Diabetes and Hyperglycemia

What is diabetes?

Diabetes mellitus, commonly referred to as diabetes, is a chronic disease in which the levels of glucose (sugar) in the blood are too high over a prolonged period. Almost 1.1 million Australians currently have diagnosed diabetes and it is the fastest growing chronic health condition in our country with around 100,000 new diagnoses each year. Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many serious health complications.

Blood glucose levels are normally regulated by the hormone insulin, which is made by the pancreas. In people with diabetes, either the pancreas doesn’t produce enough insulin (type 1 diabetes) or there is a problem with how the body’s cells respond to it (insulin resistance) and the pancreas produces inadequate insulin for the body’s increased needs (type 2 diabetes). Type 2 diabetes is far more common than Type 1, affecting 90% of those diagnosed with the condition.

Diabetes is a long-term condition and is incurable in the majority of cases. Treatment aims to prevent complications by focusing on keeping blood sugar levels as close to normal as possible, without causing hypoglycemia (low blood sugar). Research shows that type 2 diabetes can be prevented or delayed with lifestyle changes such as quitting smoking and reducing body weight by maintaining a healthy diet and regular physical exercise.  Blood pressure control, regular cholesterol tests and proper foot care are also important for people with the disease.

What is the difference between Type 1 and Type 2 diabetes?

Type 1 diabetes

Type 1 diabetes is an autoimmune disease that results in the body not producing any insulin at all. This form was previously referred to as “insulin-dependent diabetes mellitus” (IDDM) or “juvenile onset diabetes”.  Type 1 diabetes is partly inherited and unlike type 2 diabetes, its onset is unrelated to lifestyle. About 10-15% of all cases of diabetes are type 1.

People with type 1 diabetes depend on insulin injections every day to stay alive and they must test their blood glucose levels several times daily. Without insulin, people with type 1 diabetes accumulate dangerous chemical substances in their blood from the burning of fat. This can cause a potentially life threatening condition known as ketoacidosis.

If a person with type 1 diabetes skips a meal, exercises heavily or takes too much insulin, their blood sugar levels can fall too low. This can lead to hypoglycaemia. The symptoms include tremor, sweating, dizziness, hunger, headache and change in mood. This can be remedied with a quick boost of sugar and a person with type 1 diabetes should have lollies on hand at all times, just in case.


Type 2 diabetes

Type 2 diabetes is characterized by insulin resistance, which may be combined with relatively reduced insulin secretion. Type 2 diabetes is sometimes described as a ‘lifestyle disease’ because it is more common in people who don’t do enough physical activity, and who are overweight or obese. This form was previously referred to as “non insulin-dependent diabetes mellitus” (NIDDM) or “adult-onset diabetes”. These names are no longer used because type 2 diabetes does occur in younger people, and some people with type 2 diabetes require insulin therapy.

Type 2 diabetes is usually controlled with diet, weight loss, exercise, and oral medications. However, more than half of all people with type 2 diabetes require insulin to control their blood sugar levels at some point in the course of their illness.

Are there any symptoms of diabetes?

Symptoms of type 1 diabetes are often dramatic and come on very suddenly, whereas symptoms of type 2 diabetes develop more slowly and may be attributed to aging or obesity. A person may have type 2 diabetes for many years without knowing it. By the time type 2 diabetes is diagnosed, the complications of diabetes may already be present.

Common symptoms of both type 1 and type 2 diabetes include:

  • Fatigue, constantly tired and lethargic
  • Unexplained weight loss
  • Excessive thirst (polydipsia)
  • Excessive urination (polyuria)
  • Excessive eating (polyphagia)
  • Poor wound healing
  • Certain infections, such as frequent yeast infections of the genitals, skin infections, and frequent urinary tract infections, may result from suppression of the immune system by diabetes and by the presence of glucose in the tissues, which allows bacteria to grow. These infections can also be an indicator of poor blood sugar control in a person known to have diabetes.
  • Altered mental status: Agitation, unexplained irritability, inattention, or confusion can all be signs of very high blood sugar, ketoacidosis, or hypoglycemia (low sugar). Thus, any of these merit the immediate attention of a medical professional.
  • Blurry vision

What are the long-term complications associated with untreated diabetes?

If left untreated, diabetes can cause a number of serious health complications. The high sugar levels associated with this condition can cause damage to blood vessels, nerves and organs, which can lead on to health issues such as:

  • Heart disease and stroke
  • Eye damage (Retinopathy)
  • Kidney damage (Nephropathy)
  • Nerve damage (Neuropathy)
  • Foot problems (Ulcers and infections from poor circulation)
  • Sexual Difficulties (Erectile Dysfunction)

Management of diabetes

There is no cure for diabetes. Management depends on the type of diabetes but in both cases the focus should be on preventing the complications, which can cause serious disabilities such as blindness, kidney failure requiring dialysis, amputation, or even death. There are a variety of treatments for diabetes. Type 1 diabetes is treated with insulin injections and lifestyle modifications. Type 2 diabetes is generally treated with lifestyle changes first such as diabetic diet and exercise and then medication if required.

The single best thing a person with diabetes can do is to keep their blood sugar level within the suggested range every day. You should speak to your doctor to discuss your condition and the most appropriate treatment for you.  To keep your blood sugar level within the suggested range, you should combine regular blood sugar checks; a balanced diet low in simple sugars and fat, and high in complex carbohydrates and fiber; a high degree of personal motivation; and appropriate medical treatment. Consult a nutritionist or check with a doctor with questions in regard to diet. Dietary changes known to be effective in helping to prevent diabetes include a diet rich in whole grains and fiber, and choosing good fats, such as polyunsaturated fats found in nuts, vegetable oils, and fish. Limiting sugary beverages and eating less red meat and other sources of saturated fat can also help in the prevention of diabetes. Active smoking is also associated with an increased risk of diabetes, so smoking cessation can be an important preventive measure as well.

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