MSWA2016302 Network Magazine Spring 16 v4

Overview on
type 2 diabetes
Limit foods high in energy such as takeaway foods, sweet
biscuits, cakes, sugar sweetened drinks and fruit juice,
lollies, chocolate and savoury snacks. Some people have a
healthy diet but eat too much. Reducing your portion size is
one way to decrease the amount of energy you eat. Being
active has many benefits. Along with healthy eating, regular
physical activity can help you to manage your blood glucose
levels, reduce your blood fats (cholesterol and triglycerides)
and maintain a healthy weight.
Exercise
Everybody benefits from regular exercise. For people
who have diabetes, or are at risk of diabetes, it plays an
important role in keeping them healthy.
For a person with diabetes, exercise helps:
• insulin to work better, which will improve your diabetes
management;
• maintain a healthy weight;
• lower your blood pressure;
• reduce your risk of heart disease; and
• reduce stress.
Type 2 diabetes is a progressive condition in which the body
becomes resistant to the normal effects of insulin and/or
gradually loses the capacity to produce enough insulin in the
pancreas. We do not know what causes type 2 diabetes,
but it is associated with several modifiable lifestyle risk
factors. Type 2 diabetes also has strong genetic and family
related risk factors.
It is diagnosed when the pancreas does not produce enough
insulin (reduced insulin production), the insulin does not
work effectively, and/or the cells of the body do not respond
to insulin effectively (known as insulin resistance).
Type 2 diabetes represents 85 to 90 percent of all cases
of diabetes. It usually develops in adults over the age of 45
years but is increasingly occurring in younger age groups
including children, adolescents and young adults. It is more
likely in people with a family history of type 2 diabetes or
from particular ethnic backgrounds.
For some people the first sign may be a complication
of diabetes such as a heart attack, vision problems
or a foot ulcer.
Type 2 diabetes is managed with a combination of regular
physical activity, healthy eating and weight reduction. As
type 2 diabetes is often progressive, most people will need
oral medications and/or insulin injections in addition to
lifestyle changes over time.
What happens with type 2 diabetes?
Type 2 diabetes develops over a long period of time.
During this period, insulin resistance starts and this is
where the insulin is increasingly ineffective at managing the
blood glucose levels. As a result of this insulin resistance,
the pancreas responds by producing greater and greater
amounts of insulin to try and achieve some degree of
management of the blood glucose levels.
As this over production of insulin occurs over a very long
period of time, the cells in the pancreas that produce
insulin wear themselves out, so that by the time someone
is told that they have type 2 diabetes, they have lost
50-70% of those insulin producing cells. This means that
type 2 diabetes is a combination of ineffective insulin and
not enough insulin. It is a progressive condition and the
progression is related to the ongoing destruction of the
cells in the pancreas that produce insulin.
Type 2 diabetes can often initially be managed with healthy
eating and regular physical activity. However, over time most
people with type 2 diabetes will also need tablets and many
will also need insulin. It is important to note that this is just
the natural progression of the condition, and taking tablets
or insulin as soon as they are required can result in fewer
long term complications.
What causes type 2 diabetes?
There is no single cause of type 2 diabetes, but there are
well established risk factors. Some of the risk factors can be
controlled and others people are born with. People are at a
higher risk of getting type 2 diabetes if they:
• have a family history of diabetes;
• are older (i.e. over 55 years of age) as the risk increases
as we age;
• are over 45 years of age and overweight;
• are over 45 years of age and have high blood pressure;
• are over 35 years of age and are from the Pacific Islands,
the Indian subcontinent or Chinese cultural background; and
• have given birth to a child over 4.5 kg, had
gestational diabetes when pregnant, or have
Polycystic Ovarian Syndrome.
Symptoms
In type 2 diabetes many people have no symptoms at all.
As type 2 diabetes is commonly, but not always, diagnosed
at a later age, signs are sometimes dismissed as a part of
getting older. In some cases, by the time type 2 diabetes is
diagnosed, the complications of diabetes may already be
present. Symptoms include:
• being excessively thirsty
• passing more urine
• feeling tired and lethargic
• always feeling hungry
• having cuts that heal slowly
• itching / skin infections
• blurred vision
• gradually putting on weight
• mood swings
• headaches
• feeling dizzy
• leg cramps.
Eating Well
Healthy eating and an active lifestyle are important for
everyone, including people with diabetes. Having a healthy
diet and being active is an important part of managing
diabetes because it will help manage the blood glucose
levels and body weight.
Meals that are recommended for people with diabetes are
the same as for those without diabetes; there is no need to
prepare separate meals or buy special foods.
Everyone including family and friends can enjoy the
same healthy and tasty meals together. As a guide, it is
recommended people with diabetes follow the Australian
Dietary Guidelines - Healthy Eating for Adults and Children.
What should be eating?
Eating the recommended amount of food from the five food
groups will provide you with the nutrients you need to be
healthy and prevent chronic diseases such as obesity and
heart disease.
To help manage your diabetes:
• Eat regular meals and spread them evenly throughout
the day
• Eat a diet lower in fat, particularly saturated fat
• If you take insulin or diabetes tablets, you may need
to have between meal snacks
• It is important to recognise that everyone’s needs are
different. For individualised advice, all people with
diabetes should see an Accredited Practicing Dietitian
in conjunction with their diabetes team.
Energy balance
Matching the amount of food you eat with the amount of
energy you burn through activity and exercise is important.
Putting too much fuel in your body can lead to weight gain.
Being overweight or obese can make it difficult to manage
your diabetes and can increase the risk of heart disease,
stroke and cancer.
Taking care of the feet
Ulcers or other lesions on the feet are a serious danger for
people with diabetes. It is important to avoid foot damage
especially for middle-aged and elderly people.
It is important to:
• always inspect your feet before and after exercise
• avoid exercise that causes stress to the feet (e.g. running)
Exercise which poses minimal weight or stress on the feet
is ideal i.e. riding an exercise bike or brisk walking in good
footwear. Wear comfortable and well-fitting shoes. See a
podiatrist for foot care and advice.
Maintaining a healthy weight
One of the most important aspects of diabetes management
is to maintain a healthy body weight. Being overweight not
only increases the risk of heart disease, stroke and some
cancers, it also makes diabetes harder to manage. Small
changes in diet such as reducing portion sizes and swapping
to low fat dairy products, can help to achieve a healthy body
weight and manage diabetes.
A small weight loss (5-10% of body weight) can make a big
difference to diabetes management and, as a consequence,
reduce the risk of developing complications like heart
disease, stroke and some cancers. If there is a risk of
pre-diabetes (impaired fasting glucose or impaired
glucose tolerance), losing 5-10% of a person’s current body
weight can prevent type 2 diabetes in up to nearly 6 out of
10 people.
Article Credits:
Diabetes Australia
Dee Lucey, Community Access Nurse
12 Spring 2016 The MS Society of South Australia & Northern Territory The MS Society of South Australia & Northern Territory Spring 2016 13