what is diabetes?

Diabetes is a condition in which the body cannot sufficiently convert food into usable energy. The reason for this is a lack of insulin - a hormone produced by a gland called the pancreas, or failure of the body to respond normally to insulin.

When starchy food is digested, it breaks down into glucose. This builds up in the blood stream. Insulin controls the level of glucose in the blood by helping glucose go from the bloodstream into the body's cells. Once in the cells, glucose can be used for energy or stored for future needs. With some people the above process fails to work properly and this results in the condition known as Diabetes.

The common factor in all types of diabetes is the need to keep blood glucose in the normal range. This will help reduce the likelihood of long-term health problems or 'complications'. The treatments that exist now are not a cure. Diabetes is a chronic illness. Until a cure is found, treatment must continue throughout a person's lifetime.

^ How insulin helps the body use glucose from the bloodstream for energy. Reference: Ambler, G., et al, Caring for Diabetes in Children and Adolescents.

the types

> Type 1 (or Insulin-Dependent or Juvenile Diabetes) - The pancreas ceases producing insulin. Those affected require daily insulin injections to survive.

> Type 2 (or Non-Insulin-Dependent or Mature-Onset) Diabetes - The pancreas fails to produce enough insulin to meet the body's needs or the body is unable to respond normally to insulin (insulin resistance) and the pancreas fails to produce enough insulin to meet the body's increased needs. This most commonly affects older and often overweight people.

> Gestational Diabetes - The hormonal changes in a woman's body during pregnancy sometimes cause insulin resistance and again the pancreas fails to respond adequately, blood glucose levels rise. All pregnant women should be tested for gestational diabetes. Women who have had Gestational Diabetes have a 50% risk of developing type 2 Diabetes in the near future.

type 1 diabetes

Approximately 140,000 Australians have Type 1 Diabetes. The cause of Type 1 Diabetes is not totally understood. However, it is believed that people have a genetic predisposition to developing diabetes. A trigger factor such as a virus then causes the body's own immune system to incorrectly identify the insulin-producing cells as foreign and destroy them.

Managing Type 1 Diabetes is a complex question of balance. Type 1 Diabetes is treated with multiple daily insulin injections, healthy eating, regular exercise and constant monitoring of blood sugar levels through taking small samples of blood from the fingertips.

A high blood glucose level (hyperglycaemia) causes one to feel fatigued, dehydrated and ill. The kidneys filtering the blood collect more glucose than usual. This glucose must be removed from the body. You pass a lot of urine. You need more water, get thirsty and drink a lot. People with Type 1 diabetes are generally able to treat hyperglycaemia by changing their insulin dose. Symptoms of hyperglycaemia are initially relatively mild. If a person becomes ill or omits their insulin dose, the body is unable to process glucose normally.

A low blood sugar level (hypoglycaemia or hypo) also affects the body. Early symptoms are sweating, shaking, rapid heartbeat and pallor. The brain, which relies heavily on glucose to operate properly, can also be affected, leading to tiredness, trouble concentrating, mood and behaviour changes and eventually possible coma. Treatment of mild hypoglycaemia involves consumption of sugary food or drink followed by something more substantial such as bread. If a mild hypo is left untreated, the blood sugar level will continue to fall, starving the rest of the body of glucose and energy and leading to serious episodes such as blacking out. In most cases, the early symptoms can be recognised and treated without further problems.

A complex balancing act! There are a large number of factors which influence blood glucose levels. They include the amount and type of food you eat, the amount of insulin you inject, all forms of exercise, drinking alcohol, and taking prescribed and recreational drugs. Many less tangible factors are also involved, often relating to the interaction of hormones in the body, such as those produced during periods of stress, anxiety and menstruation. A reliable but unpredictable part of every day life for most people!

LADA - Latent Autoimmune Diabetes of Adulthood