Diabetes and your health

by Dinethri Ramasundara APD AN
 
World Diabetes day was on the 14th of November and the focus this year was on healthy eating which is a key factor in management of diabetes. According to ABS 2011 data, Diabetes is ranked the 6th highest cause of death in Australians. Furthermore, 5.1% of people over the age of 18 years suffer from diabetes while another 3.1% Australian adults at a higher risk of diabetes (1). Larger proportion of diabetic population tends to be men at 4.3% compared to women at 3.6%. People between the ages 65-74 years had the highest incidence of diabetes (16.0%) reflective of increasing rate of incidence with the age (2). The prevalence of diabetes has increased from 1.5% to 4.2% from 1989–90 to 2011–12 in Australia.
 
Diabetes is a chronic disease where insulin is ineffective in management of blood glucose levels resulting in high glucose levels. Glucose is the primary fuel of human body. Generally, our bodies are very efficient at maintaining safe levels of blood glucose in the body with help of pancreatic hormones Insulin and glucagon. These hormones regulate our blood glucose levels within an optimum of 4 to 6 mmol/L (fasting).
 
Have a look at the figure below as it explains glucose- insulin action well.

 
There are three types of diabetes
• Type 1 Diabetes: People with Type 1 Diabetes are unable to produce Insulin therefore require daily insulin injections to manage glucose metabolism in their body. This type of diabetes is an autoimmune disease and has no cure but lifelong management with insulin injections, nutrition and exercise.
 
• Type 2 Diabetes: This group of people produce Insulin however, it is often not enough to keep up with the demand or the body has becomes insensitive to the action of insulin. This is the most common form of diabetes, which can be prevented or delayed with lifestyle changes. Usually diagnosed with an oral glucose tolerance test.
Risk factors for Type 2 diabetes are,
o Family history of diabetes,
o Age over 55 years (increased risk as we age),
o Overweight; Excess body fat especially around your abdomen area increases insulin resistance
o High blood pressure
o Aboriginal or Torres Strait Islander, Pacific Island, Indian subcontinent or Chinese cultural background
o Woman who has given birth to a child over 4.5 kgs (9 lbs), or had gestational diabetes when pregnant or have Polycystic           Ovarian Syndrome.
 
• Gestational diabetes: occurs during pregnancy. Needs to be managed to reduce risk of complications during pregnancy and birth of the baby. Generally, managed through regular blood glucose monitoring, physical activity and adapting a healthy diet. The blood glucose levels returns to normal levels post pregnancy. Women who had gestational diabetes have an increased risk of developing Type 2 diabetes later in life therefore should be screened every 2-3 years.
 
Symptoms of diabetes

• Excessive thirst
• Frequent urination
• Feeling tired and lethargic
• Always feeling hungry
• Wounds that are healing slowly
• Blurred vision
• Weight gain
• Mood swings
• Headaches
• Feeling dizzy
• Leg cramps

Tips to manage diabetes

• Check for your risk
• Maintain your weight in a healthy weight range
• Exercise regularly; aim for at least 30minutes of physical activity daily
• Eat a balanced diet comprised of fruits, vegetables, grains and cereals, meat and alternatives and dairy, see Australian Guide to Healthy Eating for serve sizes and intake requirements https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55g_adult_brochure.pdf
• Have regular meals and snacks spread through the day
• Watch your portion sizes
• Cut back on salt; choose no added salt or reduced salt varieties
• Limit takeaways and processed food, generally these foods are high in energy, saturated fats and salt
• Limit your alcohol intake; alcohol is high in energy and frequent intake contributes to weight gain. National Alcohol guidelines recommend no more than two standard drinks on any day for healthy males and females. http://www.alcohol.gov.au/internet/alcohol/publishing.nsf/Content/guide-adult
• Quit smoking, smoking increases your risk of diabetes
• Control healthy blood pressure levels

 
References
1. http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.005Chapter1002011-12
2. http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/D4F2A67B76B06C12CA257AA30014BC65?opendocument
 
Image from http://www.endocrineweb.com/conditions/diabetes/normal-regulation-blood-glucose
http://www.holistichealthliving.com/wp-content/uploads/2015/08/diabetes-sugarcubes.jpg