Store Locator
Start Search

Diabetes

print
Diabetes
Summary
  • There are two types of Diabetes: type I and type II Diabetes.
  • In Type I patients, the pancreas produces little or no insulin.
  • In Type II patients, the pancreas produces insulin but the body does not use it properly.
Description

Diabetes or Diabetes Mellitus is a disorder characterised by hyperglycaemia (high blood glucose levels) caused by impairment in insulin secretion and/or action 1.

When the food we eat is digested, most of it becomes glucose (sugar), which the body uses for energy. In order for this to happen, the glucose must leave the blood and enter the body cells. The hormone that helps glucose enter the cells is called insulin. It is produced by an organ called the pancreas. In Diabetes, the pancreas either doesn't produce insulin, or the body is unable to use the insulin properly. This causes glucose to build up in the blood instead of entering the cells, a process called hyperglycaemia. 2

There are two types of Diabetes: type I and type II Diabetes.

TYPE I (Insulin Dependent Diabetes Mellitus- IDDM) can occur at any age but most commonly develops before the age of 30. It accounts for 10 to 15% of Diabetes cases. In Type I patients, the pancreas produces little or no insulin 3.

TYPE II (Non-Insulin Dependent Diabetes Mellitus) is usually diagnosed in people over 30 years, although it can occur in children and teenagers. In Type II patients, the pancreas produces insulin but the body does not use it properly. This is called insulin resistance 4.

There is a third type of Diabetes called gestational Diabetes, which only occurs during pregnancy. See the Gestational Diabetes topic for more information.

Diabetes is a condition requiring life-long management. There is no cure, but symptoms can be controlled with careful attention to diet and medications. Poorly controlled Diabetes may lead to serious complications. Complications of Diabetes include: 5 Diabetic retinopathy (a progressive loss of vision that can lead to blindness).

Diabetic neuropathy (nerve damage). This causes loss of sensation in the lower limbs and may lead to foot ulcers, joint problems and infections. Diabetes causes changes to the physiology of the foot such as decreased sensation (feeling) which can result in injuries to the foot going unoticed, less effective wound healing and changes to the foot. Limb amputations are sometimes necessary as a result.


Prevention

  • At present, Type I Diabetes cannot be prevented, although with careful management the symptoms can be controlled. Researchers are hoping to develop methods to prevent Type I Diabetes in the near future. 6
  • Type II Diabetes tends to be linked to several risk factors. Those at risk of developing Type II Diabetes include: 7 - People over 50 with either hypertension (high blood pressure), obesity or a close relative with Diabetes.
  • Anyone who is over 65.
  • Anyone with a history of heart disease.
  • Anyone who has had Gestational Diabetes.
  • Aborigines, Torres Strait Islanders, Pacific Islanders, people from the Indian Subcontinent or people with Chinese backgrounds.

People who fall into one or more of these risk groups should consult their Doctor for advice on preventing Type II Diabetes. Exercise, weight management and a healthy diet can all help prevent Type II Diabetes. 8


Signs & Symptoms

Symptoms include feeling thirsty all the time, urinating more frequently, blurred vision, tiredness, numbness and tingling in the feet or legs and recurrent infections 9.

  • Management

    Diabetes is a serious condition requiring life long management, which should address the following issues: 10

    Therapeutic Guidelines: Endocrinology. Melbourne: Therapeutic Guidelines Ltd; 1997

    1. Regular screening for complications. Foot care, eyes, kidney health and blood sugar control should all be checked.
    2. Education regarding ideal blood sugar levels and use of blood sugar measuring devices.
    3. Reducing risk factors such as smoking, alcohol consumption and obesity.
    4. A detailed, individual diet plan.
    5. A suitable exercise programme.
    6. Education about diabetes medications.
    7. Education about concurrent illnesses such as hypertension, high cholesterol, kidney disease and heart disease.


    Lifestyle

    Diet Hints

    There is no one "Diabetic Diet" that is suitable for all people with Diabetes. 11 Dietary needs will vary greatly depending on the person's age, health status, lifestyle and exercise routine.

    1. Consult a Dietitian, who will help you determine a meal plan suitable for your lifestyle.
    2. Foods with a high Glycaemic Index (GI) cause a more dramatic rise in blood glucose levels than foods with a low GI, therefore low GI foods are recommended. Low GI foods are mainly complex carbohydrates such as wholegrain bread, oats, high fibre breakfast cereals, pasta, barley, legumes, fruits, starchy vegetables such as corn and sweet potato and low-fat milk products 12.
    3. Avoid excessive sugar intake from foods such as cakes, biscuits, chocolate and confectionery. 13
    4. Limit the intake of saturated (animal) fat. A diet high in saturated fat interferes with diabetes control, contributes to weight gain and affects blood fat levels. This increases the risk of complications. 14
    5. A recent, controlled study involving 37,000 women has found that middle age and elderly women with high levels of red meat in their diet have an increased risk of developing type 2 diabetes. This risk is increased in women who eat high levels of processed meats such as bacon and hotdogs 15.
    6. Limit alcohol intake to no more than two drinks per day, with two alcohol-free days per week. Studies show that a light to moderate alcohol intake can reduce the risk of developing Type II Diabetes. 16 17 However alcohol may react with insulin or medications and lead to hypoglycaemia. Alcohol should not be consumed at the same time as medications, and should be consumed with a carbohydrate food. 18


    Vitamins/Minerals/Herbs

    Always consult your Doctor before taking any supplement or herbs. Nutritional supplements may only be of benefit if dietary intake is inadequate.

