Diabetes

Has your loved one been diagnosed with type 1 or 2 diabetes?

Diabetes is a chronic disease that occurs when the body is not producing insulin or not using insulin properly – the blood becomes saturated (with too much glucose) as there is not enough insulin for glucose to enter the cells and be converted into energy.

Diabetes can affect many major organs in your body, which can lead to an array of additional serious complications when left untreated. These medical problems include:

  • heart disease and stroke
  • kidney disease
  • high cholesterol
  • blindness
  • nerve disease
  • limb amputation
  • metabolic syndrome

Diabetes is very treatable – diabetics may avoid or delay other health complications by:

  • Working closely with a health care professional to manage the disease – which may include the use of medications
  • Knowing the vital health statistics and monitoring these closely each day and
  • Choosing a healthy lifestyle

Did you know there are 2 main types of diabetes?

Type 1 diabetes
  • Only 10% – 15% of all cases
  • Occurs when the pancreas no longer produces the insulin needed
  • Is not caused by lifestyle factors
  • Requires insulin therapy

Risks

  • Still being researched
  • Having a family member with type 1 diabetes slightly increases the risk of developing the disease
  • Environmental factors and exposure to some viral infections have also been linked to the risk

Diagnosis

  • Usually in childhood but it can occur at any age

Management

  • Lifelong daily insulin injections (or use of an insulin pump), regular blood glucose level tests, healthy eating and regular physical activity
Type 2 diabetes
  • Represents 85 – 90% of all cases
  • Occurs when the pancreas is not producing enough insulin or when insulin is not working effectively
  • Risk factors include family history, ethnic background and weight
  • Lifestyle factors include unhealthy eating and lack of physical activity
  • Can be managed with lifestyle changes and may require medication

Risks

  • Family history of diabetes
  • Overweight
  • Unhealthy diet
  • Physical inactivity
  • Increasing age
  • High blood pressure
  • Ethnicity
  • Impaired glucose tolerance (IGT)*
  • History of gestational diabetes
  • Poor nutrition during pregnancy

Diagnosis

  • Predominately in adults over 45 but it is becoming more common in younger adults

Management

  • Regular physical activity and healthy eating. Over time treatment may progress from lifestyle modification to blood glucose-lowering tablets and/or insulin injections

Complications that may arise if diabetes is not treated

Complications include:

  • Heart disease/stroke – high blood pressure and high blood fats (cholesterol and triglycerides) associated with diabetes can also pre-dispose to an increased risk of heart attack and stroke. Roughly 80% of people with diabetes will die from a heart attack or stroke.
  • Eye disease – Retinopathy affects about 1 in 4 people with diabetes. The development is strongly correlated to the length of time diabetes has been present and the degree of blood glucose control.
  • Kidney disease – one of the fastest-growing causes of kidney failure and the leading cause of end stage renal disease (ESRD).
  • Lower limb problems and amputation – Neuropathy or peripheral nerve disease and blood vessel damage may lead to leg ulcers and serious foot problems.

Did You Know?

  • Diabetes is the sixth-highest cause of death by disease in Australia
  • People with diabetes are twice as likely to be have high blood pressure and also are more likely to have elevated blood fats e.g. cholesterol, triglycerides
  • Diabetics are twice as likely to have cardiovascular disease, e.g. heart disease and stroke. 11% of people with diabetes have had a heart attack.
  • One in four Australian adults has either diabetes or impaired glucose metabolism
  • The total number of people with diabetes and pre-diabetes at present is 3.61 million.

What support is available for you and your loved one?

In addition to getting in-home support from our capable and caring team of nurses and personal carers, here are some valuable tips to help you manage your loved one’s needs and care as they continue to deal with the progression of diabetes.

1.     Blood glucose monitoring

Blood glucose monitoring is a valuable diabetes management tool which can help to give you or your loved one a sense of control and freedom. Regular testing can reinforce your healthy lifestyle choices, correct imbalances quickly or inform you of your body’s response.

