Type 2 Diabetes is a chronic medical condition in which levels of glucose (a type of sugar) in the blood become too high. Over time this can lead to complications such as heart disease, stroke, kidney disease, blindness, amputations and nerve damage. Approximately 20% of those aged over 65 have Type 2 diabetes on the Central Coast. The good news is that is with early diagnosis and optimal treatment you can reduce the risk of developing complications.
What Causes Diabetes?
In Type 2 diabetes our body can no longer effectively absorb glucose so high levels build up in our blood stream. Our pancreas produces insulin which is a hormone that helps the body convert glucose into energy by opening up glucose channels into our muscles cells, liver and other tissues. In diabetes the glucose channels become more resistant to insulin so the pancreas needs to produce more and more insulin to help the body absorb it (insulin resistance). Eventually, the pancreas gets tired and can’t keep up and not enough insulin is produced to absorb the glucose. Over time, the high blood glucose levels in our blood stream can cause damage to different parts of the body leading to diabetes complications.
Who is at risk of Diabetes?
People are at higher risk of diabetes if they;
- have a family history of type 2 diabetes
- are overweight
- have high blood pressure
- have poor nutrition
- have low levels of physical activity
- are from an Aboriginal or Torres Strait Islander background
- are from certain ethnicities e.g Pacific Island and Asia (including the Indian sub-continent) Middle East, North Africa, Southern Europe
- have a history of gestational diabetes or Polycystic Ovarian Syndrome
You can assess your risk by using the Australian Type 2 Diabetes risk assessment tool (AUSDRISK) – https://www.diabetesaustralia.com.au/risk-calculator. This assessment should be done by those at high risk, or aged 40 years and older, every 3 years. If your risk if high please see your doctor for a blood test.
Obviously we can’t change our genetics but in over 50% of cases a diagnosis of diabetes can be prevented or delayed by following lifestyle measures such as stopping smoking, improving diet, increasing exercise and reducing weight.
The reason for delayed diagnosis for many people with type 2 diabetes is that there are often no symptoms. Therefore complications of diabetes may already be present by the time of diagnosis.
Symptoms can include;
- increased thirst
- increased frequency of urination
- increased infections
- delayed healing of cuts
- blurred vision
Testing for Diabetes
As many people with diabetes don’t have any symptoms it is important to talk to your doctor to assess your risk. Guidelines recommend that those at high risk or greater than 40 years of age complete the AUSRISK assessment tool every 3 years. If you are high risk or have any symptoms your doctor may order;
- a fasting glucose blood test (with nothing to eat and drink for at least 8 hours prior except for water)
- a random glucose blood test
- a glucose tolerance test (GTT) where you fast and then have a sugary drinking and have a blood test 1 and 2 hours later to see how your body responds.
- Glycosylated haemoblobin (HbA1c) blood test (this gives an indication of your average blood glucose levels over the last 3 months)
The good news is that Type 2 diabetes can often be managed initially by making lifestyle changes to reduce your blood glucose levels and reduce your risk of complications such as heart disease and stroke.
This includes :
- following a healthy diet low in sugar
- increasing physical activity
- reducing weight
Your doctor may recommend you see a dietician, diabetes educator or exercise physiologist to help you with your blood glucose monitoring and a healthy lifestyle program. There are also some great online resources available.
Sometimes lifestyle measures are not enough and as the disease progresses the pancreas just can’t keep up with maintaining low blood glucose levels. Your doctor may then prescribe tablets to help with the absorption of glucose and in some cases insulin may be required. This doesn’t mean your diet and exercise program should stop however.
It is also important to ensure blood pressure and cholesterol levels remain in the recommended range and that your are regularly monitored for complications of diabetes. This may include having regular eye checks with an optometrist or eye specialist, regular foot checks with a podiatrist, and regular blood and urine tests to monitor your glucose control and kidney function. Your GP will help coordinate your care and ensure your diabetes health checks are up to date.
Type 2 Diabetes is a common chronic condition which can be prevented or delayed with lifestyle measures such as a healthy diet, exercise and weight loss The aim of early detection and treatment is to reduce levels of glucose in the blood to prevent complications of diabetes such as heart disease, stroke, kidney disease, eye problems and amputations. Your health care team can help you manage your diabetes effectively with the most important member of the diabetes team being you.
Your General Practitioner