Saturday, 11 July 2015

National Diabetes Awareness Week: July 12 to 18, 2015.

Did you know that about 280 Australians are diagnosed with Type 2 Diabetes every day? According to Diabetes Australia, approximately 1.7 million Australians are living with diabetes. Diabetes is increasing at a faster rate than any other chronic disease (such as heart disease or cancer), so chances are that someone close to you is affected by the disease. This week, July 12-18, marks National Diabetes Week; a week dedicated to highlighting the prevalence, risk factors and appropriate management of the disease. 

Diabetes is a chronic (long-term) disease, and thus being diagnosed with diabetes should not be taken lightly. There are 2 main types of diabetes; Type 1 and Type 2. Type 1 is an auto-immune condition and is most commonly diagnosed early in life, such as in childhood or early adolescence. Type 2 diabetes, the more common form of diabetes, is considered a lifestyle disease, and typically affects people in their middle ages and beyond. You may also hear the term "pre-diabetes," which simply means are on your way to developing diabetes and should adjust your lifestyle to reduce your risk. Pregnant women may develop "gestational diabetes," which is simply diabetes during pregnancy. This usually resolves once the baby has been born, though the mother is then at a higher risk of developing Type 2 diabetes later in life.

Please note: the remainder of this post will focus on the risk factors, symptoms, complications and management of Type 2 diabetes, given it is the most common form of diabetes. 
So what is Type 2 Diabetes? 
Type 2 diabetes occurs when your pancreas is not able to make enough insulin to control your body's blood glucose (blood sugar) levels. I like to think of insulin as the key to the door of cells in the body. When insulin opens the door to the cells, sugar enters the cells and gives the muscles energy to move and get you through daily life. If there is not enough insulin (not enough keys for all the doors), the sugar can't get through the doors to your cells, so it is left to build up in the blood stream. This means your blood sugar levels will be too high, and you may experience symptoms of diabetes. If left untreated, this could cause complications. This is why regular visits to your doctor are important.

Who is at risk of developing Type 2 Diabetes? 
There is no single cause of Type 2 Diabetes, though some major risk factors include:
- Being overweight or obese
- Being physically inactive
- Having unhealthy eating habits
- Smoking
- Having a family history of diabetes
- Having heart disease
- Being aged over 55
- Having had gestational diabetes
- Having Poly-Cystic Ovarian Syndrome  (PCOS)
- Being of Aboriginal, Torres Strait, Pacific Islander, Asian, Maori, Middle Eastern, North African or Southern European descent 

What are the symptoms of Type 2 Diabetes?
 Some people will experience no symptoms, whereas other people will:
- Feel more thirsty
- Feel tired
- Feel more hungry
- Need to urinate more often (especially at night)
- Have more frequent infections
- Notice cuts or wounds heal more slowly
- Have blurred vision
- Have headaches

These symptoms occur as the body tries to cope with the high amounts of sugar in the bloodstream and tries to remove the sugar from the body.

What are the complications of Type 2 Diabetes? 
As mentioned earlier, Type 2 Diabetes is a serious, lifelong condition and should be taken seriously, to reduce the risk of developing serious complications. Such complications include:
- Eye disease (retinopathy)
- Kidney disease (nephropathy)
- Loss of feeling in feet and fingers (neuropathy and Peripheral Vascular Disease (PVD))
- Heart and blood vessel disease (cardiovascular disease)
- Gum disease (peridontal disease)

Your risk of developing such complications depends on how well you manage your blood sugar levels, how long you have had diabetes, whether you smoke, drink alcohol or have high blood pressure, cholesterol or triglycerides. The power is in your hands!

How is Type 2 Diabetes managed? 
The management of Type 2 diabetes depends on how high your blood sugar levels are, and how well you body is able to regulate blood sugar on it's own. Some people may need to take medications, some may require insulin injections (especially if they have had diabetes for some time or medications are not effective), whilst others can manage simply by changing their diet and exercise habits.

1. Nutrition
Nutrition plays a big role in the management of diabetes, regardless of whether you are on medications or insulin injections or not. There is no "special diet" for diabetes, though there are some important considerations to make to manage your condition.

It is important to eat regularly, to lessen the likelihood of overeating and keep blood sugar stable. This means eating 3 main meals at a minimum. Some people may also require 2-3 snacks, though this is entirely dependent on your individual needs and is not essential for everyone.

Another important consideration is to eat according to the Australian Guide to Healthy Eating. This means:
- Eating 2 serves of fruit
- Eating 5 serves of vegetables
- Choosing wholegrain breads, cereals, pasta, rice or using ancient grains
- Eating moderate amounts of lean meat/alternatives and aiming to include fish regularly
- Including 3-4 serves of dairy foods such as milk, yoghurt, cheese or alternatives

If you have diabetes, there are no foods that you cannot eat, though high fat, high sugar and energy dense foods should be eaten only in moderation. Foods to limit include:
- those high in saturated fat, such as biscuits, cakes, pastries, processed meats, fried foods and takeaway
- those containing added salt
- those containing added sugar such as confectionary, biscuits, cakes, ice cream and sugar sweetened drinks
 - alcohol; this should be limited to 1 standard drink per day for women or 2 standard drinks per day for males. It is also advisable to include 2 alcohol-free days per week.

2. Be physically active 
Being physically active also helps to lower your blood sugar levels. It is also important for general health and wellbeing, mental state, and can help to keep your weight in check. Current recommendations encourage 30 minutes of moderate to vigorous activity each day, however something is always better than nothing! If you are someone who is typically not active, then simply making small changes and moving more will be of benefit to you. Park the car further away, take the stairs instead of the lift or wash your car by hand rather than using the automatic car wash - it all adds up! Furthermore, the daily '30 minute' target does not need to be completed in one burst; you could do 3 x 10 minute walks instead, if that better fits your schedule. As mentioned, something is better than nothing.

3. Manage your weight
Being overweight is a major risk factor for developing Type 2 Diabetes and can also make it more difficult to control your blood sugar levels if you do already have diabetes. It is said that losing even a small amount of weight can greatly improve blood sugar control and reduce the risk of heart disease and other chronic diseases. Generally speaking, eating well and being active each day will assist weight management, though portion control (ie. controlling the size of your meals) is also critical for weight management. That being said, weight is not the "be all and end all" of diabetes management, so do not focus solely on the number on the scale! As previously mentioned, your overall well-being, what you eat, how much you eat and how much you move are much more important factors.

Where can I go for more information?
If you think you may be at risk of developing Type 2 Diabetes or have been diagnosed with diabetes, consult you doctor for more information and support. It is also advisable to visit an Accredited Practising Dietitian for dietary advice tailored specifically to you. I would also recommend having an appointment with a Credentialled Diabetes Educator for advice and support regarding diabetes prevention and management. Also, be sure to visit the Diabetes Australia website for a wealth of diabetes-related information at your fingertips.

Use this National Diabetes Week to kick-start some healthy habits to reduce your risk of developing diabetes, or to improve your management of the disease. Look out for special events occurring in your area or join in and raise awareness by using the #280aday hashtag on social media.

Have a happy and healthy National Diabetes Week!

- Em x


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