Blood glucose levels respond to food (specifically carbohydrates). However, other influences such as physical activity, stress, changes to routine, and illness will also cause levels to go up or down. When visits to a health professional may be weeks or months apart, being able to understand the numbers and make good decisions between visits is vital. The frequency and timing of your blood glucose monitoring, and your recommended range, should always be determined by your doctor and communicated clearly to each member on your care provider team.

Keeping a written record of your blood glucose readings is extremely helpful. A well-kept record will show the range and patterns over time, which aids in making good lifestyle choices and/or medication adjustments. Daily blood glucose monitoring can be tedious and uncomfortable. The depth of the lancet (the tool the pricks the finger) and technique are important. If the depth and technique is OK and you are still experiencing pain or discomfort, it may be due to not changing the lancet often enough. The manufacturers recommend changing the lancet every time it is used because the lancet becomes less sharp (and may hurt more) with each use.

To subsidize the costs of blood glucose monitoring, the Australian Government established the National Diabetes Services Scheme (NDSS). This program offers discounts on blood glucose testing supplies and free needles and syringes to people who use insulin. If you are an Australian resident and have been diagnosed with diabetes you are eligible for enrolment in the NDSS. The registration form must be signed by a doctor or recognized diabetes educator. Registration with the NDSS is free and lifelong. For more NDSS information, please link to the Department of Health website: http://www.health.gov.au/internet/main/publishing.nsf/content/health-pbs-healthpro-supply-ndss.htm

2.     Physical activity

Physical activity is vital in maintaining a healthy lifestyle, controlling diabetic symptoms and preventing the longer term, more serious complications that are often associated with diabetes.. Here are our answers to some of the most frequently asked questions we receive from patients with diabetes about physical activity.

Why should I take part in physical activity?

Participating in regular physical activity helps to:

  • Improve insulin sensitivity (makes insulin work better in your body and lowers blood glucose levels)
  • Improve blood pressure and lowers blood fat (which reduce the risk of heart disease)
  • Achieve and maintain a healthy body weight
  • Increase bone strength and reduce the risk of osteoporosis
  • Improve quality of life and emotional well being
  • Slow down the overall ageing process

How much physical activity should I be doing?

The amount of physical activity that is optimal for you, depends on your current level of health and fitness. It is best to consult a health professional first to assess the optimum amount and type of exercise appropriate for you today.

The Australian national guidelines recommend 30 minutes of moderate physical activity on most days of the week in addition to your normal daily routine. Moderate physical activity will cause a noticeable increase in breathing and heart rate and may cause a light sweat but you should still be able to comfortably talk while doing it.

If you are just starting out, your activity can be accumulated over the entire day with the end goal of eventually being able to complete 30 minutes of moderate physical exercise in one session each day. Start by setting small achievable goals and look for easy ways to increase your activity each day

What type of activity is best?

The most important consideration (in order to maintain your interest and commitment) is to select an activity you enjoy. The best physical activity uses the large muscles in your body (ie. thighs, trunk and shoulders) – for example, power walking, cycling, dancing, swimming and light resistance training.

How can I keep motivated?

Keeping an exercise diary will assist you to keep on track and celebrate your accomplishments. Things to record in your diary include: your feelings, medication taken, snacks, fluid intake, the time and duration of physical activity etc. You may also like to document your corresponding blood glucose levels and any advice given to you from your health professional about changes to your health.

Getting active with friends and family can also help keep you stay motivated. Consider a pedometer – a device that measures the number of steps you take. Knowing how much you have done each day can act as a great motivational tool.

3.     Additional special considerations for diabetics
  • Discuss your exercise intentions with your doctor he/she will consider your blood glucose management, your heart and blood vessels and any diabetes related complications before advising the best physical activity for you
  • Diabetics are generally discouraged from strenuous physical activity when blood glucose levels are above 15 mmol/L.
  • Test your blood glucose levels before, during and after exercise particularly when starting a new program. This reveals how your body responds to exercise. Do not exercise if you feel unwell
  • Wear supportive shoes that fit well and check your feet daily.
  • If you take medication, always carry some foods or fluids containing carbohydrates with you.
4.     Healthy eating for the elderly

The traditional ‘diabetic diet’ has been proven to produce little benefit for blood glucose control and may place individuals at nutritional risk. It is now widely recognised that moderate amounts of sugar can be included in the diets of people with diabetes.

