We’ve all heard of diabetes and with 1.4 million Australians diagnosed with it [1], chances are you might know someone living with it. Diabetes Australia reports that 280 Australians develop diabetes every day (that’s a staggering one person every five minutes) [2] so it’s no wonder it’s been called the biggest challenge confronting Australia’s health system [3]. But do you know the different types of diabetes? The causes and symptoms? We’re here to break it down.

Type 1 diabetes

Type 1 diabetes accounts for about 10-15% of diabetes cases [4]. It’s an autoimmune condition, which means the immune system attacks healthy body cells by mistake. In the case of type 1 diabetes, the healthy cells being attacked are in the pancreas, and produce insulin.

The body’s preferred source of energy is glucose (sugar), but we need insulin to help turn glucose into energy. Without enough insulin, the glucose level in the blood will rise and the body begins to burn fat for energy instead. This process leads to an accumulation of chemical substances called ketones in the blood. High levels of ketones in the blood can be life threatening which is why people with type 1 diabetes need insulin injections or an insulin pump to replace the insulin the body can’t produce.

Symptoms

The symptoms of type 1 diabetes are varied and can come on suddenly. A simple test can tell your GP if they’re the result of type 1 diabetes, so it’s important to seek medical advice if you’re:

• excessively thirsty
• passing more urine
• feeling tired and lethargic
• always feeling hungry
• having cuts that heal slowly
• itching or have skin infections
• experiencing blurred vision
• losing weight
• having mood swings
• experiencing headaches
• feeling dizzy
• getting leg cramps.

Type 1 diabetes usually develops in children or young adults, though it can occur at any age. What causes it is still a mystery and unfortunately it can’t be prevented or cured. But while experts know it isn’t down to lifestyle factors, maintaining a healthy lifestyle is important in managing it and avoiding serious diabetes-related complications.

Type 2 diabetes

Associated with lifestyle factors, type 2 diabetes is the big-ticket item, representing a whopping 85–90 percent of all diabetes cases [5]. And while it usually develops in people aged over 45, worryingly it’s increasingly occurring in younger people.

In type 2 diabetes the body doesn’t respond to insulin properly (insulin resistance). To try and manage the blood glucose levels (to keep them from rising), the pancreas produces more and more insulin and over time those hard-working insulin-producing cells wear themselves out.

Type 2 diabetes has strong genetic links, in other words it runs in the family. So if you’ve got a family member with type 2 diabetes then unfortunately you’re more at risk. This risk increases greatly with certain lifestyle factors, such as high blood pressure, being overweight (particularly around the waist), eating a poor diet and not doing enough physical activity.

While there’s no cure for type 2 diabetes, the good news is that its progression can be slowed or stopped through positive lifestyle changes such as a healthier diet and more physical activity (more on this below!). Tablets and/or injections may still be needed to help avoid long-term complications. Unfortunately, there are large numbers of people with silent, undiagnosed type 2 diabetes and these complications, such as a heart attack or vision problems, will be the first sign of diabetes. It’s important to know your risk to minimise or even prevent complications. Head to the Diabetes Risk Calculator to answer 11 quick questions. You should also see your GP if you experience any of the type 1 diabetes symptoms.

Pre-diabetes

Pre-diabetes is when your blood glucose levels are higher than normal but not high enough to be diagnosed with type 2 diabetes.

There are around two million Australians with pre-diabetes [6]. They experience either impaired glucose tolerance (IGT) – where blood glucose levels are higher than normal (but not high enough to be classified as diabetes), or impaired fasting glucose (IFG) – where blood glucose levels are heightened in the fasting state (but again not high enough to be diabetes). You can have both IFG and IGT.

You can have pre-diabetes and have no symptoms. People with pre-diabetes have a higher risk of developing type 2 diabetes. Pre-diabetes risk factors include:

• being overweight (especially around the waist – more than 94cm for men and more than 80cm for women)
• not being physically active
• having high triglycerides (a type of fat found in your blood), low HDL-C (good cholesterol) or high total cholesterol
• high blood pressure
• a family history of type 2 diabetes or heart disease.

