What is diabetes and what is the difference between Type-1 and Type-2 diabetes?
Diabetes, or diabetes mellitus, is a condition where the body has trouble processing glucose in your body into energy.
A normal pancreas is able to produce a hormone called insulin which helps to regulate the amount of glucose that is in a person’s bloodstream.
In Type-1 diabetes, the pancreas is unable to produce enough insulin, and so the amount of glucose in the blood remains at high levels – this is known as hyperglycaemia.
In Type-2 diabetes, the pancreas may or may not be producing enough insulin, but the body’s cells have lost its ability to process the insulin and so the blood glucose also remains at a high level in the bloodstream.
What are the symptoms of diabetes?
Both types of diabetes share very similar symptoms, which in the long term can lead to complications. These symptoms may include:
Slowed healing and frequent infections.
Causes and risk factors
Because Type-1 diabetes is an autoimmune disorder, there may be a genetic factor in its development. There are other environmental factors which may trigger Type-1 diabetes, but none have been proven. As such, nothing has also been proven to delay or prevent the onset of this disorder.
The diagnosis of Type-1 diabetes is usually early on in life but can present itself later in life too.
Type-2 diabetes is a metabolic disorder that develops over time. The body’s cells begin to lose their ability to use the insulin produced by the pancreas, and as a result blood glucose levels increase. The pancreas continues to increase the amount of insulin it produces, until eventually it isn’t able to produce enough anymore. This may lead to the need for insulin to be injected daily.
Because it takes time for this whole process to occur, if it is caught early enough, there are ways to delay or even prevent its onset.
There are a range of risk factors which may predispose a person to developing Type-2 diabetes. To check your risk for yourself, you can click here to access a national standard screening tool (AUSDRISK) provided by Diabetes Australia.
Although this is a good indication of your risk of developing Type-2 diabetes, your general practitioner or a specialist will need to perform further tests and confirm any diagnosis.
Preventing, delaying and managing Type-2 diabetes
As there are both genetic and environmental risk factors, there are ways to prevent or delay the onset of Type-2 diabetes by modifying a person’s lifestyle. These are also ways to help control blood glucose in the event that you are diagnosed with Type-2 diabetes.
Blood glucose is affected by how much or how little you eat, what you eat, when you eat, how much exercise or physical activity you do, and by the other medicines you may be taking.
Regular physical activity
Regular physical activity can help control body weight, which is a major risk factor for Type-2 diabetes, and other cardiovascular complications.
By committing to 30 minutes of physical activity each day, this will help your body control the blood glucose, improve general wellbeing, helps with weight loss and maintenance, and improves cholesterol levels. A weight loss of 5-10% can help control blood glucose.
Speak to your doctor before commencing exercise programmes to see if it is suitable for you.
Limiting alcohol intake
Alcohol is a double-edged sword in that it can either increase or decrease your blood glucose depending on the situation.
High carbohydrate beverages will increase your blood glucose.
A combination of alcohol and medications taken for diabetes may decrease blood glucose too much and cause hypoglycaemia.
Smoking is a risk factor for developing cardiovascular complications which then lead to Type-2 diabetes.
Patients with Type-1 diabetes will generally be on injectable insulin or an insulin pump as their body does not have the ability to produce insulin.
Meanwhile, there are a wide range of medications used to help treat Type-2 diabetes. Some medications will help stimulate the pancreas to produce more insulin (sulfonylureas), while others increase the cells in the body’s sensitivity to insulin (thiazolidinediones), and there are ones which decrease the body’s own glucose production (metformin), or slow down the absorption of glucose into the body (acarbose).
Newer medications stimulate the release of insulin and reduce the liver’s production of glucose (incretin enhancers and mimetics) or prevent the reabsorption of glucose by the kidneys (SGLT2 inhibitors).
The use of the above medications will depend on other concurrent medications and conditions. Depending on your blood glucose control, your doctor may also introduce additional medications to the original ones prescribed. Insulin is also the gold standard for Type-2 diabetes and will be the endpoint once other means of blood glucose control have failed to reach target levels.
Maintaining lifestyle changes as mentioned in the previous section is also an essential part of the overall management of Type-2 diabetes.
What else to consider?
Ongoing management of the conditions is essential in preventing complications for both Type-1 and Type-2 diabetes. Because diabetes can have widespread effects on the body, it is important to have regular appointments with your general practitioner and your diabetes specialist to receive check-ups on the condition. Seeing a diabetes educator regularly will also be beneficial to your ongoing care.
Self-monitoring of blood glucose
As one of the main aims of diabetes is to maintain glucose levels within a certain range, keeping a diary of your own blood glucose readings ensures that you remain on top of that goal. It becomes a balancing act of what you eat, exercise, medications, environmental stresses, and more to get your blood glucose into that range.
Diabetes Australia has a very detailed section on blood glucose monitoring which will help you take control for yourself.
As part of the National Diabetes Service Scheme (NDSS), our pharmacy is an access point for diabetes consumables such as testing strips and insulin needles which are available at a government-subsidised price.
People who have diabetes will find that they will develop issues with their eyesight at some point. Poor blood glucose and blood pressure control can affect the small blood vessels in the eye and can speed up the deterioration of vision. It is therefore important to catch any changes to the eyesight early, and visits to the optometrist or doctor for an eye check-up be scheduled every two years.
Diabetes can cause problems with nerves in your feet, and blood circulation problems can cause infections to manifest. This can then lead to possible ulcers and amputations. It’s important to check your own feet every day, and to notify your doctor if you notice anything unusual – this could be anything from redness to broken skin or discolouration of the toenails.
Tingling or burning pain, coldness or numbness could all be signs of nerve damage in your feet, so it’s recommended to make sure your doctor is aware of these issues.
It is recommended that regular feet checks are conducted by your general practitioner or a podiatrist, who your doctor can refer you to.
Flu and pneumonia vaccinations
Diabetes can lower a person’s ability to fight off infections, so it is recommended that people with diabetes be vaccinated against the flu every year, and against pneumonia according to your doctor’s advice.
People who have a chronic condition such as diabetes may qualify to have the annual flu vaccine covered by the National Immunisation Schedule, fully subsidised by the government.