Everything you need to know about type-2 diabetes

What is type 2 diabetes?

Insulin is a hormone that helps us metabolise the glucose in food, but this does not function normally in people with type 2 diabetes, and the result is higher-than-normal blood glucose levels (also known as ‘blood sugar levels’), which over time damages blood vessels and nerves. This in turn, can lead to heart problems, strokes, eye damage, kidney problems, and foot and leg problems.

Type 2 diabetes occurs when people either produce some insulin but not enough, or their insulin doesn’t work as well as it should, because their body has become 'resistant' to it. People with type 1 diabetes, on the other hand, do not produce any insulin, relying on daily insulin injections instead.

You can reduce your likelihood of developing type 2 diabetes by being physically active, following a healthy, balanced and varied diet, and not being overweight. Once you have it, it cannot be cured but your chances of developing complications can be reduced by making some lifestyle changes and taking medication.

What are the signs and symptoms of Type 2 diabetes?

People with diabetes may feel tired and thirsty, they may find they are passing urine more often, have blurred vision, lose weight, suffer from recurring infections (like thrush for example) and find that sores take longer to heal.

However, these symptoms don’t usually develop until blood sugar levels are very high, and they often come on so slowly for people with type 2 diabetes that they don't notice them. As a result, many people don’t even know they have type 2 diabetes and it can go undiagnosed for many years, by which stage, complications may have already developed.

Diagnosis:

Given the seriousness of type 2 diabetes, early diagnosis is very important. You can help to identify whether you’re at risk of developing type 2 diabetes by being familiar with the common risk factors. One of the most important is being overweight or obese. Others include:

• Eating a poor diet;
• Having high blood pressure;
• Having high cholesterol;
• Smoking;
• A family history of diabetes;
• Being physically inactive (e.g. not exercising for at least 30 minutes per day on five or more days each week); and
• Being of Aboriginal, Torres Strait Islander, Pacific Islander or Maori descent.

An online test is available to help you predict your level of risk, called ‘AUSDRISK’. The test also provides a course of action based on your estimated risk. See Additional Resources and Information for the link.

If you are identified as being at risk, or if you are experiencing symptoms of high blood sugar such as those listed above, your doctor will usually check for diabetes by doing a blood test. There are three types of blood test used:

• A fasting plasma glucose (FPG) test, which measures blood glucose in a person who has not eaten anything for at least 8 hours. This is the most common type of test used for diagnosis.
• A random plasma glucose (RPG) test which measures blood glucose at any time without regard to when a person last ate.
• An oral glucose tolerance test (OGTT) which measures blood glucose in the fasting state, and at regular intervals over a 2 hour-period, after a person drinks a glucose-containing beverage. This test is only used to confirm a diagnosis, when a FPG or RPG test result is inconclusive.

If you have symptoms of high blood glucose, then one FPG or RPG is generally sufficient to make a diagnosis. If you have an abnormal test result but no symptoms, however, you may need to have a second test (preferably an FPG) on a different day, to confirm your diagnosis.

Treatment:

Because diabetes cannot be cured, the aim of treatment is to prevent disease complications, by controlling blood glucose levels and other risk factors, such as high blood pressure, cholesterol and obesity.

Complementary medicine and lifestyle approaches:

If you’ve been diagnosed with type 2 diabetes, you can get a head start on your health by making lifestyle changes, which may include:

• Eating a healthy, balanced diet;
• Regular physical activity;
• Losing weight if you are overweight;
• Not smoking; and
• Not drinking too much alcohol.

Weight management is particularly important, through healthy eating and regular exercise. These lifestyle interventions can be sufficient to control your blood glucose levels and reduce your risk of heart disease.

Learning more about type 2 diabetes and how to make positive lifestyle changes is also very important. Joining a local diabetes support group is a useful way of doing this, by allowing you to talk to, and learn from, other people with diabetes. Your doctor, community health centre, diabetes educator or local council can advise about programs and groups in your local area.

If you have type 2 diabetes, your doctor will probably refer you to other health professionals. You may be referred to a diabetes educator, a dietitian for advice on eating well, a podiatrist to care for your feet, and an optometrist to check your eyes.

Getting to know your doctor and health care team is an important part of managing diabetes. You’ll need to see your doctor frequently, and he or she will be an important source of information, advice and help. Keeping all check-up and blood test appointments will help you and your doctor keep track of how well your diabetes is being controlled, and enable any problems to be picked up early.

You and your GP can also set out a plan of action for your health, called a GP Management Plan (GPMP). GPMPs are funded by Medicare, to help people with chronic medical conditions (such as type 2 diabetes) take an organised approach to managing their health needs.

Traditional medicine-based treatment:

Medications are also an important treatment for type 2 diabetes. Even if you don’t require it initially, because type 2 diabetes progresses, you are likely to need medication at some stage in life.

Many people will need to take several different medicines in order to:
• Lower blood glucose levels (for example insulin, or oral tablets such as metformin); and
• Help prevent or treat cardiovascular problems, such as aspirin (in a low dose), blood-pressure-lowering medicines, and/or cholesterol-lowering medicines.

If you have type 2 diabetes, you may also need to monitor your blood glucose levels by testing them yourself, as often as needed. Registering with the National Diabetes Services Scheme (NDSS) will enable you to buy cheaper glucose testing strips, and receive free needles (for insulin injection pens) and syringes. The NDSS also provides information and support services on managing diabetes. Registering is free. See Additional Resources and Information for the link.

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