Diabetes is one of the biggest health issues facing the world. In Australia, according to Diabetes Australia, 280 people are diagnosed with diabetes every day. It’s estimated that there are currently 1.7 million Australians who have diabetes including 500,000 who have yet to be diagnosed.
Diabetes is formally known as diabetes mellitus which translates to roughly ‘sweetness passing through a siphon’ owing to the fact that those with diabetes cannot control the level of glucose in their blood. In those with diabetes, that extra glucose spills over into the urine giving very high levels of glucose in the urine when there is usually none. Ancient physicians use to diagnose it by tasting the urine for sweetness. We’ve moved on from this time thankfully!
The blood glucose level is very tightly controlled by the pancreas, a feather shaped hormone in the upper abdomen near the stomach. It releases a number of hormones but the one that we are concerned with in diabetes is called insulin. When blood sugar rises, the pancreas gives out insulin which sends messages to many of our cells, especially liver, muscle and fat cells, to store the extra glucose.
There are two types of diabetes and they have very different causes and therefore treatment. They are commonly known as Type 1 and Type 2 Diabetes.
So, what is Type 1 diabetes?
In type 1 diabetes, there is a primary problem with the pancreas’ ability to make insulin. The special cells in the pancreas that normally make insulin are lost, thought to be due to an auto-immune condition or perhaps an infection. There may also be a genetic component. We most commonly see this type of diabetes in childhood, and it comes on relatively quickly with dramatic symptoms like weight loss, excess thirst, excess urination, extreme fatigue, confusion, weakness or double vision. It used to be called ‘juvenille diabetes’ but this term is no longer in use for a number of reasons.
What is Type 2 diabetes?
The other type of diabetes is called type 2 diabetes. In this type of diabetes, the pancreas can still make insulin but the cells that are supposed to listen to its message aren’t doing so. This means that the glucose they’re supposed to store away just hangs around in the bloodstream. In some cases, the pancreas doesn’t quite make enough insulin although this is quite different to type 1, notable because it happens very slowly. Type 2 diabetes has some genetic component but also has important associations with lifestyle such as our diet, whether or not we exercise and we have too much weight around our midsection. Worryingly, we used to see this exclusively in adults over 45 but more recently we are seeing this in younger people including children.
Type 2 diabetes can grumble along undetected for a while because often the symptoms aren’t as dramatic in type 1 diabetes, but can include many of the same symptoms. We often screen people’s blood sugar since it can go undiagnosed for so long when the symptoms aren’t really noticeable.
What about glucose?
Whichever type of diabetes someone has, it’s very important to get the glucose under control. Over time, the high blood sugars lead to a number of serious complications such as heart disease, stroke, kidney failure, infection, peripheral vascular disease and blindness. For those with type 1 diabetes, the insulin must be injected and there are a number of different ways of doing this including pumps or injections several times a day. For type 2 diabetes, treatment can include dietary changes, medications or even insulin. Either type though needs careful and ongoing assessment by a doctor to ensure treatment is going well (even if it’s just a diet) as well as attention to improving overall health.
For more information on diabetes, talk to your GP or visit Diabetes Australia.