Diabetes Basics

What is Diabetes?

Diabetes is a chronic medical condition that results when the body stops producing a hormone called Insulin. Without insulin the body is unable to convert the carbohydrates we eat, to the glucose we need for energy.

Insulin is a hormone produced in the pancreas and helps the glucose enter the cells, without insulin the glucose stays in the blood and this is why people with diabetes have higher blood glucose levels.

What is Type 1 Diabetes?
  • Used to be called Juvenile Onset Diabetes
  • Has a rising number of adults developing Type 1 Diabetes
  • Is an autoimmune condition
  • Accounts for about 15% of people with Diabetes
  • Is the most common childhood disease in developed countries
  • Is not lifestyle related and cannot be prevented or cured
  • On the rise by 3% annually. 1 person every 4 hours in Australia is diagnosed with Type 1 Diabetes
  • Needs insulin for survival from diagnosis
Type 1 Diabetes - Symptoms, Management

Signs and Symptoms

  • Excessive thirst
  • Excessive urination
  • Nausea and vomiting
  • Abdominal pain
  • Weakness and fatigue
  • Irritability
  • Blurred vision
  • Infections
  • Unexplained weight loss

Management

Type 1 diabetes management involves achieving a balance between insulin, food, daily activity and exercise. Insulin is the only medication available at this time to help manage Type 1 Diabetes, and is given either by injection via a pen device or by needle and syringe, up to 6 injections a day, or via an insulin pump.

Insulin is matched to food intake allowing people with Type 1 Diabetes to enjoy a free diet, as those without diabetes do. A healthy diet with everything in moderation for everyone with or without diabetes is encouraged

Blood glucose levels are checked regularly every day, 4-6 times, through finger sticks or sometimes by wearing a continuous glucose monitor. Blood glucose targets are set individually and no two people will have the same insulin regime or needs.

Regular visits with diabetes team are needed, including an Endocrinologist, GP, Credentialled Diabetes Educator and Dietitian

What is Type 2 Diabetes?
  • Used to be called maturity Onset Diabetes.
  • Most common type of Diabetes, representing about 85% of people with Diabetes.
  • People who have a family history of Type 2 Diabetes, who have had Gestational Diabetes (GDM) or who have a history of Polycystic Ovarian Syndrome (PCOS) are at increased risk of developing Type 2 Diabetes.
  • A significant proportion of Type 2 Diabetes can be related to lifestyle factors such as poor diet choices and unhealthy eating habits, being overweight and lack of physical inactivity.
  • Generally affects mature adults, however more young people and children are being diagnosed.
  • Progressive condition, treated initially with lifestyle change, weight loss, tablets and eventually and injectable medication (GLP1 Receptor Agonist or Insulin).
  • Forecast that by 2030 there will be 3.3m Australians with Type 2 Diabetes.
  • 60% of Type 2 Diabetes can be prevented!
Type 2 Diabetes - Symptoms, Management

Signs and Symptoms

  • Excessive thirst
  • Excessive urination
  • Nausea and vomiting
  • Unexplained weight loss
  • Weakness and fatigue
  • Irritability
  • Blurred vision
  • Infections

Management

Type 2 diabetes is managed with healthy eating and regular physical activity. Over time, you may also need glucose lowering medications (tablets or injectable medications). As diabetes progresses, some people will need insulin injections to help keep their blood glucose levels in the target range.

 

Blood Glucose Levels (BGL)

Being able to check your BGL will help you develop the confidence needed to look after your diabetes. By monitoring your BGL, you will know immediately if your glucose level is too high (hyperglycaemia) or too low (hypoglycaemia). It is also provides your medical team with information regarding dosage adjustments for your insulin, planning your meals and if your blood glucose targets aren’t being met.

When to Check

Ideal times to check your BGL are fasting (before your first meal of the day) and no sooner than two hours after food.

There will be times, however, when you are asked to check your BGL more often. This could be for a number of reasons, such as:

  • your activity level has changed
  • you go on travelling or holiday
  • changes or adjustments have been made to your medications
  • your BGL is going too low or too high
  • you start having night sweats or morning headaches.

What Affects you BGL

Your blood glucose levels can be affected by a number of things, including:

  • food you eat
  • exercise
  • physical activity
  • medications
  • stress
  • illness
  • alcohol
Hypoglycaemia (Low BGL) - Causes, Symptoms, Treatment

Hypoglycaemia is a low blood glucose levels of 4.0mmol and under. Hypoglycaemia is a medical emergency and should be treated immediately.

Causes

Hypoglycaemia can be caused by one or a number of events, such as:

  • Delaying or missing a meal
  • Not eating enough carbohydrate (encourage all meals to be eaten including snacks)
  • Unplanned physical activity
  • More strenuous exercise than usual
  • Drinking alcohol – the risk of hypoglycaemia increases, the more alcohol you drink
  • Too much insulin
  • Stress

While these are known causes of hypoglycaemia, in 20% cases, no specific cause can be identified.

Symptoms

Symptoms of hypoglycaemia vary between individuals, but common symptoms are:

  • Weakness, trembling or shaking
  • Sweating
  • Light headedness
  • Headache
  • Dizziness
  • Tearful/crying
  • Irritability/ Aggression
  • Hunger
  • Lack of concentration/behaviour change/ confusion
  • Numbness/tingling around the lips and tongue
  • In severe cases, fitting and unconsciousness

Treatment

To treat hypos, use the 15 rule:

1. First give 15 grams of fast acting carbohydrate:

  • 1/2 can of regular soft drink (not ‘diet’) OR
  • 1/2 glass of fruit juice (poppers are great) OR
  • 6-7 jellybeans OR
  • Glucose tablets equivalent to 15 grams carbohydrate.

2. Wait 15 minutes, re check BGL.
If it isn’t rising, give another 15 grams of quick acting carbohydrate from the above list.

3. If the next meal is more than 20 minutes away, give some longer acting carbohydrate.

  • a sandwich OR
  • 1 glass of milk OR
  • 1 piece of fruit OR
  • A little packet of Tiny Teddies OR
  • 1 tub of low fat yoghurt OR
  • 6 small dry biscuits and cheese

*Please note: if there is no glucose monitor available to check BGL: feed

If unconscious:

  1. Make sure they are safe and out of harms way
  2. Do not put anything into their mouth
  3. Roll them into the recovery position
  4. Ring 000
  5. If you are trained to give Glucagon then do so, then ring 000
  6. Stay with them until the ambulance arrives