What is diabetes?
Diabetes is a chronic condition that can affect the entire body. When diabetics eat glucose, which is in foods such as breads, cereals, fruit and starchy vegetables, legumes, milk, yoghurt and sweets, it can’t be converted into energy as it would be in a non-diabetic. Instead of being turned into energy the glucose stays in the blood, which is why blood glucose levels (or glycemia) are higher in people with diabetes. [1]
If blood sugar is consistently high, over time it can affect the heart, eyes, kidneys, nerves and other parts of the body. Sometimes people with diabetes aren’t aware that they have the disease until they begin to have other health problems. But the good news is that the risk of complications can be decreased through good management of the disease and by controlling blood glucose (sugar). [2]
Currently, an estimated 280 Australians develop diabetes every single day. The 2005 AusDiab Australian Diabetes, Obesity and Lifestyle Study showed that 1.7 million Australians have diabetes, but that up to half of the cases of type 2 diabetes remain undiagnosed.[3]
Diabetes has become so common that it has now reached epidemic proportions in Australia and around the world. Staggeringly, it’s estimated that by 2031, up to 3.3 million Australians will have type 2 diabetes.[4]
This is likely driven by rising obesity, the ageing population, dietary changes and sedentary lifestyles. The rising incidence of type 1 diabetes is also contributing to the growth of diabetes in Australia, and the prevalence of type 1 diabetes was actually predicted to increase by 10 percent between 2008 and 2013.[5]
Type 1 diabetes – causes and effects
Causes
Type 1 diabetes occurs when the pancreas isn’t able to produce all the insulin required to sustain the body. This is because the body’s immune system attacks and destroys the insulin-producing cells in the pancreas. It represents 10 to 15 percent of all cases of diabetes and is the most common chronic childhood disease in developed nations. But, unlike type 2 diabetes, type 1 diabetes isn’t caused by lifestyle factors.[6]
Instances of type 1 diabetes is increasing at about three percent a year and the exact cause is still unknown. One theory is that some people have a genetic predisposition for the condition and when exposed to an environmental trigger, possibly a viral infection, the immune system then destroys the insulin producing cells in the pancreas.[7]
A revolutionary 2002 study into the interplay between heredity and environment in the dramatic increase in type 1 diabetes opened exciting new avenues in the scientific field when it investigated the potential impact of season and climate on the development of the disease in children. Researchers looked at the possibility that the initiation of the autoimmune process of type 1 diabetes in genetically susceptible subjects begins in the perinatal period due to a viral infection. What the results of this research suggest is that mothers who become pregnant during the period of yearly viral epidemics transmit to the foetus, either a virus or antiviral antibodies, which determine whether or not a child will develop type 1 diabetes.[8]
Effects
The onset of symptoms is usually quite abrupt and can include[9]:
- excessive thirst and urination
- unexplained weight loss
- weakness and fatigue
- irritability
Without insulin the body burns its own fats as a substitute. Unless treated with daily injections of insulin, people with type 1 diabetes accumulate dangerous chemical substances in their blood from the burning of fat. This can cause a condition known as ketoacidosis, which is potentially life threatening if not treated. To stay alive, people with type 1 diabetes depend on up to four insulin injections every day of their lives and must test their blood glucose levels several times daily.[10]
While a great deal of research is being carried out, at this stage nothing can be done to prevent or cure type 1 diabetes.[11]
Type 2 diabetes – causes and effects
Causes
Type 2 diabetes is characterised by insulin resistance and/or impaired insulin secretion. It differs from type 1 diabetes because it is not caused by the body’s immune system but solely from a combination of genetic predisposition and environmental factors.[12]
It’s the most common form of diabetes, contributing more than 85 percent to the total number of people with the condition in Australia. It’s typically diagnosed after the age of 40, although it is starting to be diagnosed much earlier – even among adolescents.[13]
Type 2 diabetes has a strong genetic predisposition, which is triggered by lifestyle factors. A 2013 study found that the epigenetic factor is a chemical change on the DNA strand following a certain pattern, known as DNA methylation. This is actually good news because it means that despite an individual carrying the genes of susceptibility to type 2 diabetes, they have the potential to prevent the disease developing if they have the foresight to make positive and lasting changes to lifestyle to avoid its development.[14]
You may be susceptible to developing type 2 diabetes if[15]:
- you’re aged 40 years and over
- you’re overweight
- have high blood pressure
- do little physical activity
- have a high fat, high sugar diet.
