Diabetes Basics: Understanding
Diabetes is a disease that currently
affects over one million people across Australia, and
the numbers are on the rise. However, although diabetes
is so widespread, many of us don’t have a good
basic understanding of the disease or how to manage
Even if you don’t have
diabetes yourself, you are likely to know someone who
does, and it's good to be familiar with the basics.
This two-part guide explains the basics of diabetes
and diabetes management in easy-to-understand terms.
For the second part of the guide click on the link for
Diabetes Basics: Management and treatment at the end
of the article.
What is diabetes?
The diabetic condition is one in which the body doesn’t
produce or properly use insulin and therefore cannot
let glucose (converted from carbohydrates) into the
cells for energy.
- Carbohydrates are the body's primary source of energy.
Although the body can use protein, fats and carbohydrates
for energy, it is the carbohydrates that trigger a
more dramatic insulin release and response. Here's
what happens to carbohydrates in your body if you don't
- When you eat a food containing carbohydrates, the
carbohydrates are converted to glucose and released
into the bloodstream.
- The glucose then wants to
get into the body’s
cells to give them energy. However, the glucose cannot
just enter the cells – it needs a "key" to
unlock the cell "door", and insulin carries
- Therefore, when glucose levels in the bloodstream
get high enough, the pancreas releases some insulin
to go and unlock the cells so that the glucose can
get in and give energy to the cells.
If you do have diabetes, the process fails at one of
- In Type 1 diabetes, the pancreas does not produce enough
- In Type 2 diabetes, the cell’s
keyholes are not the right shape for the insulin
Either way, glucose cannot enter the cells and so remains
in the blood stream.
What is hyperglycemia?
When glucose remains in the blood stream, glucose levels
get too high; this is called hyperglycemia - also known
as high blood-glucose (sugar).
The body tries to combat hyperglycemia
by pulling water out of the body’s cells and
sending it into the bloodstream. In the bloodstream,
the water dilutes the high glucose and then excretes
it in the urine. This produces symptoms of frequent
urination, continual thirst, and tiredness. At the
same time, the cells remain starving for glucose and
send signals to the body to eat more food. People with
diabetes are thus often very hungry.
Checking your blood sugar count regularly and then treating
high blood-glucose early can help you detect and avoid
If you don't treat hyperglycemia quickly, a serious
condition called ketoacidosis can occur. This occurs
when your body does not have enough insulin. To make
more, your body tries to break down fats into glucose.
However, this produces waste products called ketones.
Your body cannot tolerate large amounts of ketones and
tries to remove them through the urine. Unfortunately
your body cannot remove all of the ketones this way and
they can build up in your blood. This excess of ketones
in your blood can lead to ketoacidosis. This is a life-threatening
condition that needs to be treated immediately.
What health problems occur as a result of diabetes?
Many health problems can occur as a result of
In the short term, there is ketone damage, extreme thirst,
exhaustion, nausea, and slow healing of wounds.
If diabetes remains untreated and the blood-glucose
level stays high for many years, damage to nerves and
blood vessels can occur. This in turn leads to the more
serious complications associated with diabetes such as:
- High blood pressure
- High cholesterol
- Heart failure
- Eye diseases including diabetic retinopathy,
- Foot ulcers leading to amputations
- Renal disease
What is the difference between Type 1 and Type 2 diabetes?
most important difference between Type 1 and Type 2 diabetes
is that Type 2 diabetes is preventable. Although it has
a genetic basis, Type 2 diabetes is very dependent on
environmental factors. The misshapen "key
holes" in Type 2 diabetes which stop insulin from
entering the cells are almost always caused by excess
fat or inactivity; in fact 90 percent of people with
Type 2 diabetes are overweight or obese. Losing weight
and increasing physical activity can help treat or
prevent Type 2 diabetes in most cases.
Type 1 diabetes, on the other hand, is a hereditary
condition where the problem is lack of insulin. Type
1 diabetes must be managed through insulin injections
as well as carefully-monitored eating and regular exercise.
Although the causes of Type 1 and 2 diabetes are different,
both forms of the disease are equally serious and have
equally serious consequences if left untreated.
There is also a third type of diabetes called gestational
diabetes. Gestational diabetes occurs during pregnancy,
but with proper management the condition usually resolves
itself after the baby is born. Gestational diabetes occurs
in about eight percent of pregnancies.
|Type 1 Diabetes
||Type 2 Diabetes
- 10 - 15 percent of diabetes cases are Type
- Usually occurs in children and young adults.
- There are strong genetic links, however something
such as a viral infection is required to trigger
the immune system to destroy the insulin-making
cells in the pancreas. This is called an autoimmune
- As the pancreas cannot produce insulin, Type
1 diabetes is managed with daily insulin injections.
- It is important to eat healthy meals spread
evenly throughout the day, and to carry out
regular physical activity.
