Diabetes

Diabetes is Australia’s fastest growing chronic condition, with around 282 people across the nation being diagnosed with the condition every day.

In Western Australia alone, there are more than 128,000 people now diagnosed with diabetes and for every person diagnosed, it is estimated there is another person who has diabetes but does not know it yet. It is important to be aware of the signs and symptoms and to talk to your doctor about them.

Type 1 diabetes

Type 1 diabetes is a condition where the pancreas does not produce insulin because the cells which make insulin have been destroyed by the immune system.

This type of diabetes accounts for 10 to 15 per cent of all people with diabetes.

It is usually diagnosed during childhood or young adulthood but can occur at any age. The cause of type 1 diabetes is unknown, however there is a strong genetic link.

Find out more about type 1 diabetes on the Diabetes WA website (external site).

Type 2 diabetes

Type 2 diabetes is a condition where the body produces insulin but the insulin is ineffective, or there is not enough insulin, or both.

It accounts for approximately 85 per cent of people with diabetes and while it is usually seen in adults, it is increasingly being seen in teenagers and children.

Research indicates that there are a range of associated risk factors. Some of these risk factors can be changed such as diet, physical exercise and weight, but others cannot including age, family history, ethnic background and a history of gestational diabetes.

Find out more about type 2 diabetes on the Diabetes WA website (external site).

Pre-diabetes

Pre-diabetes is a condition where blood glucose levels are higher than the usual range, but not high enough for type 2 diabetes to be diagnosed.

There is strong evidence to show that up to 58 per cent of people with pre-diabetes can prevent type 2 diabetes by adopting a healthy lifestyle and losing 5 to 10 per cent of their body weight.

There are 2 types of pre-diabetes:

• impaired glucose tolerance (IGT)
• impaired fasting glucose (IFG).

Find out more about pre-diabetes on the Diabetes WA website (external site).

Gestational diabetes

Gestational diabetes is a form of diabetes that occurs during pregnancy and goes away as the baby is born, (unless it was coincidental that either type 1 or type 2 diabetes developed during the pregnancy). Between 5 to 8 per cent of pregnant women will develop gestational diabetes and this is usually around week 24 to 28 of the pregnancy.

To keep blood glucose levels in the non-diabetes range, mothers need to make 2 to 3 times more insulin than normal. Some mothers develop more insulin resistance than others and cannot make enough effective insulin.

It is extremely important to have a follow-up glucose test 6 to 8 weeks after the baby is born to check that the blood glucose levels have returned to the healthy ranges. Women who have had gestational diabetes are 50 per cent more likely to develop type 2 diabetes later in life so it is important to have regular blood glucose checks every 1-2 years. There is also an increased risk of type 2 diabetes for the baby, so living a healthy lifestyle is important for the whole family.

Gestational diabetes will not lead to your baby being born with diabetes. In gestational diabetes, excess glucose passes through the placenta to the baby. This may lead to the baby growing larger than average. At birth, there is also the risk the baby's blood glucose levels may be too low. Baby may also have suckling and some breathing problems.

Gestational diabetes can also lead to high blood pressure during pregnancy.

Find out more about gestational diabetes on the Diabetes WA website (external site).

National Gestational Diabetes Register

The National Gestational Diabetes Register was established within the National Diabetes Services Scheme (NDSS) to help women who have had gestational diabetes to manage their health into the future. Registration is free for women who have been diagnosed with gestational diabetes, reside in Australia and hold (or are eligible to hold) an Australian Medicare Card. For more information visit the NDSS website (external site).

While diabetes is undiagnosed or if the blood glucose levels are frequently higher than the healthy ranges, it can increase the risk of potential complications.

However, looking after your diabetes and having regular checks will help to delay or even prevent the development of diabetes complications.

Heart attack and stroke

Heart attacks and strokes are up to 4 times more likely in people with diabetes.

Eye damage

People with diabetes are at a high risk of eye damage. Eye damage occurs when small blood vessels in the retina (back of the eye) are damaged. It occurs over time and is a result of high blood glucose levels, high blood pressure and high blood cholesterol. This can lead to impaired vision or blindness. Check-ups every 1 to 2 years can lead to early discovery and prevention of further damage. Diabetic retinopathy and potential vision loss affects 1 in 6 people with diabetes.

Kidney damage

The kidneys act as a filtering system for waste products. This filtering system is made up of many tiny blood vessels which can be damaged by raised blood glucose levels, high blood pressure and high cholesterol levels. If this damage continues to occur over a period of time, the kidneys stop working. Annual checkups lead to early discovery and prevention of further damage.

Cardiovascular disease

High blood glucose levels cause the blood to become thicker and stickier. This makes it harder for the heart to pump it around the body. High cholesterol and high blood pressure make the blood vessel walls thicker and harder. The increased pressure on the heart and blood vessels may result in heart attack, stroke or blood vessel damage to the feet and arms (though this is less common). Annual checkups lead to early discovery and prevention of further damage

Nerve damage and foot complications

Having high blood glucose for a long time can damage nerves. Nerves are like power cords and when the insulation gets damaged by high blood glucose levels, the signals do not get through properly.

Damage to the nerves (neuropathy) and the blood supply of the feet caused by diabetes can put your feet at risk of damage. Nerve damage can result in loss of sensations in the feet and wounds can occur without the person noticing. Injuries that go unnoticed or untreated can lead to foot ulcers and amputation. Knowing the risk and taking care of your feet can prevent amputation.

Nerve damage can also cause pain, often at the same time as having numb feet. Annual checkups lead to early discovery and prevention of further damage.