People of South Asian, African, African-Caribbean and Middle Eastern descent have an increased risk of developing type 2 diabetes at a much earlier age. Overall, the risk of developing type 2 diabetes increases with age because people tend to gain weight and exercise less as they get older. Maintaining a healthy weight with a balanced diet and regular exercising will certainly assist in both the prevention and management of type 2 diabetes .[16]
Genetics is one of the main risk factors for type 2 diabetes. The risk is increased if there is a close relative, such as a parent, brother or sister, who has the condition. The closer the relative, the greater the risk. In fact, a child who has a parent with type 2 diabetes has about a one-in-three chance of also developing it.[17]
Effects
The onset of symptoms is usually quite slow and can go undetected for considerable lengths of time. Symptoms can include[18]:
- excessive thirst and urination
- hunger
- frequent infection
- fatigue
- tingling in hands and feet
- blurred vision
- nausea
Type 2 diabetes can often initially be managed with healthy eating and regular physical activity. But over time most people with type 2 diabetes will also need tablets and even insulin. There’s currently no cure for type 2 diabetes.[19]
Gestational diabetes – causes and effects
Causes
Gestational diabetes occurs during pregnancy and is a common condition where there is too much glucose in the blood. In pregnancy, the placenta produces hormones that help the baby grow and develop. These hormones also block the action of the mother’s insulin so the need for insulin in pregnancy is two or three times higher than normal. If her body is unable to produce this much insulin, gestational diabetes develops.[20]
Risk factors for developing gestational diabetes include[21]:
- increasing maternal age – over 30 years old
- a family history of type 2 diabetes
- being overweight or obese
- being of Indigenous Australian descent
- belonging to certain ethnic groups – Indian, Chinese, Middle Eastern, South East Asian, Polynesian/Melanesian and African
- experiencing previous gestational diabetes
- experiencing previous difficulty carrying a pregnancy to term
- having a twin or triplet pregnancy
- women who have had Polycystic Ovarian Syndrome
Effects
Generally, foetus development is not affected by gestational diabetes. But as glucose crosses the placenta, the baby is exposed to the mother’s high glucose level later in pregnancy and this high level of glucose in the baby’s blood stimulates their pancreas to produce extra insulin. This can cause the baby to put on extra weight, which may result in a large baby that may need to be delivered early. And, once born, and the baby is no longer exposed to the mother’s high blood glucose levels, the baby’s extra insulin can cause temporarily low blood glucose.[22]
There is evidence that gestational diabetes which is not well managed can be associated with long-term health problems in the offspring including obesity, hypertension and diabetes.[23]
Between 4 to 11 percent of pregnant women (depending on demographic area) will develop gestational diabetes and the majority of these mothers will get it around the 24th to 28th week of pregnancy. It’s at this time that special blood tests are carried out, except for those women at high risk who may be tested earlier.[24]
Gestational diabetes is managed by[25]:
- eating a healthy balanced diet
- maintaining physical activity throughout the pregnancy
- monitoring blood glucose levels.
The good news is that after the baby is born, the mother’s blood glucose levels will generally return to normal. However, a 2002 study published in American Diabetes Care Journal found there is a heightened risk for women who experience gestational diabetes to go on to develop type 2 diabetes. Their research revealed that the cumulative incidence of type 2 diabetes increased markedly in the first five years after delivery.[26]
Long-term effects of diabetes on the body
If diabetes isn’t treated or appropriately managed, serious and long-term health complications can arise. They include[27]:
- Heart disease – People with diabetes have a higher risk for heart attack and stroke.
- Eye complications – People with diabetes have a higher risk of blindness and other vision problems.
- Kidney disease – Diabetes can damage the kidneys and may lead to kidney failure.
- Nerve damage (neuropathy) – Diabetes can cause damage to the nerves that run through the body.
- Foot problems – Nerve damage, infections of the feet and problems with blood flow to the feet can be caused by diabetes.
- Skin complications – Diabetes can cause skin problems, such as infections, sores and itching. Skin problems are sometimes a first sign that someone has diabetes.
- Dental disease – Diabetes can lead to problems with teeth and gums, called gingivitis and periodontitis.
