Diabetes (type 1 and 2)
Understanding Type 1 Diabetes
Type 1 diabetes is a chronic autoimmune condition where the body’s immune system attacks insulin-producing cells in the pancreas. This leads to little or no insulin production, causing high blood sugar levels. It can develop at any age but is most commonly diagnosed in children, teens, and young adults.
Risk Factors for Type 1 Diabetes
While the exact cause of type 1 diabetes is unknown, several risk factors can increase the likelihood of developing the condition:
- Family History: Having a parent or sibling with type 1 diabetes slightly increases the risk.
- Genetics: Certain genes are associated with a higher risk.
- Virus exposure: Autoimmune diseases including type 1 diabetes often occur after a viral illness.
- Geography: The incidence of type 1 diabetes increases as you move away from the equator.
- Age: It is more common in children and young adults, with two peak periods: ages 4-7 and 10-14.
Recognising the Symptoms of Type 1 Diabetes
Symptoms of type 1 diabetes can appear suddenly and may include:
- Increased thirst and frequent urination
- Extreme hunger
- Unintended weight loss
- Fatigue and weakness
- Blurred vision
- Irritability and mood changes
Diagnostic Methods for Type 1 Diabetes
Diagnosis typically involves several blood tests:
- Glycated Hemoglobin (HbA1C) Test: Measures average blood sugar levels over the past 2-3 months
- Random Blood Sugar Test: A blood sample taken at a random time; a level of 11.1 mmol/L or higher suggests diabetes.
- Fasting Blood Sugar Test: Measures blood sugar after an overnight fast; a level of 7 mmol/L or higher on two separate tests indicates diabetes.
Steps to Take if You Suspect Type 1 Diabetes
If you suspect you or your child may have type 1 diabetes, urgent healthcare review is required. Early diagnosis and treatment are crucial to managing the condition and preventing complications.
Management:
- Insulin replacement: Patients with type 1 diabetes require insulin replacement and this can be delivered through frequent injections or a continuous insulin delivery pump
- Glucose monitoring: The gold standard of care is continuous glucose monitoring through a small wearable monitor. These are now subsidised in Australia for all people with type 1 diabetes.
- Complication screening: All patients with diabetes require monitoring of complications, especially of their eyes, kidneys and feet. Managing cardiovascular disease risk factors like blood pressure and cholesterol are also critical aspects of care.
- Type 1 diabetes in pregnancy: People with type 1 diabetes can have healthy pregnancies. Optimisation of glycaemic control prior to pregnancy and frequent monitoring throughout pregnancy can decrease risks in type 1 diabetes pregnancy such as large for gestational age, pre-eclampsia and neonatal hypoglycaemia
Lifestyle:
Type 1 diabetes is not caused by lifestyle factors but the following lifestyle factors can optimise management and decrease complications.
- Healthy Diet: Focus on a balanced diet with plentiful plant foods, lean protein and quality carbohydrates
- Regular Exercise: Helps manage blood sugar levels and decrease risk of complications.
- Avoiding Smoking and Excessive Alcohol: These can negatively impact blood sugar control and increase risk of complication
Understanding Type 2 Diabetes
Type 2 diabetes is a complex condition where the body either does not respond to insulin appropriately or doesn’t produce enough insulin to maintain normal blood sugar levels. Type 2 diabetes was previously considered older onset diabetes but with increasing rates of obesity and inactivity, it is becoming increasingly common in young people. The younger the age at diagnosis, usually the higher risk of developing complications such as eye, kidney or heart disease.
Risk Factors for Type 2 Diabetes
Several factors can increase the risk of developing type 2 diabetes:
- Weight: Being overweight or obese, especially with a high waist circumference is a significant risk factor.
- Diet quality: Diets high in ultra processed foods and saturated fat increase risk of type 2 diabetes
- Age: The risk increases with age, especially after 45.
- Family History: Having a parent or sibling with type 2 diabetes increases your risk.
- Physical Inactivity: Lack of regular physical activity contributes to the development of type 2 diabetes.
- Ethnicity: Certain ethnic groups, including First Nation Australians.
- Other Health Conditions: Conditions such as high blood pressure and abnormal cholesterol levels can also increase the risk.
- Medications: Certain drugs, especially ones used for schizophrenia can increase risk of type 2 diabetes
Recognising the Symptoms of Type 2 Diabetes
Symptoms of type 2 diabetes can develop slowly and may include:
- Increased thirst and frequent urination
- Increased hunger
- Unintended weight loss
- Fatigue
- Blurred vision
- Slow-healing sores
- Frequent infections
- Areas of darkened skin, usually in the armpits and neck
Diagnostic Methods for Type 2 Diabetes
Diagnosis typically involves several tests:
- Glycated Hemoglobin (HbA1C) Test: Measures average blood sugar levels over the past 2-3 months
- Fasting Plasma Glucose (FPG) Test: Measures blood sugar after an overnight fast
- Oral Glucose Tolerance Test (OGTT): Measures blood sugar before and after drinking a sugary liquid
- Random Plasma Glucose Test: Measures blood sugar at any time of the day
Lifestyle Changes
Managing type 2 diabetes involves making healthy lifestyle changes:
- Healthy Diet: Focus on a balanced diet with plentiful plants and whole food, lean protein and high-quality low GI carbohydrates.
- Regular Exercise: Helps improve insulin sensitivity, manage blood sugar levels and overall health.
- Weight Management: Maintaining a healthy weight is crucial for managing diabetes. Even modest (5% total body weight) weight loss can improve insulin sensitivity.
- Monitoring Blood Sugar: Regular checks to maintain target blood sugar levels, especially if people are on insulin therapy.
Management of Type 2 Diabetes
Effective management of type 2 diabetes involves a combination of medical treatments and lifestyle adjustments:
- Medications: Most medications work by improving insulin sensitivity and increasing insulin production. Newer diabetes treatments including the classes SGLT-2 inhibitors improve blood glucose levels but also have evidence for decreasing risk of heart disease, kidney disease, strokes and liver disease.
- Dietary Changes: Dr Smith usually recommends a Mediterranean type diet approach for patients with type 2 diabetes as it has an abundance of evidence for decreasing risk of heart disease, diabetes and obesity. Dr Smith can help work with your specific dietary requirements to optimise diabetes management and overall health.
- Exercise Routine: Developing a regular exercise routine that fits your lifestyle and helps maintain blood sugar control.
- Regular Monitoring: Ongoing monitoring of blood sugar levels and symptoms is essential to adjust treatment plans as needed.
- Education and Support: Participating in diabetes education programs and support groups to stay informed and motivated.
Dr Smith's Blog Posts on Diabetes
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