The food choices recommended for older people with diabetes are based on the national dietary guidelines. The emphasis is on selecting a variety of nutritious foods, based on high fibre carbohydrates and healthy fats in moderation. A good balance of foods can improve blood glucose management, general wellbeing and assist with weight maintenance. Please consult your health practitioner before adjusting your diet.
All carbohydrate foods end up as glucose in the blood but they do so at different rates. The Glycemic Index (GI) is a way of describing how a carbohydrate containing food affects blood glucose levels.

Foods with a low GI raise blood glucose more slowly than foods with a high GI. Therefore, including at least three low GI foods throughout the day, can help with overall blood glucose management. Carbohydrate containing foods that have a lower GI include: oats, wholegrain breads, legumes (including baked beans, kidney bean and lentils), sweet potato, corn, dairy foods like yoghurt, custard and milk, pasta and fruits such as apples, oranges and pears
Diabetics no longer need to avoid all sugars. We now know that sugar found naturally in or added to nutritious foods such as breakfast cereals, custards and yoghurts, should not adversely affect blood glucose levels and can in fact be part of a healthy diet. There is no reason to have a separate diabetics menus or special ‘diabetic’ desserts.

Examples include:

  • Fruit or dairy based desserts such as custards, milk puddings and fruit crumbles
  • A small carton of flavoured milk (reduced fat)
  • A teaspoon of sugar in a cup of tea or coffee
  • A small amount of sugar or honey on high fibre breakfast cereal
  • A thin spread of jam on a slice of toast

When you are ready to find support and discuss a holistic and supportive diabetes care plan, call us on 9499 1200 or submit a written request here by following this link to our contact page. We are happy to offer you a Free checklist – 10 steps to good health and a Risk factor guide – understanding your risks for type 2 diabetes so that you can take steps today to improve your quality of life.

Call Sequel today on 9499 1200 to discover how we can be of assistance.

Amy's story

Amy was first diagnosed with type 2 diabetes at the age of 45 – she is now 87 and living at home with her youngest daughter Nicole. As you can imagine, when Amy was first diagnosed 40+ years ago, much less was known about how health and lifestyle choices influence the progression of the disease. Amy now requires full time, high level care to assist with managing her diabetes, kidney disease, high cholesterol and poor circulation. Amy has had several toes amputated over the years and her family must be vigilant with inspecting her limbs every day and recording all of her vital statistics. It is difficult for Nicole who has three young children of her own and the household to manage. Sometimes Nicole feels like she just needs a break and a bit of time out for herself but she finds it hard to “let go” and place her trust in someone else where the care of her mother is concerned.

Amy also has a very restrictive diet and must be hoisted in and out of bed to ensure she is able to shower and attend her medical appointments. Meal time is a very busy time – Nicole has to manage feeding her three rambunctious kids (who won’t sit still for a minute) with finding the time to get her mother sitting upright so that she can ensure she is taking on enough nutrition to balance her delicate insulin levels.

We first met Nicole and Amy 9 years ago when Amy was still living in her own home with her [then] husband. Sequel was providing in home care with a personal care assistant for approximately 10 hours each week to assist with showering and transportation to medical appointments.

More recently, with the introduction of nursing services, we assisted with medication management, blood glucose testing. After her father’s passing, Nicole moved her mother in with her and her personal carer continued to drop by each day. When Amy’s care progressed to a high level (she essentially became bed bound) a couple of years ago, Sequel worked with Amy and Nicole to come up with a more comprehensive plan of seventeen to twenty hours a week to help Nicole get Amy out of bed each day and provide some much needed respite for Nicole each week. With our recent addition of div 1 and 2 nurses, we are also able to step in and provide more advanced medical care when Amy requires it.