    • Antioxidants such as vitamin C and vitamin E can protect blood vessels and reduce the risk of heart and vascular complications in people with Diabetes. 19
    • Lipoic Acid has been shown to improve insulin sensitivity in patients with Type II diabetes. 20 - Magnesium may improve insulin action and can reduce the risk of complications by lowering blood cholesterol and fat levels. 21 - Chromium helps control blood glucose levels and can improve cholesterol levels in Type II Diabetes 22 - Zinc improves blood sugar control and may help prevent complications. 23
  • Pharmacist's Advice

    Ask your Pharmacist for advice.

    1. If you have any queries regarding your medication for Diabetes, ask your Pharmacist.
    2. Blood glucose testing monitors are available to monitor your blood glucose. Ask your Pharmacist for advice.
    3. Urinalysis testing strips can help detect excess glucose and ketones in the urine. These should be used in conjunction with blood glucose testers.
    4. Sugar-free medications such as cough syrups are available. Remember to ask your Pharmacist for brands suitable for Diabetics.
    5. Smoking increases the risk factors for other diseases such as heart disease and vascular disease. Ask your Pharmacist for help quitting smoking. Nicotine patches, nicotine chewing gum, nicotine inhalers and the QUIT programme are all available from your Pharmacy.
    6. Foot care products such as wound dressings, corn pads, nail clippers and orthopaedic shoes can be recommended by your Pharmacist. A Podiatrist should always be consulted for any problems with the feet.
    7. Exercise is vital, especially for Type II Diabetes. It reduces body fat, improves blood glucose control, lowers fat levels in the blood, lowers blood pressure and reduces the risk of heart disease. 24
    8. See the Vitamins/Minerals/Herbs section in this topic and ask your Pharmacist for advice on dietary supplements.
  • Notes

    Organisations & Support Groups

    Diabetes Australia - http://www.diabetesaustralia.com.au


    Medical Terms

    Hormone: a chemical produced in the body that has certain effects and functions in the body.

    Ketones: A substance produced when fats are metabolised. During hyperglycaemia excess amounts of ketones can be detected in the urine.


    References

    1. Beers M H and Berkow R. The Merck Manual. 17th ed. Whitehouse Station (N.J.): Merck Research laboratories; 1999.
    2. USA Centre for Disease Control and Prevention. Diabetes FAQ. Accessed December 14, 2001 At URL http://www.cdc.gov/diabetes/faqs.htm 
    3. Beers M H and Berkow R. The Merck Manual. 17th ed. Whitehouse Station (N.J.): Merck Research laboratories; 1999.
    4. Beers M H and Berkow R. The Merck Manual. 17th ed. Whitehouse Station (N.J.): Merck Research laboratories; 1999.
    5. Beers M et al (eds). The Merck Manual of diagnosis and therapy (17th ed). Whitehouse Station (N.J.): Merck Research laboratories; 1999.
    6. Gorus FK et al. Prospects for predicting and stopping the development of type 1 of diabetes. Best Pract Res Clin Endocrinol Metab 2001 Sep;15(3):371-89.
    7. Diabetes Australia Queensland. Diabetes: Frequently asked queries. Accessed December 17,2001 at URL http://www.daq.org.au/Queries.html
    8. Tuomilehto J et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001 May 3;344(18):1343-50.
    9. Diabetes Australia. Defuse Diabetes. National Campaign leaflet; Nov 1999.
    10. National Prescribing Service Newsletter. Managing type 2 diabetes. Aug: no 17, 2001
    11. Diabetes Australia Queensland. Diabetes: Frequently asked queries. Accessed December 17,2001 at URL http://www.daq.org.au/Queries.html.
    12. Diabetes Australia Queensland. Living With Diabetes. Accessed December 17, 2001 at URL http://www.daq.org.au/live.html.
    13. Diabetes Australia Queensland. Living With Diabetes. Accessed December 17, 2001 at URL http://www.daq.org.au/live.html.
    14. Diabetes Australia Queensland. Living With Diabetes. Accessed December 17, 2001 at URL http://www.daq.org.au/live.html.
    15. Red Meat Increases Type 2 Diabetes Risk in Older Women. Diabetes Care 2004;27:2108-2115. Reuters Health Information 2004.
    16. Conigrave KM et al. A prospective study of drinking patterns in relation to risk of type 2 diabetes among men. Diabetes 2001 Oct;50(10):2390-5.
    17. Tanasescu M et al. Alcohol consumption and risk of coronary heart disease among men with type 2 diabetes mellitus. J Am Coll Cardiol. 2001 Dec;38(7):1836-1842.
    18. International Diabetes Institute. Diabetes Factsheet: Alcohol. Accessed December 17, 2001 at URL http://www.diabetes.com.au/factsheets/alcohol.pdf.
    19. Title LM et al. Oral glucose loading acutely attenuates endothelium-dependent vasodilation in healthy adults without diabetes: an effect prevented by vitamins C and E. J Am Coll Cardiol 2000 Dec;36(7):2185-91.
    20. Jacob S et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial.Free Radic Biol Med 1999 Aug;27 (3-4):309-14.
    21. Djurhuus MS et al. Magnesium reduces insulin-stimulated glucose uptake and serum lipid concentrations in type 1 diabetes. Metabolism 2001 Dec;50(12):1409-1417.
    22. Bahijiri SM et al. The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes. Saudi Med J 2000 Sep;21(9):831-7.
    23. Gupta R et al. Oral zinc therapy in diabetic neuropathy. J Assoc Physicians India 1998 Nov;46(11):939-42.
    24. Hamdy O et al. Diet and exercise in type 2 diabetes mellitus. Endocrinol Metab Clin North Am 2001 Dec;30(4):883-907.
Email to friend