Nerve damage can also affect:

• blood pressure – with a severe drop when standing
• bladder – it may lose the signal to urinate and as a result not empty completely
• stomach – it may take a lot longer for the food to pass from the stomach through to the small bowel, making it hard to predict affect of food on blood glucose levels and increasing the risk of low blood glucose levels
• the bowels – uncontrollable diarrhoea may occur.

Sexual dysfunction

Erectile dysfunction for men and reduced sexual sensation for women can be a long-term problem with diabetes. It occurs when blood vessels or nerves in the area are damaged. Men may find it difficult to obtain or sustain an erection. Annual checkups lead to early discovery and prevention of further damage.

Read more about the complications of diabetes on the Diabetes WA website (external site).

Depression or low mood

Depression, anxiety and distress affects roughly 1 in 3 people with diabetes.

Tooth decay and gum infections

Tooth decay and gum infections are more common in people with high blood glucose levels.

The signs and symptoms of diabetes may include:

• thirst
• frequent urination
• lethargy or feeling very tired
• blurred vision
• sudden unexplained weight loss: type 1 diabetes
• infections or wounds that don't heal
• feeling hungry
• mood swings.

Often in type 2 diabetes signs and symptoms may not be present.

In a nutshell, the aim of diabetes treatment is to help you feel well, be healthy and enjoy life.

This will involve keeping your blood glucose levels within the target ranges. It can be useful to talk about what target ranges are suitable for you.

Managing your cholesterol and blood pressure are also important to reduce your risk of long-term complications which can affect your eyes, kidneys, nerves, heart and circulation. Checking in with your emotional health and having a support network can also help you live well with diabetes.

Depending on the type of diabetes, your management may include:

• Insulin replacement (type 1 diabetes and some people with type 2 or gestational diabetes)
• Oral medications or injectable medications (insulin or other injectable medications) for people with type 2 diabetes

There are also positive steps you can take towards managing your diabetes and staying in good health. Some apply to your lifestyle while others are important check-ups which need to be done on a regular basis.

Be physically active

Stay as physically active in as many ways and as often as you can. Aim for a minimum of 30 minutes every day. Activity can be cumulative, that is 10 minutes plus 10 minutes plus 10 minutes. Read more about physical activity.

Eat healthily

Choose a variety of foods low in fat (particularly saturated fat), added sugar and salt which are high in fibre, good quality, low GI carbohydrates.

Eat less food (energy) than you use (burn) to reduce body weight if you are overweight.

Read about eating for good health (external site).

Monitor your blood glucose levels regularly

Monitor your blood glucose levels regularly and use your results to make decisions about managing your diabetes including:

• physical activity
• healthy eating
• stress management.

Blood glucose levels kept within recommended ranges will lower your risk of many diabetes complications.

Read more about blood glucose monitoring on the Diabetes WA website (external site).

Do not smoke

If you smoke, quit. Get help if needed – talk to your doctor, call Quitline on 137 848 or visit Quit Now (external site).

Read about getting ready to quit smoking.

Reduce alcohol intake

If you drink alcohol, do so in moderation.

Learn more about alcohol and your health.

Keep track of your weight (and waist)

If you are overweight, even small amounts of weight loss can make a big difference to your general health and diabetes management. Ask your doctor or diabetes health team if this applies to you.

Read more about healthy weight and waist measurement.

Have regular check-ups

Keep track of your regular health checks with your diabetes team. Have your doctor arrange for the recommended management and diabetes complication checks:

• blood pressure every visit
• blood glucose average (HbA1c) 3 to 6 monthly
• cholesterol (lipid profile) and kidneys (microalbumin) every year.

Ask your doctor if you have had your cycle of care.

Get your eyes checked

Have your eyes (retinas) checked by an eye specialist or trained optometrist every 1 to 2 years, (unless otherwise recommended), to check the blood vessels in the back of your eyes.

Find out more about eye tests and looking after your eyes on the Diabetes WA website (external site).

Look after your feet

Take care of your feet and look at them daily. Cut nails carefully and wear well-fitting supportive shoes.

Have your feet checked by a doctor, registered podiatrist or credentialed diabetes educator twice a year, or more often if you need treatment.

For more information about what a check involves and looking after your feet visit the Diabetes WA website (external site).

• Some area health services and local councils offer subsidised podiatry services. Contact your local hospital, council or community health centre to find out more.
• Department of Veteran Affairs (DVA) (external site) gold card holders are entitled to free podiatry services from private podiatrists.
• Private health funds may cover some podiatry services depending on the type and level of insurance.
• The Australian Podiatry Association (external site) will help you to find a podiatrist with specialised knowledge about diabetes.
• A doctor can refer people with diabetes and serious foot problems (such as ulcers or neuropathy) to high risk foot clinics.
• Have your feet checked twice a year by your doctor or diabetes health professional.

Managing stress and your emotional health

If you have diabetes it is very important that you recognise when you are stressed and take positive steps to address it.

Learn more about managing your stress on the Diabetes WA website (external site).

Education

Learn more about how to self-manage your diabetes. Diabetes WA run programs on various topics to help you self-manage your diabetes. These programs give you the opportunity to hear about other peoples experiences in a comfortable setting.

To find out more about the programs visit the Diabetes WA website (external site).

Managing your diabetes in hospital

You might be able to do so in some WA public hospitals. We recognise that you are the expert in the daily care of your diabetes and we are looking at ways to support you while in our care.

For more information, read the Managing your diabetes needs while in hospital guide (PDF 207KB)