You might have noticed the unusually high rate of postings here lately, as we try to catch up on the backlog of fabulous stories from our radio show. Stuart’s story about diabetes first went to air on 2 August 2012 – please listen to the podcast if you haven’t heard it already, otherwise, feel free to read on…
Diabetes mellitus is a chronic condition to do with blood sugar that affects 1.7 million Australians; however, up to half the cases of type 2 diabetes are undiagnosed, and by 2031 it’s estimated that 3.3 million Australians will have the condition. It’s linked to about 10% of Australian deaths annually, either as an underlying cause or as an associated complication.
The symptoms are frequent urination (called polyuria), high sugar content in the urine (glycosuria), increased thirst and increased hunger, amongst other, more serious symptoms. But what does it mean?
In many ways, diabetes is just a name, and it’s a really old name. In fact, it’s an ancient Greek word meaning “to pass through” and describes the symptom in diabetics of frequent urination.
In case you had thought diabetes is a disease of modern times, the word was first used in 230 BCE by Apollonius of Memphis describing the condition. But Indian and Egyptian physicians had noted the condition over a thousand years before that.
The second part of the name is mellitus, from the Greek Melissa, meaning honey, and explains the second symptom of the condition: the high sugar content of the urine. The reason for both of these is raised levels of glucose in the blood, which gets filtered by the kidneys and excreted, rather than being used by the body’s cells for energy.
There are generally two types of chronic, or ongoing, forms of diabetes, the imaginatively titled type 1 and type 2. A third common condition is known as gestational diabetes: it’s restricted to pregnant women, and usually dissipates after they give birth.
Type 1 diabetes is caused by a failure of the pancreas to produce insulin, which is a hormone that causes tissues in the liver, muscles and fat deposits take up glucose and store it for later use. This is treated by regular injections of insulin from external sources, which has been the primary (and only successful) treatment of the condition since its discovery in the 1920s. Before this, Type 1 diabetics rarely reached adulthood, and lapsed into coma before dying as children.
Type 2 diabetes is the result of insulin resistance, where the body’s tissues do not react appropriately to the action of the hormone, and therefore do not remove glucose from the bloodstream.
In these cases, other medications are used to lower the total blood sugar of patients, in order to avoid some serious side effects related to consistently high glucose in the blood, including heart disease, nerve damage, and poor circulation leading to further complications.
Type 2 diabetes is the most common form of the condition, and accounts for about 90% of total cases, but is obviously quite different in cause to type 1 diabetes. While medicine can explain elevated blood sugar to some degree in type 2 diabetes, the causes of insulin resistance remain relatively unknown, except there is a large hereditary factor involved.
There is also a correlation with age, general fitness levels, diet and lifestyle, but such a correlation does not necessarily indicate that diabetes is caused by old age, obesity, poor diet and lack of appropriate exercise, and it certainly does not explain all cases.
Being diagnosed with diabetes may not change your life immediately, but it means that you should be able to avoid some pretty horrible effects as you get older, thanks to the scientific training of your doctor.