Diabetes is the name given to a group of different conditions in which there is too much glucose in the blood.
The pancreas either cannot make insulin or the insulin it does make is not enough and cannot work properly. Without insulin doing its job, glucose builds up in the blood leading to high blood glucose levels which cause the health problems linked to diabetes.
What is diabetes?
There are two main types of diabetes – type 1 and type 2.
- Type 1 is less common usually affecting children and young adults but it can occur at any age. In type 1 diabetes, the pancreas cannot produce enough insulin because the cells that actually make the insulin have been destroyed by the body’s own immune system. This insulin must be replaced. Therefore people with type 1 diabetes must have insulin every day to live. At present insulin can only be given by injection or by insulin pump, but other methods of getting it may be possible in the future.
- Type 2 diabetes is a lifestyle disease affecting 85-90% of all people with diabetes. It usually occurs in adults but younger people and even children are now getting this lifestyle disease. Type 2 diabetes is strongly associated with high blood pressure, abnormal blood fats and the classic ‘apple shape’ body where there is extra weight around the middle.
People with type 2 diabetes are usually insulin resistant. This means that their pancreas is making insulin but the insulin is not working as well as it should.
The pancreas responds by working harder to make more insulin. Eventually it can’t make enough to keep the glucose balance right and blood glucose levels rise.
Adopting a healthy lifestyle may delay the need for tablets and / or insulin. However, it is important to know that if you do need tablets and/or insulin, this is just the natural progression of the disease.
By taking tablets and/or insulin as soon as they are needed, complications caused by diabetes can be reduced.
The National Diabetes Services Scheme provides information on how to help you manage diabetes in a variety of languages.
Exercise, physical activity and sport
Getting enough regular physical activity is important for maintaining good health and ensuring good diabetes management. While you might be thinking ‘that’s easier said than done’, you may be surprised to learn that exercising isn’t about ‘no pain-no gain’. Regular physical activity can become an enjoyable part of your day with long-term benefits to your diabetes and your overall health.
Healthy eating, along with regular physical activity, can help you to manage your blood glucose levels, reduce your blood fats (cholesterol and triglycerides) and maintain a healthy weight. Healthy eating for people with diabetes is no different to that which is recommended for everyone. There is no need to prepare separate meals or buy special foods. So relax and enjoy healthy eating along with the whole family. Please see below for specific nutrition information.
Find out more about:
Blood glucose monitoring
Self-blood glucose monitoring is a valuable diabetes management tool, which enables you to check your blood glucose levels as often as you need to, or as recommended by your diabetes health care team.
Regular testing and recording of your blood glucose levels can help you monitor the effects of your healthy lifestyle choices and inform you of your response to other choices and influences. Importantly, changes in your blood glucose pattern can alert you and your diabetes health care team to the need for a change in how your diabetes is being managed.
There are various new and exciting technologies now available to help patients with diabetes manage their condition.
An insulin pump is a small battery operated electronic device about the size of a pager. It continuously delivers insulin under the skin through a very thin plastic needle (cannula) that stays in place for up to three days.
Pumps are worn 24 hours a day, but can be detached as necessary for swimming, showering and other activities.In recent years, the use of insulin pumps by people with type 1 diabetes in Australia has become increasingly popular.
You may consider an insulin pump if you want:
- To improve blood glucose fluctuations
- To have more flexibility
- A better quality of life
- Are planning a pregnancy
The Diabetes Education Service provides an insulin pump service. The service offers those who have made the decision to start pump therapy a comprehensive and holistic approach to their care. If you are considering starting on an insulin pump, please discuss this with your diabetes specialist to determine your suitability.
Learn about using your insulin pump.
Bolus advisor blood glucose meters
Also known as bolus calculators, these blood glucose meters incorporate not only a blood glucose testing system, but also a built-in calculator which will calculate a suggested insulin dose based on:
- Your current blood glucose level
- The amount of carbohydrate in the food you are about to eat
- The amount of insulin still working from your previous injection
- Your target blood glucose level
- Any health events happening (for example, sick days)
- Exercise you have done or plan to do
A continuous glucose monitor (CGM) is a device that measures glucose levels continuously, 24 hours a day. CGM does not replace normal blood glucose testing. However, it does enable you to see what is happening in between tests.
CGM provides more complete information, so you and your doctor or diabetes educator can make confident decisions about your diabetes management. The Diabetes and Endocrinology service offers a CGM service to our patients.
Find out more about our continuous glucose monitoring service.
