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Background information

Introduction

Diabetes is a big health problem in Australia. There are around 700,000 people with diabetes, and at least half of them are unaware they have it. Some people have type 1 diabetes, but most (85-90%) have type 2 diabetes [1].

Two causes of type 2 diabetes are:

  • Being overweight/fat
  • Not doing enough exercise

The rate of diabetes among Indigenous Australians is around 2-4 times higher than for the general population. Some reasons for this will be explained later [2].

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What is diabetes?

Diabetes is a sickness that happens when the body does not produce enough insulin (a hormone which controls the amount of sugar in our blood).

When food and drink go into the stomach, some of it is broken down into sugar - the sugar then goes into the blood. This is when the insulin is needed (a body part, called the pancreas, makes insulin). Insulin is like a key that unlocks the body cells so that the sugar can move into muscles and give you energy. Without the insulin key, the sugar stays in the blood and causes you to feel tired because you are not getting enough energy. So when you have diabetes you don’t have enough insulin and you may feel tired. Diabetes causes other problems too, which will be explained later [3].

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Types of diabetes

There are three main types of diabetes:

  • Type 1 diabetes
  • Type 2 diabetes
  • Gestational diabetes (diabetes in pregnancy)

Type 1 diabetes is most common among children and young adults. It is more serious than type 2 diabetes and requires regular injections of insulin. It is not caused by eating bad tucker or not doing enough exercise. No one is really sure why people get this sickness, but some possible reasons are given later [1].

Type 2 diabetes is much more common, and usually it is people over the age of forty who get this sickness. As stated above, it can be caused by eating too much rubbish food and not moving around or exercising enough. Some people have the sickness for many years before realising it. Once people know they have diabetes they can start eating better food and exercising more. This can lessen the sickness and in some cases cure it [8].

Gestational diabetes is the kind of diabetes that women having a baby sometimes get. The diabetes is likely to go away after she has had her baby. But it can make a woman more likely to get diabetes again later in life. Women who have had this type of diabetes need to eat good tucker and keep active, so the sickness won’t return [6, 11].

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How can people tell that they have diabetes?

When people have diabetes their blood sugar level is too high.

The normal blood sugar level (the amount of sugar in your blood) is between 4 and 7 millimoles per litre. If a person has a level above 7.8 they have diabetes. This level is measured by a special machine at your clinic [3].

Signs that a person may have diabetes:

  • Sores and boils that won't heal
  • Going to the toilet a lot
  • Feeling thirsty all the time
  • Feeling tired and weak
  • Blurry vision
  • Leg cramps and itching [12]

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How does a person get diabetes?

Type 1 diabetes

As stated above, it is not known what makes people get type 1 diabetes. Babies who are very small at birth are more likely to get this sickness. More than 80% of people with type 1 diabetes have no one in their family who has had the disease.

You could also get this sickness from:

  • Viruses
  • Some toxic chemicals
  • Not getting good food [2, 13, 14]

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Type 2 diabetes

You can get type 2 diabetes from the way you live and also from things you can’t change.

Things you can’t change

Things you can’t change that could make you get type 2 diabetes are:

  • if someone in your family has/had diabetes
  • being Indigenous
  • Getting older [1, 6]
If someone in your family has/had diabetes

If someone in your family had type 2 diabetes there is a high chance that you could get it too. This is because you have similar genes. Genes are instructions passed from parent to child that decide the make-up of the body and mind [2].

Being Indigenous

Indigenous Australians are 2-4 times more likely than the general population to get type 2 diabetes [1, 2, 15, 17, 18].

If you are over 40 you are more likely to get diabetes

As you get older, your body stops working as well as it did when you were younger. The older people get, the more likely they are to get type 2 diabetes [7].

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Things you can change

Things you can change that might stop you getting type 2 diabetes:

  • Lose weight (if you are overweight)
  • Eat less rubbish food (fatty and sweet things)
  • Do more exercise
  • Reduce your blood pressure (do more exercise, don’t smoke, drink very little alcohol) [1, 6]
Being overweight

When too much food (energy) is eaten, our bodies store it as fat. Over time, the build-up of fat will make you overweight or obese (very over weight). Being overweight may be the most important factor in causing you to get type 2 diabetes. You are even more likely to get type 2 diabetes if most of your fat is around your middle (belly). Around 40% of adults in Australia are overweight or obese [19].