- 85 - 90 percent of diabetes cases are Type
- Usually occurs in adults, however more younger
people are now starting to develop Type 2 diabetes.
- Associated with lifestyle factors, especially
high blood pressure, high cholesterol, and
the classic ‘apple shape’ body
where there is extra weight around the waist.
- Insulin is produced, but is not working as
well as it should be which requires the body
to produce more insulin. The body has trouble
getting the balance right, leading to Type
- Type 2 diabetes is managed with a healthy
diet and regular exercise. Sometimes medications
(tablets or insulin injections) may be required.
- Usually develops abruptly
- Frequent urination
- Continual thirst
- Rapid weight loss
- Unusual hunger
- Extreme weakness/fatigue
- Nausea, vomiting, irritability
- Usually develops gradually
- Any Type 1 symptom
- Excessive itching
- Skin infections
- Slow healing of wounds
- Blurred vision
- Tingling/numbness in feet
- Blurred vision
Who gets diabetes?
Type 1 diabetes is mostly genetic
and usually occurs in children or young adults. Researchers
believe that in Type 1 diabetes the body’s immune
system is somehow environmentally triggered to destroy
the cells in the pancreas that produce insulin. But
why this happens is not understood.
Overweight and inactive adults are the people most likely
to develop Type 2 diabetes. Obesity, a family history
of diabetes, aged over 55 years, high blood pressure,
a previous diagnosis of gestational diabetes, delivery
of a baby over 4.5 kg, and pre-diabetes (see the section
'What is pre-diabetes?' on the next page) are also common
factors in people predisposed to the disease. Those aged
over 35 years and of Aboriginal, Torres Strait Islander,
Pacific Islands, Indian subcontinent or Chinese cultural
background also have an increased risk of Type 2 diabetes.
How do I know if I have diabetes?
Cramps or burning sensations in your feet could signal
diabetesDiabetes is first diagnosed by symptoms. Urine
tests and blood tests are then used to confirm a diagnosis.
Symptoms can develop suddenly in healthy children or
adults, and gradually over several years in overweight
adults. If you have any of the following symptoms you
should see your doctor for testing:
- Increased thirst
- Unusually frequent hunger
- Frequent urination
- Unusual fatigue
- Blurred vision
- Cramps or burning sensation in your
feet and/or legs
- Unexplained weight loss
- Nausea or vomiting
- Sores that do not heal
- You should see your doctor
for a blood-glucose test at least once every three
What is pre-diabetes?
Pre-diabetes, also called glucose
intolerance, is a condition in which a person's blood
glucose levels are higher than normal but not high enough
for diagnosis of Type 2 diabetes. It is estimated that
1 in 4 Australians have pre-diabetes or diabetes.
Left unmanaged, pre-diabetes can develop into Type 2
diabetes. Lifestyle improvements, including better diet
and more exercise, can prevent pre-diabetes from turning
into this more serious condition.
What is silent diabetes?
Have your blood-glucose level checked by a doctor every
three yearsFor every person who has been diagnosed with
diabetes, there is also someone who has it but remains
undiagnosed - in Australia, that's over 500,000 undiagnosed
This is because many of the symptoms can initially be
very mild or ignored. It is also possible to have very
high blood-glucose levels, with damage to the body occurring,
yet not feel unwell. This is called silent diabetes.
It is still important to treat these cases, though, because
research has shown that good control of blood glucose
levels prevents or lessens the likelihood of the complications
of diabetes. Therefore, you should have your blood-glucose
level checked by your doctor every three years.
Prevention is the best cure for Type 2 diabetes; this
fact can't be emphasised enough. Diabetes Australia recommends
a well-balanced diet and regular exercise to greatly
reduce your risks of pre-diabetes and Type 2 diabetes.
Remember – this one is up to you. Don’t just
sit around waiting for diabetes to happen, take action
before it does.
Of course, for many people, making the change to eating
more healthily and exercising more often can be a very
difficult one. If you know that you need to make changes
to your current lifestyle but are struggling for motivation
and support, talk to a health professional: it is a lot
easier with support and guidance. A dietitian, doctor
or diabetes educator will help you to get on track with
healthy living in order to prevent Type 2 diabetes.
If you haven’t done so
already, take a good look around CalorieKing.com.au
for lots of information, ideas, support and tools for
effective weight control. Also talk to existing members
in our community Forums to find out how CK has helped
them make important lifestyle changes.
Please note: This article is for informational purposes
only and is not intended to replace professional medical
advice. Please see your doctor immediately if any of
the following occurs:
- Your blood glucose level is consistently high or
low even though you are taking your insulin/medications
- Your symptoms worsen
- You get chest pain, vision problems,
sweatiness or numbness
Reproduced with permission from CalorieKing.com.au. All material copyright CalorieKing.com.au