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Managing diabetes

Diabetes is, by any measure, one of the most significant health issues facing Australia today. In 2015, more than 1.2 million Australians, or roughly five per cent of the population, reported being diabetic.

However, it’s also an issue that disproportionately affects older Australians. While around one in 20 people between the ages of 45 and 54 have diabetes, this figure grows to one in five for those aged 65 or above. So what’s behind this phenomenal increase? And how can we best treat and manage this potentially debilitating illness?

When we say diabetes, we’re actually referring to two closely linked, but quite different, diseases: Type 1 and Type 2 diabetes. Type 1 diabetes, sometimes called insulin-dependent diabetes, is an autoimmune disease typically diagnosed in childhood in which the pancreas is unable to produce enough insulin, the hormone that regulates glucose when it enters the body. There’s no known cause, although it has a strong genetic component, and sufferers must monitor their blood sugar levels and inject themselves with insulin.

Type 2 diabetes, which represents 90 per cent of the diabetes cases reported in Australia, is a rather more recent phenomenon. In Type 2 diabetes, the pancreas has produced so much insulin over an extended period of time that cells in the body stop responding to it in the usual way, a phenomenon known as insulin resistance. This is usually caused by a persistently elevated blood sugar level. This causes the insulin-producing part of the pancreas to become exhausted, eventually mimicking the effects of Type 1 diabetes. However, unlike Type 1 diabetes, the onset of Type 2 is strongly associated with lifestyle factors, like poor diet and obesity.

Reading the signs

One of the difficulties in seniors is that the early symptoms – excessive urination, persistent thirst and lethargy – are usually just part of what we call “getting old”. But it’s important to report any noticeable changes to your doctor, as the earlier Type 2 diabetes is caught, the easier it is to slow and manage its progress. Left unchecked, it can cause heart attack and stroke as well as damage to your kidneys, eyesight and bones.

If you’ve been diagnosed with Type 2 diabetes, treatment will depend on what stage the disease has been diagnosed at. In its early phases, the best and most effective prescription for Type 2 diabetes is simply to remove the risk factors that produced all that insulin in the first place. Chief among these are the sugar-rich foods and drinks so prevalent in modern diets. When you consume high amounts of glucose in a short period of time, it puts a huge amount of strain on an already exhausted insulin-producing system, thereby accelerating the decline of the pancreas. A diet rich in fresh fruit and vegetables will go a long way to improving your outlook.

If your insulin levels are markedly lower than the healthy range, you’ll likely be prescribed a range of tablets. These come in three basic forms: medicines to increase your sensitivity to insulin; medicines that increase the amount of insulin your pancreas creates; and hypoglycaemic agents – basically, tablets that slow down the rate at which glucose is absorbed into the bloodstream.

If these fail, your doctor may recommend insulin injections. 

While there’s no cure for diabetes, it has become one of our best-managed diseases. While a diagnosis is frustrating, it’s important to stay positive, follow your doctor’s advice and make the basic changes to your diet and lifestyle that will help you survive and thrive for years to come.