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WHAT IS DIABETES ?

Diabetes is a disease caused by a decreased production of insulin or by the decreased ability of the body to use insulin. Insulin is a hormone which regulates the level of glucose (sugar) in the bloodstream. Glucose is a critical source of energy utilised by every organ in the body and is the ONLY energy source utilised by the brain. Without insulin, the glucose level rises in the bloodstream, but the body is unable to effectively use it. Insulin is the key which opens up the body cells to let sugar in.

Insulin is made in a gland named pancreas which is found behind the stomach.
When there is too little insulin produced by the pancreas, or insulin that does not work well, the sugar cannot enter the cells. It stays in the bloodstream and rises to abnormal levels ( higher than 8 mmoles/L ) and cannot be used by the body.
A high level of blood sugar or Hyperglycaemia affects your body's functioning and you start to experience the following signs and symptoms:

• you feel tired and sleepy because you are lacking energy,
• you get thirsty and drink a lot of water,
• you also pass large amounts of urine because the body is trying to get rid of the excessive sugar through the urine,
• your vision may become blurry because body fluids are concentrated and the lens in your eye changes shape,
• you may experience weight loss or gain, feel hungry and eat more,
• skin infections and itching, especially in the genital area may be present,
• tingling and numbness in feet may also be present.

Depending on the type of Diabetes you have, symptoms may develop quickly (in days or weeks), or slowly (in months or years).
There are two types of Diabetes:

• Insulin Dependent Diabetes Mellitus (IDDM)
• Non Insulin Dependent Diabetes Mellitus (NIDDM)

The first type of Diabetes (IDDM), usually appears in people under 30 years of age and who are within normal range of body weight. In this case, the symptoms develop quickly and are usually more severe. People with IDDM have little if any insulin produced by their body so daily insulin injections are required to keep the blood sugar as close to the normal range as possible.
The second type of Diabetes (NIDDM), usually occurs in middle - aged or older people, the majority of whom are overweight. Symptoms may not always be present. In this case, some insulin is still produced but it may not be secreted or function normally. Being overweight is often a major part of the problem, so weight control is one of the aims of treatment

KEY POINTS

• Diabetes is a condition in which the body is not able to use food for energy because there is little insulin produced by the pancreas or insulin which does not work well.
• Insulin is a hormone which acts as a key in opening the way for sugar to get into the cells where it is needed for energy.
• There are two types of Diabetes:
  1.Insulin Dependent Diabetes Mellitus
  2.Non Insulin Dependent Diabetes Mellitus

How do you get Diabetes?

Diabetes is a complex condition. According to Diabetes Australia, about half a million Australians have diabetes. Anyone can develop diabetes at any age. Diabetes is not caused by eating too much sugar, and it cannot be caught from other people.
Although the causes of diabetes are not yet fully understood, it is said that the majority of the people with insulin dependent diabetes are born with a tendency to develop diabetes (genetic predisposition). If these people are exposed to a trigger such as a viral infection which can damage the insulin producing cells of the pancreas, then diabetes will develop because the pancreas is unable to produce sufficient insulin for the body's needs.
In the case of non - insulin dependent diabetes, possible causes include:

• being overweight and unfit ( extra fat interferes with the transfer of sugar),
• getting older ( over 40 years ),
• if you have a family member who has diabetes (for example, either parent, brother or sister),
• if you are a woman who has had diabetes during a pregnancy or large babies ( over 4000grams or 9 lbs).

• KEY POINTS

• Diabetes can not be caught from other people.
• It is not caused by eating too much sugar ; it tends to run in families.
• Anyone can get diabetes at any age.
• Overweight people are more likely to suffer from non - insulin dependent diabetes.

How is Diabetes treated?

Good control of diabetes depends firstly on your understanding and acceptance of a chronic illness, and secondly, your willingness to change your attitude and behaviour in adopting a healthy lifestyle.
This means:

• educating yourself about the diabetes and its management,
• having healthy, balanced meals high in fibre, low in fat and sugar,
• regular suitable exercises,
• taking medication (if prescribed by your doctor),
• regular self - testing blood sugar levels to check control of your
• diabetes,
• regular medical, podiatry (feet), and eye check ups,
• learn to manage everyday stress,
• give up the cigarettes and limit your alcohol intake.

Having diabetes means making changes in your lifestyle, but there is no reason why you cannot continue to lead an ordinary, active life.

KEY POINTS

• Knowledge is the key to managing your diabetes and living a happy and active life.
• Adopting a healthier lifestyle, is the best way to live with diabetes.

Accepting the diagnosis

Finding out that you have diabetes may come as a shock to your sense of security and self-esteem. This is a normal reaction some people experience.
During the initial period, it is perfectly normal to experience feelings of grief, helplessness, despair denial and self pity. Your responses to the diagnosis of diabetes are not the problem. The real problem is that you probably have a number of misconceptions about diabetes which are causing anxieties, and you need to get satisfactory answers to your questions and curiosities. Therefore, you need to discuss this with your Doctor or Diabetes Educator.
It may take a little time for you to accept that your diabetes is not going to go away, but it can be treated effectively, and you can live an active and fulfilling life.
The treatment requires that you change your lifestyle. That is, the way you eat, the way you exercise, the way you practice good health habits
When you make these changes, it means that you are gradually working towards accepting your diabetes and taking control of your life.

Controlling your diabetes is critical for your physical and emotional well-being.

You need to remember that everyone copes differently. The adjustment you will make to living with diabetes depends on your personal values, supportive family environment, professional support and community support ( Diabetic support groups). Inform your family and friends that you have diabetes and explain to them how it affects you (explain your need for a controlled diet). Join a Diabetic support group in your local community. Enquire about diabetes education and support at your local Community Health Centre, Hospital or Diabetes Australia.

KEY POINTS

• Negative feelings are a normal response to being diagnosed with diabetes.
• Working towards accepting your diabetes and getting on with your life is crucially important for your physical and emotional well-being.
• You are not alone ; half a million of Australians have diabetes.
• Support is readily available from your Doctor, Diabetes Educator and Diabetic support groups in your community. Seek it out.

Information prepared by:- West Heidelberg Community Health Centre

Lynne E Gannon, Podiatrist, Diabetes Educator
Eileen Holbery, Dietician, Diabetes Educator
Richard Moore, General Practitioner
Meni Stefanovski, Community health nurse, Diabetes Educator