Frequently Asked Questions about diabetes

In people with diabetes, blood glucose levels are higher than normal because the body does not produce enough insulin and often cannot use insulin properly.

Insulin is a hormone needed for glucose to enter the cells and be converted to energy.

There are two main types of diabetes: type 1 and type 2 diabetes.

Type 1 diabetes:

• Occurs when the pancreas does not produce insulin.
• Represents 10–15 per cent of all cases of diabetes.
• Usually the onset is abrupt and symptoms are obvious.
• Symptoms can include excessive thirst and urination, unexplained weight
• loss, weakness, fatigue and blurred vision.
• Half of new cases occur in people aged 15 years or over.
• Latent autoimmune diabetes in adults (LADA) is a slow onset form of type 1 diabetes occurring in adults over 30 years of age. LADA is frequently misdiagnosed as type 2 diabetes.

Type 2 diabetes:

•  Occurs when either the insulin is not working effectively (insulin resistance) or the pancreas does not produce sufficient insulin (or a combination of both).
• Represents 85–90 per cent of all cases of diabetes.
• Usually develops in adults over the age of 45 years but it is increasingly occurring at a younger age.
• Is more likely to develop in people with a family history or from particular ethnic backgrounds.
• Symptoms may be similar to those for type 1 diabetes. Other symptoms of type 2 diabetes include; frequent infections (thrush, urinary tract or skin infections), slow wound healing. Many people with type 2 diabetes do not have any symptoms or they may be very mild.
• In early stages type 2 diabetes can usually be managed with a healthy lifestyle and regular medical checks but eventually medications and/or insulin may be required.

Type 1 diabetes is an autoimmune condition. Usually the onset is abrupt and symptoms are obvious. Type 1 diabetes is more commonly diagnosed in children and young adults but can occur at any age. Type 1 diabetes is always treated with insulin.

Type 2 diabetes is the form of diabetes that is related to ageing, family history and lifestyle factors (overweight and inactivity). It occurs when the insulin is not working effectively (insulin resistance) or the pancreas does not produce sufficient insulin (or a combination of both).  Most people with diabetes have type 2. It usually develops in adults over the age of 45 years but it is increasingly occurring at a younger age.

Type 2 diabetes is treated with healthy eating, exercise and weight control. Tablets and insulin may also be required.

Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are both conditions where blood glucose levels are higher then normal but not high enough for a diagnosis of type 2 diabetes. The term 'pre-diabetes' is also sometimes used to describe these conditions.

Symptoms of type 1 diabetes can include excessive thirst and urination, unexplained weight loss, weakness and fatigue.

Symptoms of type 2 are similar to those for type 1 diabetes. However, some people with type 2 diabetes do not have any symptoms at all. For others the first indication may be a complication of diabetes such as a heart attack, vision problems, or a foot ulcer.

Diabetes is serious. Diabetes can cause serious complications. For example:

• People with diabetes are up to two times more likely to develop heart disease and stroke.
• Diabetic retinopathy causes 17 per cent of all blindness and vision impairment and is the most common form of blindness in adults 20–74 years.
• The rate of lower limb amputation is 15 times higher in people with diabetes than those without diabetes.
• Diabetes is the leading cause of kidney failure. People with diabetes develop kidney damage at three times the rate of those who do not have diabetes.

People with diabetes are at similar risk of death to smokers. Over five years people with diabetes are twice as likely to die as people with normal glucose tolerance.

• The total number of Australians with diabetes and pre-diabetes is estimated to be approximately 3.7 million.
• About one in four Australian adults over the age of 25 years has either diabetes or impaired glucose metabolism.
• More than 1.2 million Australians have been diagnosed with diabetes. For every person diagnosed, it is estimated that there is another person who is not yet diagnosed.

People with one or more of the following risk factors are at increased risk of type 2 diabetes:

• People who are inactive.
• People who have a family history of type 2 diabetes.
• People who are overweight or obese.
• People with pre-diabetes this is where the glucose (sugar) levels in the body are higher than they should be, but not high enough to be diagnosed with diabetes. Not all people with pre-diabetes will develop diabetes but those that do have pre-diabetes are at high risk of developing the condition.
• People with high blood pressure and/or high fat levels in the blood or a history of cardiovascular disease.
• Aboriginal and Torres Strait Islander people.
• People from the following ethnic backgrounds: Pacific Island, Maori, Asian (including the Indian sub-continent), Middle Eastern, North African or Southern European.
• Women who have had diabetes during pregnancy (gestational diabetes).
• Women who have polycystic ovarian syndrome and who are overweight. People who smoke
• People taking antipsychotic medication.