You should also be mindful of pre-diabetes if you:

• have polycystic ovarian syndrome (PCOS)
• have had gestational diabetes or given birth to a big baby (more than 4.5kgs)
• are an Aboriginal or Torres Strait Islander
• are from certain ethnic backgrounds such as the Pacific Islands, Asia, and the Indian sub-continent.

One in three people with pre-diabetes will go on to develop type 2 diabetes without positive lifestyle changes, including healthy eating, increased activity and losing weight [7]. But at least that puts some power in your hands, read on for more!

Lifestyle changes

An Accredited Practising Dietitian can help you work out a healthy eating plan for losing weight and reducing the risk of type 2 diabetes. This may include reducing the kilojoules and fats consumed (particularly saturated fats) and choosing high fibre, low GI carbohydrate foods such as wholegrain breads and cereals, legumes, and fruit. You can find a dietitian in your area through Dietitians Australia.

Doing regular physical activity helps your body to use insulin better and can also help you manage high blood pressure, maintain a healthy weight, and support your mental wellness. So it’s important to aim to do at least 30 minutes of physical activity (like walking, swimming, and strength training) on most days of the week. Remember to talk to your GP before starting any new type of exercise.

For more on how you can be proactive with your health including by eating well and exercising, see what Diabetes Australia recommends.

Gestational diabetes

Gestational diabetes mellitus (or GDM) can happen during pregnancy. It’s the fastest growing type of diabetes in Australia, affecting thousands of pregnant women [8].

When you’re pregnant, the placenta produces hormones that help the baby to grow and develop (amazing!) but these hormones also block the action of the mother’s insulin (insulin resistance). This means you need 2 to 3 times more insulin than normal during pregnancy and if you already have insulin resistance, your body may not be able to cope with the extra demand for insulin production (leading to higher blood glucose levels and gestational diabetes).

An oral glucose tolerance test (or OGTT) for gestational diabetes is done at 24-28 weeks of pregnancy (except for those women who already have diabetes). Women with certain risk factors should be tested earlier in their pregnancy though, so chat to your GP or health professional if you:

• had gestational diabetes in a previous pregnancy
• are aged 40 or over
• have a family history of type 2 diabetes or your mum or sister had gestational diabetes
• are above the healthy weight range
• have previously had high blood glucose levels
• are an Aboriginal or Torres Strait Islander
• are from an African, Melanesian, Polynesian, South Asian, Chinese, Southeast Asian, Middle Eastern, Hispanic, or South American background
• have polycystic ovary syndrome (PCOS)
• have previously given birth to a large baby (weighing more than 4.5kg)
• are taking anti-psychotic or steroid medications.

Your health professional will talk you through the best treatment plan for you, usually involving healthy eating, regular physical activity, and monitoring and maintaining healthy blood glucose levels. Some women may need medication and/or insulin injections to help manage gestational diabetes.

For most women, the diabetes will stop when their bundle of joy arrives, but some women will still have high blood glucose levels after delivery. There can be an increased risk of the woman and baby developing type 2 diabetes in the future so, depending on your risk factors, you may need to be tested for type 2 diabetes again. Ask your doctor for more info.

We’re here to help

It’s important to remember that while a diabetes diagnosis for yourself or a loved one can feel overwhelming, support is available through your GP and other health professionals. And we’re here to help!

Got Extras cover?

Check your Extras cover to see what you could be claiming for. Our Top Extras and Mid Extras include benefits for podiatry and you can claim towards certain weight loss programs under our Healthy Lifestyle benefit. Top Extras also provides benefits for dietitian support and blood glucose monitors (including CGMs).

Head over to our FAQs for more info on claiming benefits under Healthy Lifestyle and blood glucose monitors under artificial aids and appliances.

Got Hospital cover?

Find out more about the provision and replacement of insulin pumps to treat diabetes under Hospital cover. And whether it’s support with nutrition plans, weight loss, or managing chronic conditions including pre-diabetes or type 2 diabetes, eligible Teachers Health members can access tailored support services to help get (and keep!) you on the right path to a healthier future.

References:
1-8: diabetesaustralia.com.au

Source:
diabetesaustralia.com.au