What causes type 2 diabetes?

Diabetes runs in the family – if you have a family member who has diabetes you will have a genetic predisposition to diabetes.

Additionally, the risk of developing diabetes increases with certain lifestyle factors that may influence blood pressure, being overweight or obese (in Australia the healthy weight body mass index (BMI) is between 18.5-24.9). BMI is calculated by dividing weight by the square of height: weight (kg)/height (m)². Other modified lifestyle factors include insufficient physical activity/sedentary lifestyle, poor diet, and the class apple shape body where the extra bodyweight is carried around the waist. Diabetes Australia have a simple online tool to help determine your own risk. Take a couple of minutes after reading this post to check your own risk. Click here to access the link and complete the Risk Calculator.

Amputations and Diabetes

The Australia Commission on Safety and Quality in Health Care published a report in 2016 indicating that there are more than 4,400 amputations every year in Australia as a result of diabetes. This gives Australian the silver medal in regards to the rest of the world, for the second highest rate. Many of these amputations are the direct result of foot ulcers and lower limb wounds. For those readers who don’t know – diabetes effects your circulation. It has been found that patients with diabetic foot ulcers have morbidity and mortality rates on par with aggressive forms of cancer. A way to mitigate risk of developing or worsening of diabetic related symptoms is having a qualified team of health professionals around you. This includes diabetes educators, podiatrists, and other allied health services to ensure you or someone you know with diabetes – gets the care they need.

Who do you know that has Diabetes?

Based on figures from 2020, approximately 1.3 million Australian’s were living with diabetes. This was roughly 1 in 20, at the time. This proportion of people were represented by those with type 1 diabetes, type 2 diabetes, and other forms of diabetes. However, excludes gestational diabetes (diabetes developed during pregnancy). These figures only represent those who actually have a formal diagnosis. There is evidence to support that many people live with undiagnosed forms of diabetes. So the aforementioned statistics likely underestimate the true diabetes prevalence in Australia.

Hospitalisations of missed warning signs in Type 1 diabetics

A study published in the American Journal of Forensic Medicine and Pathology identified that 640 people per year are hospitalised due to potentially life-threatening health complications as a result of missed warning signs of type 1 diabetes. Additionally, some people who present to emergency departments aren’t necessarily aware that they have diabetes. Some are diagnosed after arriving for what they thought was the result of some other medical ailment. A study conducted on ~4,800 patients from an emergency department in South Western Sydney corroborated these findings, particularly in those ≥60 years of age.

A proven way to mitigate late diagnoses of type diabetes is through education. A study published by the journal of Paediatric Diabetes found that awareness campaigns reduced the number of people in diabetic ketoacidosis (DKA) by more than 60%. DKA is a life-threatening complication of diabetes.

The 4Ts

The early warning signs of type 1 diabetes can be summarised by the 4T’s. These are:

• Tired – unexplained or excessive fatigue
• Thirsty – A thirst that can’t be quenched
• Thinner – sudden or unexplained weight loss
• Toilet – going to the toilet a lot

Figure 1: The 4T’s – Image from Diabetes Australia

These signs and symptoms don’t automatically mean you have type 1 diabetes. Let’s just make that crystal clear. However, if you have a family history of diabetes, the above ‘T’s’ remain constant, ≥60 years of age and/or these occur often, it may be worth catching up with your General Practitioner and start the conversation. At the end of the day if a trip to the GP results in a negative diabetes diagnosis than that is an advantageous outcome.

What’s the different between type 1 and type 2 diabetes?

Type 1 diabetes mellitus is caused by autoimmune destruction of pancreatic B cells and is defined by an absolute insulin deficiency. It usually becomes apparent in childhood or teenage years, and survival depends on exogenous insulin replacement after each carbohydrate-containing meal. Exogenous insulin replacement is the medical phrase used referring to the insulin people inject or infuse via an insulin pump.

Type 2 diabetes mellitus (T2DM) is associated with insulin resistance in target tissues and pancreatic compensation with high plasma insulin levels. It typically occurs in mature-aged people. T2DM is diagnosed when the pancreas is unable to maintain sufficiently high levels of insulin to allow for the peripheral uptake of glucose, resulting in hyperglycaemia. This situation is referred to as a ‘relative’ insulin deficiency. For those who don’t know, hypERglycaemia is high blood sugar and hyPOglycaemia is low blood sugar. A way I think of it is ‘PO’ equals ‘LOW’.

Other rarer forms of diabetes mellitus include mature-onset diabetes in the young, late (also commonly, latent) autoimmune diabetes in adults and gestational diabetes. For the purposes of this article we will refer to the two main categories of diabetes mellitus, T1DM and T2DM.

Diabetes, Healthy Weight, and Exercise

If you have diabetes it’s going to be really important for you to monitor your food and fluid consumption. Ideally, consuming a wide variety of nutritionally valuable foods is recommended. Rather than just me saying “eat healthy foods”.. I would typically refer/prefer to say “eat nutritionally valuable foods”. This is more specific to foods and drinks that contain sufficient varieties of both macronutrients and micronutrients. This also allows and individual to see through common marketing tactics that may use words such as ‘super-food’ or ‘power-food’, as these statements are vague and non-specific.

Regarding physical activity, being as active as possible for at least 30mins per day of moderate physical activity would typically be the recommendation for most people based on the Australian Physical Activity Guidelines. For those wanting to lose weight, you may require more than this – however, if there can be a consideration of food intake, you may not need to do this. This is where working with your Nutritionist, Exercise Physiologist, and General Practitioner can help you achieve this.

To find out more about how to manage your diabetes, feel free to book online to see our Nutritionist or Exercise Physiologist. Alternatively, you can call us on 07 3398 7022.