Eating too much rubbish food

Eating rubbish food leads to obesity as well as high blood pressure, which can make you more likely to get diabetes.

A healthy diet should include:

  • lots of different fruit and vegetables
  • low fat milk foods (e.g. yoghurt)
  • less salt
  • less sugary foods
  • less fatty foods

A bad diet usually includes foods that have:

  • lots of salt (e.g. chips, 2-minute noodles)
  • lots of sugar (e.g. lollies, coke)
  • lots of fat (e.g. bacon)
  • not very much fibre (fibre can help you eat less because it makes you feel full) [20 - 24]
Not getting enough exercise

Not doing very much exercise (activity) means that you do not use very much energy and this can make you put on weight (get fat) [7].

High blood pressure

High blood pressure is when there is too much pressure placed on the walls of blood vessels that carry the blood around the body. This can cause damage to the heart and other parts of the body such as the kidneys, as well as help you to get diabetes [24].

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What can happen to a person who has diabetes?

If you have diabetes for a long time it can cause damage to your body. The longer you have diabetes, the more likely it is that damage will happen [1].

Having diabetes can lead to:

  • heart attack
  • stroke
  • nerve damage (loss of feeling)
  • feet problems
  • loss of muscle strength (feeling weak)
  • gut problems
  • sex problems
  • unable to control going to the toilet
  • damage to kidneys (renal failure)
  • damage to eyes (blurry vision, blindness) [1, 2, 29 - 36]

