Diabetes
Diabetes is a condition affecting
the production or usage of insulin by the body. Insulin is a natural
hormone produced by the pancreas to control the availability of
energy to the body's cells from the food we eat.
Diabetes Australia estimates that
approximately 800,000 Australians have diabetes,with half being
unaware of their condition!
Within the body, glucose, a simple
sugar, is the main
Form of energy used by cells, especially the brain. Insulin
Abnormalities mean that glucose levels in the blood build
Up, but are unable to be used effectively by cells.
This has two major effects:
The body is starved of energy
and cannot function well high glucose levels cause damage to blood
vessels and nerves throughout the body
There are three different types of diabetes:
Type I or juvenile-onset diabetes
Type II or adult-onset diabetes
Gestational diabetes (diabetes of pregnancy)
a. Type I or juvenile-onset diabetes
usual onset in childhood, but
may occur later in life, and is often abrupt\results from too
little insulin being produced by the pancreas\appears to result
from the body's own immune system destroying the\insulin-producing
cells of the pancreas (the Beta-cells) The cause of the auto-immune
attack is not certain, but possibly results from a combination
of factors including genetics and possibly a virus (whose identity
is not yet known) risk factors include: family history accounts
for 15% of diabetes cases
b. Type II or adult-onset diabetes
usual onset in middle age, but
may be earlier or later in some people results from failure of
the body's cells to use insulin to full effect often normal or
high levels of insulin are found in the early stages, with levels
dropping as the condition progresses and the pancreas becomes
exhausted risk factors include:
family history (strong factor)
overweight
high fat diet
age over 55 years
low exercise levels
some medications (eg. prednisolone)
accounts for 85% of diabetes cases
c. Gestational diabetes (diabetes
of pregnancy)
is more common in women with a
family history of Type II diabetes (see
above) may or may not persist after pregnancy may recur with future
pregnancies is routinely tested for in pregnancy - affects 1-3%
of pregnancies risk factors include: previous pregnancies affected
All types of diabetes share the same symptoms. Symptoms may range
from very obvious to quite subtle. In Type I (juvenile-onset)
diabetes the symptoms tend to be more noticeable than in Type
II (adult-onset) or gestational diabetes. Some people may be unaware
of their diagnosis.
Symptoms include:
excessive thirst and urination
constant hunger and/or weight loss (despite good intake of food)
marked tiredness (despite adequate rest) blurred vision frequent
infections or poor healing drowsiness
or even coma from excess blood glucose when very severe
Untreated diabetes can result
in real damage to vital body organs over time. It is
often mistakenly thought that because it is not painful that it
can't be damaging. This is not true! As with high blood pressure,
constant stress on the body over time causes significant damage.
Complications
With diabetes the most common consequences of not controlling
blood glucose levels are:
clogging of blood vessels causing:
angina and heart attacks strokes blindness foot ulcers - may require
amputations damage to nerves causing: blindness
numbness or tingling/burning of feet and hands
weakness of some muscle groups
erectile dysfunction (impotence) elevated
cholesterol levels
kidney damage which may require
dialysis if severe poor immune function causing: increased
frequency of infections
slower healing of infections cataracts
of the eyes
Currently the best prevention for diabetes (in particular Type
II and gestational
types) is: maintaining body weight in the ideal range (for your
height) a healthy, low-fat, balanced diet moderate regular exercise
Early diagnosis and management
can make a big difference in preventing damage to: eyes nerves
blood vessels which can reduce serious complications like: stroke
heart attack amputations
People with a family history or
symptoms of diabetes should have regular blood sugar tests by
their local doctor.
Other important tests are: blood
pressure cholesterol
Although there is no cure for diabetes, early diagnosis and treatment
is effective in controlling the disease.
Treatment includes: a. Diet eat
a balanced diet - about 60% complex carbohydrates, 20% protein
and
20% fat eat at regular times, especially if diabetes requires
insulin carry fast glucose food such as barley sugar or honey
to avoid a low blood sugar level crisis (hypoglycaemia)
b. Exercise regular moderate exercise
aids the uptake of glucose and sensitivity to
insulin stop exercising and see your local doctor if you experience:
chest discomfort shortness of breath light-headedness
c. Monitoring regular self-monitoring
of blood glucose levels (check the frequency with
your doctor) with a finger-prick blood test or by urine dipstick
test
monitor more frequently during:
illness
infections stress increased exercise
keep a notebook record of blood
glucose levels, test results, medications used, and contact details
of local doctor or specialist. see your doctor or endocrinologist
(diabetes specialist) regularly to check:
blood pressure
urine levels of protein
blood tests for kidney function
blood glucose control
foot sensation and any other relevant tests
see a podiatrist regularly to
prevent foot ulceration. This is especially important if sensation
in the feet is reduced
An eye specialist regularly to assess and manage any eye problems
caused
By diabetes. regular dental review to ensure gums and teeth are
well maintained.
d. Medications medication may
be needed to help control blood glucose levels. The tablets aim
to normalize blood glucose levels by: enhancing the body's usage
of insulin or increasing insulin production by the pancreas or
decreasing glucose production by the liver most Type I and some
Type II and gestational diabetics need insulin injections to keep
blood sugar levels normal.
Insulin is injected under the
skin.
There are different types of insulin that last for different lengths
of
Time. Dose and frequency is tailored to their blood sugar levels,
activity
Levels, usual diet, and other factors.
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