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Diabetes is a condition where the body has difficulty controlling the level of glucose (sugar) in the blood. It occurs when the body does not make enough insulin or when the insulin that is made is not working properly. This leads to increased blood glucose levels and diabetes. There are three different types of diabetes, Type 1 diabetes, Type 2 diabetes and gestational diabetes. Some people have impaired glucose tolerance or insulin resistance and may be able to delay or avoid the onset of Type 2 diabetes if they modify lifestyle risk factors. There are over 225,000 people in New Zealand with Type 1 or Type 2 diabetes and the number is growing.

What Is Diabetes?

    Type 1 diabetes is usually diagnosed in childhood or adolescence. In Type 1 diabetes, the pancreas does not produce insulin because the cells that make the insulin have been destroyed by the body’s own immune system. People with Type 1 diabetes need to inject insulin every day and follow a special diet.
    Type 2 diabetes is by far the most common type of diabetes, affecting 85-90% of people with diabetes. It usually affects older adults, but younger people and children are getting Type 2 diabetes. In Type 2 diabetes, the pancreas makes insulin, but the insulin does not work as well as it should, so the pancreas makes more. Eventually it can’t make enough to keep the glucose balance in control.
    Gestational diabetes occurs during pregnancy and usually goes away after the baby is born. Between 3-8% of pregnant women will develop gestational diabetes. In pregnancy, the hormones produced by the body to help the baby grow also block the action of the mother’s insulin. Gestational diabetes develops if the body is unable to produce enough insulin in response to this increased need for insulin. This form of diabetes normally resolves after pregnancy but women who have had gestational diabetes are at an increased risk of developing Type 2 diabetes later in life.

Impaired Glucose Tolerance

Impaired Glucose Tolerance (IGT), Impaired Fasting Glucose (IFG) and pre-diabetes are similar conditions where the body does not handle glucose well so that glucose levels may take extra time to return to normal values after a meal. People with these conditions usually have insulin which does not function as it should and this is called insulin resistance. These conditions are risk factors for developing Type 2 diabetes. Modifying lifestyle factors such as reducing weight if overweight and increasing exercise may delay or stop these conditions developing into Type 2 diabetes.

What Factors Increase The Risk Of Developing Type 2 Diabetes?

Family history of diabetes Overweight and obesity
Increasing age Low activity levels
Ethnicity (incidence of diabetes is higher in Torres Strait Islanders and Aborigines) High blood pressure
Polycystic Ovarian Syndrome High cholesterol
Women who have had gestational diabetes or given birth to a baby 4.5 kg Smoking

The good news is that there are lifestyle factors you can change which will reduce the risk of developing Type 2 diabetes.

Downsize your waist to less than 102 cm (men) or 88 cm (women).

Exercise for at least 2.5 hours per week.

Eat more vegetables and switch to high fibre, whole grain cereal products.

Reduce your fat intake and switch to small amounts of monounsaturated, polyunsaturated and omega 3 fats such as canola, olive oils and sunflower oil.

Type 2 diabetes shows both the dangers of drinking too much and the dangers of smoking. To help with the prevention of Type 2 diabetes, read a selection of helpful quit smoking tips and articles on how to reduce your drinking

If you’re not sure how much you’re drinking, read our blog post to help you: What is a standard drink?

Diabetes can also be related to stress, which is why it’s important to know the signs of stress as well as the best ways of managing stress.

It is still not known exactly which factors cause Type 1 diabetes, and therefore there are no recommendations to prevent it.

How Can I Tell If I Have Diabetes?

Some of the symptoms that are common between all types of diabetes include: tiredness, increased thirst, frequent urination, headaches, leg cramps, increased hunger.

The symptoms specific to Type 2 diabetes are more gradual in onset. They may also include blurred vision, skin infections, slow healing, tingling and numbness in the feet.

Diabetes is diagnosed by either a Fasting Blood Glucose or Oral Glucose Tolerance Test which are simple blood tests ordered by your doctor.

How Is Type 1 Diabetes Treated?

People with Type 1 diabetes must inject insulin at least once per day. Balancing the amount of carbohydrate foods they eat with the right amount of insulin is important to prevent blood sugar levels from going too high, or low.

How Is Type 2 Diabetes Treated?

The primary treatment for Type 2 diabetes involves adopting a healthy lifestyle. This includes healthy eating, regular physical activity and reducing those changeable risk factors, such as being overweight and smoking. It is important to self monitor blood glucose levels regularly and have regular check-ups with your GP. In some cases, if blood glucose levels remain uncontrolled by a healthy diet alone, your GP may prescribe medication and/or insulin injections.

Tips For Good Blood Glucose Control

Nutrition is important for everyone. Maintaining a healthy weight, being physically active most days and distributing small meals and snacks throughout the day without skipping meals are good for everyone’s health. If you have diabetes you may find that selecting low glycaemic index foods improves your blood sugar control. You also need to take care of your diet if you have high cholesterol or triglyceride levels or high blood pressure.

Are You At Risk?

Visit the Diabetes New Zealand website www.diabetes.org.nz for more information.

This fact sheet contains general information and is not intended as a substitute for medical advice. Please consult your healthcare professional for specific advice for your personal situation.

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Diabetes New Zealand – July 2014

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