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References

1. McCarty D, Zimmet P, Dalton A, Segal L, Welborn T (1996) The rise and rise of diabetes in Australia, 1996. A review of statistics, trends and costs. Canberra: Diabetes Australia
2. Commonwealth Department of Health and Aged Care, Australian Institute of Health and Welfare (1999) National Health Priority Areas Report: diabetes mellitus. Canberra: Australian Institute of Health and Welfare
View report
3. World Health Organization (1999) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Geneva: World Health Organization
View report
4. O'Dea K (1991) Westernisation, insulin resistance and diabetes in Australian Aborigines. Medical Journal of Australia;155(19):258-263
5. Colagiuri S, Miller JCB (1997) The metabolic syndrome: from inherited survival trait to a health care problem. Experimental and Clinical Endocrinology & Diabetes;105(supplement 2):54-60
6. Commonwealth State Diabetes Forum (1999) Highlights of government support for diabetes, Australia 1999. Canberra: Commonwealth of Australia
View report
7. O'Dea K (1992) Diabetes in Australian Aborigines: impact of the western diet and lifestyle. Journal of Internal Medicine;232(103-107)
8. Health Department of Western Australia (2000) Health measures for the population of Western Australia: trends and comparisons. Perth: Health Department of Western Australia
9. Colman PG, Thomas DW, Zimmet PZ, Welborn TA, Garcia-Webb P, Moore MP (1999) Position statement: new classification and criteria for diagnosis of diabetes mellitus. Medical Journal of Australia;170:375-378
View paper
10. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (1998) Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care;26(Suppl 1):S5-S20
View paper
11. de Courten M, Hodge A, Dowse G, King I, Vickery J, Zimmet P (1998) Review of the epidemiology, aetiology, pathogenesis and preventability of diabetes in Aboriginal and Torres Strait Islander populations. Canberra: Commonwealth Department of Health and Family Services
12. Diabetes Australia (2000) Defuse diabetes. Know your risks - assessing the risk of type 2 diabetes. Perth: Diabetes Australia
13. Khan N, Couper J (1994) Low birth-weight infants show earlier onset of IDDM. Diabetes Care;17(7):653-656
View abstract
14. Colagiuri S, Colagiuri R, Ward J (1998) National diabetes strategy and implementation plan. Canberra: Commonwealth Department of Health and Family Services
15. Di Francesco A, Gillam C, Unsworth M (1999) Diabetes in Italian and Vietnamese communities: an assessment of service needs in the inner city area of Perth. Perth: Eastern Perth Public and Community Health Unit
16. Zimmet P (1992) Kelly West Lecture 1991. Challenges in diabetes epidemiology - from West to the rest. Diabetes Care;15(2):232-252
17. Carter JS, Pugh JA, Monterrosa A (1996) Non insulin-dependent diabetes mellitus in minorities in the United States. Annals of Internal Medicine;125(3):221-232
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18. Neel JV (1962) Diabetes mellitus: a "thrifty" genotype rendered detrimental by progress? American Journal of Human Genetics;14:353-362
19. Australian Society for the Study of Obesity (1995) Healthy weight Australia - a national obesity strategy. Canberra: Australian Society for the Study of Obesity
View abstract
20. Shannon C (2002) Acculturation: Aboriginal and Torres Strait Islander nutrition. Asia Pacific Journal of Clinical Nutrition;11(supplement 3):S576-S578
View abstract
21. Australian Bureau of Statistics, Australian Institute of Health and Welfare (2003) The health and welfare of Australia's Aboriginal and Torres Strait Islander people 2003. Canberra: Australian Institute of Health and Welfare and the Australian Bureau of Statistics
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22. O'Dea K, Spargo RM, Nestel PJ (1982) Impact of westernization on carbohydrate and lipid metabolism in Australian Aborigines. Diabetologia;22:148-153
23. McDermott R, Rowley KG,Lee AJ, Knight S, O'Dea K (2000) Increase in prevalence of obesity and diabetes and decrease in plasma cholesterol in a Central Australian Aboriginal community. Medical Journal of Australia;172(10):480-485
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24. O'Dea K (1994) The therapeutic and preventative potential of the hunter-gatherer lifestyle: insights from Australian Aborigines. In: Temple NJ, Burkitt DP, eds. Western diseases : their dietary prevention and reversibility. New Jersey: Humana Press:349 - 380
25. Australian Bureau of Statistics (2002) National Health Survey: Aboriginal and Torres Strait Islander results, Australia 2001. (ABS Catalogue no. 4715.0) Canberra: Australian Bureau of Statistics
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26. Braun B, Zimmerman M, Kretchmer N, Spargo R, Smith R, Gracey M (1996) Risk factors for diabetes and cardiovascular disease in young Australian Aborigines: a 5-year follow-up study. Diabetes Care;19(5):472-479
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27. Eastman RC, Keen H (1997) The impact of cardiovascular disease on people with diabetes: the potential for prevention. The Lancet;350(supplement):29-32
28. Jarrett R (1989) Epidemiology and public health aspects of non insulin dependent diabetes mellitus. Epidemiologic Reviews;11:151-171
29. Most RS, Sinnock P (1983) The epidemiology of lower extremity amputations in diabetic individuals. Diabetes Care;6:87-91
30. Nutbeam D, Thomas M, Wise M (1993) National Action Plan: diabetes to the Year 2000 and beyond. Canberra: The Australian Diabetes Society
31. Couzos S, Metcalf S, Murray R, O'Rourke S (1998) Recommendations for clinical care guidelines on the management of non-insulin-dependent diabetes in Aboriginal and Torres Strait Islander populations. Canberra: Office for Aboriginal and Torres Strait Islander Health Services, Commonwealth Department of Health and Family Services
32. Knuiman MW, Welborn TA, McCann VJ, Stanton KG, Constable IJ (1986) Prevalence of diabetic complications in relation to risk factors. Diabetes;35:1332-1339
33. Phillips CB, Patel MS, Weeramanthri TS (1995) High mortality from renal disease and infection in Aboriginal central Australians with diabetes. Australian Journal of Public Health;19(5):482-486
34. Bergstrom B, Lilja B, Osterlin S, Sundkivst G (1990) Autonomic neuropathy in non-insulin dependent (type II) diabetes mellitus. Possible influence of obesity. Journal of Internal Medicine;227:57-63
35. Australian Institute of Health and Welfare (2002) Australia's health 2002: the eighth biennial health report of the Australian Institute of Health and Welfare. Canberra: Commonwealth of Australia
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36. Phillipov G, Alimat A, Phillips P, Drew A (1995) Screening for diabetic retinopathy. Medical Journal of Australia;162:518-520

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Last updated: 3 July 2007