Therapy Options

Diabetes: the statistics

According to Diabetes Australia, there are¹:

Around 1.7 million Australians diagnosed with diabetes
1.2 million known and registered with diabetes
Up to 500,000 undiagnosed people with Type 2 diabetes (estimated).

A quick overview

The term diabetes mellitus applies to several disease states. Hyperglycaemia, high blood glucose, is the main symptom of all types of diabetes. However, its cause differs, depending on the type of diabetes that the patient has been diagnosed with. Therefore, the most current classification system organises the types of diabetes according to the various causes.

The exact cause of diabetes is unknown, although both genetic and environmental factors, as well as lifestyle issues (for example, obesity and lack of exercise) appear to play roles. There are two major types of diabetes: Type 1 and Type 2.

Type 1 diabetes

Type 1 diabetes is an autoimmune disease that causes the body’s immune system to mistakenly attack and destroy the insulin producing beta cells of the pancreas. It is a chronic, lifelong disorder with no known cure. The onset of the symptoms often appears to be abrupt, however, research studies² show that the autoimmune pathologic process actually begins years before the physical signs and symptoms suddenly become evident. Some of the most obvious and common symptoms at onset include increased thirst, increased hunger, frequent urination, and weight loss.

According to the Juvenile Diabetes Research Foundation (JDRF), in Australia, Type 1 diabetes accounts for around 95% of the diabetes found in children³.

Type 1 Diabetes: signs and symptoms

Some of the common symptoms of Type 1 diabetes are:

Increased thirst and frequent urination
Weight loss
Extreme hunger
Vomiting
Abdominal pain
Fatigue.

Exogenous insulin is pharmacologically produced insulin and can be administered using insulin syringe, pen or pump
Patients with Type 1 diabetes use glucose meters,and ketone strips to monitor their blood glucose and ketone levels in their day-to-day management of diabetes
Most individuals with Type 2 diabetes present with dyslipidaemia and/or hypertension. (Note: Because these individuals have a much greater risk for developing cardiovascular disease, many health care professionals often place more focus on treating these conditions than treating the hyperglycaemia).
Children of individuals with Type 2 diabetes have a 30% increased risk of developing impaired glucose tolerance, or prediabetes, and a 15% increased risk for developing Type 2 diabetes.^4,5

Women with Type 1 diabetes may also stop menstruating. These signs and symptoms manifest suddenly and severely upon onset.

Type 2 Diabetes

Type 2 diabetes accounts for approximately 85% of the diabetes population.¹ While its exact cause is not known, patients with Type 2 diabetes do not suffer from the autoimmune destruction of beta cells. Although it’s a progressive disease, most patients continue to produce insulin for a long time after diagnosis. Many continue to produce insulin throughout their lives and may need external insulin only at a later stage.

Type 2 diabetes: Signs and symptoms

Type 2 diabetes patients see many harmless symptoms initially, which takes longer to diagnose. Symptoms of hyperglycaemia are similar to that of Type 1 diabetes:

Increased thirst and frequent urination
Extreme hunger
Fatigue
Blurred vision.

Other problems may occur at a later stage, including low healing process or tingling and numbness in the hands or feet. Men with Type 2 diabetes may also experience erectile dysfunction.

Risk Factors

There are many factors that may increase the risk of developing either type of diabetes. These include:

Family history
Ethnicity
Certain viral infections
Weight
Inactivity
Age
Prediabetes (a condition in which the blood sugar level is higher than normal)
Gestational diabetes (diabetes that develops during pregnancy).

Treatment

There are several ways you can help patients manage their glucose levels.

Diet and exercise: This is particularly useful for patients with Type 2 diabetes. You could consider prescribing a diet and exercise regime, which, along with nutrition counselling and behaviour modification with a diabetes educator or dietician, will go a long way to helping patients keep their glucose level under control.

Oral therapy: If diet and exercise are insufficient, oral medications can be prescribed.

Multiple Daily Injections (MDI): Technically defined as the administration of three or more injections of insulin a day, the MDI regimen consists of a minimum of four injections per day.

Insulin Pump Therapy: This therapy mimics the functions of a normal pancreas more closely and replaces the need for frequent injections by delivering precise doses of rapid-acting insulin.

Sensor Augmented Therapy: There are three main components to Sensor Augmented Therapy: a “smart” Insulin Pump, a Continuous Glucose Monitoring (CGM) system and therapy management software.

1. Diabetes Australia website https://www.diabetesaustralia.com.au/diabetes-in-australia

2. American Diabetes Association. (1998). Medical Management of Type 1 Diabetes Vol 1 (3rd ed.). Alexandria, Virginia: Author

3. http://jdrf.org.au/what-is-type-1-diabetes

4. International Diabetes Federation. (2009). Facts & Figures. Retrieved on July 17, 2009, from www.idf.org

5. Centers for Disease Control. (2007). National Diabetes Fact Sheet. Retrieved on July 17, 2009, from www.cdc.gov