What is diabetes?

Diabetes mellitus, more commonly known simply as diabetes, is a health condition where there is too much sugar in your blood.

People with diabetes have difficulty changing glucose (a type of sugar) into energy. This leads to high levels of sugar in your blood (hyperglycaemia).

Your blood glucose levels are normally controlled by a hormone called insulin. Diabetes happens when your pancreas can’t produce enough insulin or when your body can’t use the insulin because it’s resistant to it.

There are several types of diabetes:

• type 1 diabetes
• type 2 diabetes
• gestational diabetes, which happens when a woman has high blood glucose levels during pregnancy
• pre-diabetes, where your blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes

What are the symptoms of diabetes?

Common symptoms of diabetes are:

• being very thirsty or hungry
• passing more urine (wee) than usual
• feeling tired
• unexplained weight loss (for type 1 diabetes), or gradual weight gain (for type 2 diabetes)
• having cuts that heal slowly
• itchy skin or skin infections
• blurred vision

Type 1 diabetes is usually spotted quickly as symptoms can appear suddenly.

Many people with type 2 diabetes:

• don’t have any symptoms at all
• have signs that go unnoticed for a long time

What causes diabetes?

There are different causes of diabetes according to the type.

Type 1 diabetes

Type 1 diabetes is an auto-immune condition: your body’s immune system attacks the cells in your pancreas that produce insulin.

The exact cause of this reaction is still unknown. Diet and lifestyle are not factors that determine who gets type 1 diabetes. Research shows that both your genetics and the environment may play a part in the development of type 1 diabetes.

Type 2 diabetes

Type 2 diabetes happens slowly over years as your body’s insulin becomes less effective at managing your blood glucose levels.

As a result, your pancreas produces more and more insulin. Eventually your insulin producing cells wear out and become ineffective. Type 2 diabetes is a mix of low insulin and ineffective insulin.

The risk of getting type 2 diabetes increases with certain factors:

• a family history of diabetes
• low levels of physical activity
• poor diet
• being obese or overweight, especially around your waist
• having high blood pressure

Gestational diabetes

During pregnancy, hormones that give nutrition to your growing baby reduce the effectiveness of your own insulin.

If your pancreas is unable to produce enough insulin, your blood glucose levels rise and you get gestational diabetes.

When should I see my doctor?

See your doctor if you are experiencing symptoms of diabetes or have concerns about your risk of diabetes.

Early diagnosis and treatment can help to reduce your risk of serious complications.

How is diabetes diagnosed?

If your doctor suspects that you have diabetes, they will order blood tests. These will check your glucose levels.

This may include the following tests.

• Blood glucose test — this may be done after fasting (not eating for a few hours) or without any special preparation (random or non-fasting blood glucose test).
• Oral glucose tolerance test (OGTT) — this involves drinking a sugary drink, then testing your glucose levels 1 to 2 hours later.
• HbA1c test — this test doesn’t need you to fast as it doesn’t test your glucose levels directly. It shows how much sugar there has been in your blood over the past few months.

If you’re pregnant, your doctor will screen for gestational diabetes as part of your standard antenatal testing.

How is diabetes treated?

Although there is no cure for diabetes it can be managed with lifestyle changes and medicines.

Type 1 diabetes

If you have type 1 diabetes, you will need to have insulin replacement. This may be through injections or an insulin pump. This helps control your body’s blood glucose levels.

There's nothing you can do to prevent type 1 diabetes. However, your lifestyle choices after your diagnosis can lower your risk of getting complications.

Type 2 diabetes

Type 2 diabetes can sometimes be controlled by lifestyle changes, such as eating a healthy diet and being physically active.

Eventually, you may need to take medicines to control your blood glucose levels. Your doctor may prescribe tablets or injectable medicines (insulin or others). These will help to keep your blood glucose in the target range.

Gestational diabetes

Gestational diabetes can often be managed by keeping blood glucose levels within a healthy range for pregnancy.

This involves a healthy eating plan and regular physical activity.

You may need medicine if you don’t get good glucose control with lifestyle changes alone.

Blood glucose monitoring

Regular blood glucose monitoring is crucial to diabetes management. This helps you to understand the relationship between your blood glucose, food, exercise and insulin in your body.

It also helps you keep track of potential treatment side effects, such as hypoglycaemia (a sudden drop in blood sugar).

Can diabetes be prevented?

While type 1 diabetes can’t be prevented, there is clear evidence that you can delay or stop type 2 diabetes.

Healthy habits that can help prevent type 2 diabetes include:

• healthy eating
• keeping a healthy weight, or losing weight if you are overweight or obese
• regular physical activity

See your doctor for regular health checks.

You may want to join a prevention program, see below.

• New South Wales — the Get Healthy Service offers a free health coaching program to help manage your health if you have type 2 diabetes.
• Northern Territory — Healthy Living NT has community and group diabetes education sessions.
• Queensland — My Health for Life is a free program where you work with a health coach to achieve your health goals.
• South Australia — Better Health Coaching Service is a free and confidential telephone service which supports South Australians to be active, eat well and reduce the risk of chronic disease.
• Tasmania — the COACH Program is an evidence-based, award-winning coaching prevention program for people with chronic disease or at high risk of chronic disease.
• Victoria — the Life! Program is a free healthy lifestyle program that helps you reduce your risk of type 2 diabetes, heart disease and stroke.
• Western Australia — Let’s Prevent is a free online health program that helps you plan to get your body healthy and prevent type 2 diabetes, heart disease and stroke.

Complications of diabetes?

Diabetes is a complex disease that can affect your whole body. Some complications of diabetes are below.

• Heart disease and stroke: people with diabetes are up to 4 times more likely to suffer a heart attack or stroke.
• High blood pressure: people with diabetes may get high blood pressure (hypertension) due to changes to their body chemistry.
• Foot problems: having diabetes increases your risk of foot and leg ulcers and amputations — see a podiatrist regularly.
• Vision problems: diabetes is the leading cause of preventable blindness in working-age adults.
• Kidney disease: diabetic kidney disease is the most common cause of kidney failure.

FootForward is a program designed to help people with diabetes understand the importance of getting your feet checked.

You can also sign-up for eye check reminders at KeepSight Australia.

Diabetes can have a big impact on your mental health. More than 3 in 10 people with diabetes experience depression, anxiety and distress.

There are many ways you can lower your risk of complications. Talk to your doctor or a diabetes educator about how to look after yourself. This may minimise or even stop diabetes complications.

Resources and support

To learn more about diabetes, try these resources:

• Diabetes Australia's website has practical advice for living with diabetes
• You can join the National Diabetes Services Scheme (NDSS) for free access to a range of resources, support services and subsidised diabetes products

Aboriginal and Torres Strait Islander peoples

For First Nations resources, try:

• Diabetes Australia's page Aboriginal and Torres Strait Islander Unit
• Healthy Living NT's Indigenous Resources

Other languages

Do you prefer reading in languages other than English? These websites offer translated information about diabetes:

• National Diabetes Services Scheme (NDSS) Information in your language
• Multicultural Health Communication Service NSW
• Health Translations Victoria

Apps and tools

You might find these apps and tools helpful:

• healthdirect's Risk Checker (diabetes, heart disease and kidney disease)
• Diabetes Australia’s risk calculator