Hypoglycaemia is a condition that occurs when the blood glucose level has dropped too low, usually below 3.5 mmol/L, although this can vary. It is important to treat hypoglycaemia quickly to stop the blood glucose level from falling even lower. It is also commonly referred to as a ‘hypo’, low blood glucose
Looking after your diabetes and having regular checks will help to delay or even prevent the development of diabetes complications, including problems with your feet.
Find out more about our Diabetic Foot service.
Living well with diabetes
Travelling with diabetes
Travel can and should be fun and having diabetes doesn’t mean your travelling days are over. With good planning, there’s no reason why your travels won’t be safe, fun and hassle-free whether within Australia or overseas.
You will require a letter for travelling with medications and sharps. Contact your doctor or diabetes educator to provide you with a letter explaining your medical condition and the supplies you need to travel with.
Driving and diabetes
Driving a motor vehicle comes major personal and legal responsibilities and liabilities. Driving is a complex physical and mental skill.
People with diabetes need to take extra precautions to maximise road safety when driving.
Find out more about driving and diabetes.
Alcohol, drugs and diabetes
In Australia, drinking alcohol is generally acceptable and for many people is a normal part of social events. Most people with diabetes can enjoy a small amount of alcohol, but you should confirm this with your diabetes health care team.
For people with diabetes, illicit drug use can result in poorer blood glucose control with potentially serious consequences.
Sexual health and diabetes
While most people with diabetes are able to lead completely normal sex lives, diabetes may contribute to sexual problems for some people.
If this happens to you, speak to your GP or your diabetes health care team.
Pregnancy and diabetes
Pregnancy in women with type 1 or type 2 diabetes usually results in a normal delivery with no effects on the mother's or child’s long term health.
However, poorly controlled blood glucose levels during pregnancy can have long term effects for both mum and baby, as well as complications during delivery.
You can have a health pregnancy and a good outcome with planning, multidisciplinary care and excellent control of blood glucose levels.
Gestational diabetes (sometimes referred to as GDM) is diagnosed when higher than normal blood glucose levels first appear during pregnancy. From 3 to 8% of pregnant women will develop gestational diabetes around the 24th to 28th week of pregnancy. Some may be earlier.
While the woman with gestational diabetes’ blood glucose levels usually return to normal after the birth of the baby, there is a known increased risk for developing type 2 diabetes in the future. If you have had gestational diabetes, your child may also be at risk of developing type 2 diabetes later in life.
Find out more about gestational diabetes.
Mental health and diabetes
Research indicates there are strong links between depression and diabetes.
Depression is very common - one in five people will have depression at some time in their adult life.
For people who live with diabetes this figure is even higher.
Kids, transition and diabetes
There will come a point - usually around 16 to 18 years old - when as a young person with diabetes, you will make the move from childhood medical support services and specialists to adult medical care. This is a big step and it can be quite daunting to leave behind the team that you may have known and trusted for years.
One of the biggest differences between child and adult health services is the independence you will gain. But at the same time, you will be expected to know how to manage and take control of your diabetes yourself.
More information about transitioning to adult care can be found via the National Diabetes Services Scheme.
The Royal Melbourne Hospital Young Adults with Diabetes Service (YADS) is designed specifically for patients with diabetes who are aged between 18 and 25 yrs.
Find out more about young adults with diabetes.
Diabetes and work
People with diabetes successfully undertake all types of jobs. A general misunderstanding of diabetes is still common in our community and among some employers.
Concerns from uninformed employers might include thinking that people with diabetes will ‘black out’ all the time, or have frequent sick days. The reality is that most employers don’t even know that people have diabetes.
Diabetes and health insurance
Discrimination by health insurance companies against people with diabetes or any other chronic illness is not allowed, by law.
Diabetes and complimentary medications
It is expected that people with diabetes will, at various times, have other health conditions that may require medication.
Most Australians take complementary medicines at least once a day and, as a nation, we spend more money on them than on conventional medicines. Before you do take them, you need to know:
- Is the preparation safe?
- Will it work?
- Will it affect my diabetes?
Talk to your GP or diabetes health care team before taking new medications.
Diabetes and advocacy
Who would you go to if you:
- Faced discrimination or problems while at work and other areas of public life
- Needed help to secure your rights
- Needed help to link to services
- Had suggestions on how to improve diabetes information, services and policies
Each year up to 700 people with diabetes have been assisted by the Diabetes Australia Advocacy Program.