be used to make energy.
To put it simply, insulin is like a key that unlocks our cell doors to allow glucose to move into the cells and be used as energy.
Our body always needs a certain amount of glucose in our blood stream, and for most people, the body does a pretty good job of maintaining this. Without diabetes:
- The pancreas (an organ found next to your stomach) produces insulin all day in response to blood glucose levels rising above the usual range, and
- the liver supplies glucose whenever blood glucose levels start to drop below the desired range.
What is diabetes...
Diabetes occurs when the body does not produce any, or enough insulin, or when the insulin being produced does not work effectively.
Without insulin, glucose builds up in the blood stream.
Too much glucose in the blood stream over time can lead to small and large blood vessel damage, leading to diabetes-related complications. This is why one of the main aims of diabetes management is too keep blood glucose levels as close to a persons target range as possible. This can be a very challenging task due to the many factors that affect blood glucose levels - remember, its not just affected by food!
The difference between type 1 and type 2
Some of you may be aware that the two main types of diabetes include type 1 and type 2 diabetes.
Type 1 diabetes is an autoimmune condition. This means that the bodies own immune system has attacked the insulin producing cells of the pancreas, therefore the pancreas can no longer produce insulin. Although for many people there is a strong genetic link to type 1 diabetes, we are not sure why this auto-immune reaction occurs. Type 1 diabetes is often diagnosed in childhood or adolescence, but it can occur at any age. It is not linked to lifestyle factors and cannot be prevented.
Important point no. 2 - type 1 diabetes cannot be prevented.
Type 1 diabetes is managed by administering insulin regularly throughout the day - remember, without diabetes our body will produce insulin all day in response to fluctuating blood glucose levels. A person with type 1 diabetes has to mimic this natural process manually, using multiple injections of insulin or via an insulin pump that delivers a constant supply of insulin over the day. This helps to keep blood glucose levels as close to a target range as possible. Doses of insulin will constantly need to be reviewed and changed throughout a persons life with type 1 diabetes, as doses will be affected by numerous factors such as growth, weight changes, hormonal changes, physical activity levels and food intake.
Managing type 1 diabetes is a balancing act of eating well for health, moving regularly, monitoring blood glucose levels and titrating insulin doses according to what is happening in their life that day. It’s a big job!
Type 2 diabetes occurs when the body does not produce enough insulin or when the bodies cells are resistant to the insulin being produced - you may have heard the term 'insulin resistance' before. People are often told that they have 'mild' diabetes when being diagnosed with type 2, but it is just as serious as type 1 diabetes and can lead to the same complications if ignored or not managed well.
Important point no. 3 - all diabetes is serious with the risk of developing complications if ignored or not managed.
Type 2 diabetes may be managed using dietary and physical activity interventions alone, however many people require oral medications and/or insulin in order to manage blood glucose levels effectively. Because type 2 diabetes is what we call a progressive condition, many people will need medications or insulin to help manage blood glucose levels as their body slowly stops producing as much as it used to.
Are you at risk of type 2...
Type 2 diabetes is much more complex than people believe. People diagnosed with the condition do not always fit the stereotype of someone who is carrying extra weight, who may not lead the healthiest of lifestyles. This is because it can result from a combination of genetics and risk factors that cannot be changed. These risk factors include, having a family history of type 2, having a history of gestational diabetes (diabetes during pregnancy), increasing age, coming from an Aboriginal, Torres Straight Islander, Asian (including Indian) or Middle Eastern background and having a history of cardiovascular disease. Although there is a genetic link and these non-modifiable risk factors, the risk for type 2 diabetes is greatly increased when associated with lifestyle factors such as:
- Low levels of physical activity.
- Carrying extra weight (especially around in abdominal area).
- High blood pressure.
- High cholesterol.
This means that type 2 diabetes may be prevented or its onset delayed with a healthy lifestyle.
Important point no. 4 - you may be at risk of type 2 diabetes and not even know it.
This information shows how its important it is to identify if you are at risk of type 2 diabetes and the steps you can take in order to reduce this risk. To learn more about your risk complete this free online tool TODAY http://www.ausdrisk.com.au
Stay tuned for more posts this week about preventing and managing diabetes.