Women who have had type 2 diabetes when pregnant (gestational diabetes)

Gestational diabetes is a form of diabetes that occurs in around five per cent of pregnancies. In the majority of women it disappears after the birth. Gestational diabetes significantly increases a woman's risk of developing type 2 diabetes.

Around 17 per cent of Australian women with gestational diabetes develop type 2 diabetes within 10 years and up to 50 per cent within 30 years. If a woman has had gestational diabetes in previous pregnancies she is more at risk of developing gestational diabetes in subsequent pregnancies.  Women with a history of gestational diabetes usually do not perceive that they will develop diabetes, despite knowing the risks associated with gestational diabetes.

Men

Men have a higher incidence of diabetes than females. More men than women are overweight or obese, increasing their risk of developing type 2 diabetes.

Other groups of Australians who are at risk of type 2 diabetes

The rate of diabetes among Aboriginal Australians is over three times that of non-Aboriginal Australians. The higher prevalence is largely due to lifestyle risk factors such as overweight, social disadvantage, smoking and poor diet.

Males from culturally and linguistically diverse (CALD) backgrounds are about 30 per cent more likely to die from diabetes (as the underlying cause) than other males. Females from CALD backgrounds are 50 per cent more likely to die from diabetes as the underlying cause than other females.

Maintaining a healthy weight, being physically active and following a healthy eating plan can reduce a person's risk of developing type 2 diabetes.

There is no cure for diabetes. Diabetes can be successfully managed.

People with diabetes need to work with a team of health care professionals, which includes their doctor, diabetes educator and dietitian. They should also work closely with their doctor for regular checks of eyes, kidneys, feet, blood pressure, blood lipids, body weight and blood glucose levels.

Maintaining a healthy lifestyle can also help reduce the risk of developing the complications of diabetes. This means being physically active most days, maintaining a healthy weight, adopting healthy eating with fruit, vegetables and low fat foods and not smoking.

People with type 1 diabetes need insulin for the rest of their lives.

Some people with type 2 diabetes can manage their condition with regular physical activity, healthy eating and loss of excess weight. Others may need tablets and/or insulin injections as well.

Diabetes can only be diagnosed with a blood glucose test ordered by a GP or specialist and performed at a laboratory.

You can assess your risk for type 2 diabetes by taking the Australian Type 2 Diabetes Risk Assessment test. The tool assesses a person's risk of developing type 2 diabetes within the next five years,  based on a score for risk factors. Those with a score of 15 or more are encouraged to see their GP and to consider participating in a Lifestyle modification program, such as the Life! Program.

Take the test

1. Be registered with the National Diabetes Services Scheme (NDSS) to get cheaper diabetes supplies and information. For further information about the NDSS call the Diabetes Infoline on 1800 637 700.
2. Become a member of Diabetes Victoria to have up to date information on management, events, services and research to help you live well with diabetes. To join call our membership team on: 1300 437 386 or visit the membership page.
3. If you or your family needs a lot of medicines in a year sign up for the Pharmaceutical Benefits Scheme (PBS) SafetyNet.
4. Talk with your local chemist/pharmacist, visit the Medicare website or call PBS Infoline on 1800 552 152
5. Talk with your local chemist/pharmacist about generic medicines that cost less. Also ask them if they offer a cheaper price if you buy in bulk, for example a 3 month supply of your medicine.
6. Shop around for the best price on non-PBS scripts.
7. Call the Medicines information line with the National Prescribing Service (NPS) on: 1300 633 424 (1300 MEDICINE). NPS works to give you information on your prescription, over-the-counter and complementary medicines.This service is available Monday to Friday 9am–5pm AEST for the cost of a local call. Calls from mobiles may cost more.
8. Ask your local doctor about the Home Medicines Review Service. They can help if you are/have:

• Taking five or more medicines
• Taking more than 12 doses of medicine a day
• Have had major changes in your medicines over the last three months, including just coming out of hospital
• The medicines you are taking require a health professional to keep a close eye on you to see that they are working
• Have had a reaction to a medicine
• Need help to manage your medicines because of your health, for example, not able to see so well
• Need help to read or understand English
• Seeing many doctors at the same time

Diabetes Victoria Helpline 1800 637 700

To obtain information on a lifestyle course to prevent type 2 diabetes ring 13 RISK (13 7475).