Diabetes Diagnosis, Even If You Feel Well, Calls For A Fresh Approach To Life
The Age
Tuesday April 13, 1993
DIETARY sugar exists in various forms and our bodies rely upon it for energy. The level of sugar in the bloodstream is tightly maintained in a certain range at all times, regulated mainly by a hormone from the pancreas called insulin. When this regulatory system fails, the blood sugar rises and diabetes occurs. There are two types of diabetes: Insulin-dependent diabetes or Type I diabetes.
All children with diabetes are in this category. Some adults develop the condition as well. For some reason the body's immune system attacks its own pancreatic cells and insulin is no longer adequately produced. It may be of dramatic onset and the person may be very sick.
Stabilisation on insulin is required.
Non-insulin dependent diabetes or Type II diabetes.
This type occurs in adults and is far more common. Sometimes it is called maturity-onset diabetes. Insulin is often produced in increased amounts but the body's organs, such as the liver and muscles, fail to respond and a state of insulin-resistance is said to occur. Type II diabetes is a huge health problem in our community. It affects about 450,000 Australian adults and yet only half of these people are aware of it. The incidence is increasing at an alarming rate and is almost at epidemic proportions in some countries, probably due to lifestyle factors including diet, obesity, lack of exercise, and an ageing population.
If the blood sugar remains high, various body organs such as the blood vessels and the nervous system may be damaged. Visual loss, circulatory problems and kidney disease can result from blood vessel changes. Loss of sensation in the feet sometimes occurs, and this may lead to the development of foot ulcers. Heart attacks and strokes are also more common in people with diabetes. When diabetes occurs in pregnancy there are increased risks for the baby. For this reason a test for diabetes is often done between 26 and 30 weeks gestation.
The tell-tale symptoms of diabetes are increased thirst, dry mouth and passing lots of urine. Other symptoms such as fatigue, weight loss and skin infections may also be present. However, with the more common Type II diabetes, people often feel perfectly well and it can be difficult convincing them that they have a problem at all, let alone a problem that calls for some major lifestyle changes. Although diabetes may be suspected if a urine specimen tests positive for sugar, a blood test is necessary to confirm the diagnosis.
The treatment of diabetes has improved greatly in recent years. A careful approach to diet is important. Many patients with Type II diabetes can maintain their blood sugar close to the normal range with diet alone. If not, tablets are available to improve the body's response to its own insulin. For patients who require insulin, better delivery systems such as injection pens make the whole business of having to take insulin much easier to manage.
Education and team approach are vital in the management of diabetes.
Patients and their families are encouraged to learn as much as possible about the condition. The GP, dietician, diabetes specialist, eye doctor, diabetes educator and podiatrist all help in various ways.
Diabetes Australia also provides excellent support and personal instruction. Foot-care, eye checks and recognising if the blood sugar drops too low are just some aspects of diabetes that need to be covered. Because blood tests are far more reliable than checking the urine for sugar, people with diabetes are often taught to do their own blood tests so they can manage their diabetes more accurately.
Type II diabetes is more common in people with a family history.
Likewise, being overweight, high blood pressure, vascular disease, or elevated blood fats all increase the risk. It is also seen more frequently in some population groups such as Aborigines, Indians and Maltese. Interestingly, women who have given birth to large babies are also more at risk. All these people should have a simple screening blood test to see whether they have diabetes. Early diagnosis and treatment gives a much better outlook and will delay or even prevent complications.
© 1993 The Age