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Diabetes mellitus is a chronic disease that significantly affects the health of Australians. It may lead to a range of complications which can cause disability, and reduce people’s quality of life and life expectancy. Diabetes is responsible for an enormous public health and social burden, and is one of the top 10 causes of death in Australia.
Diabetes is a long-term (chronic) condition in which the body loses its ability to control the level of glucose (sugar) in the blood. Insulin is a hormone produced by special cells in the pancreas that helps the body to convert glucose from food into energy. People with diabetes either don’t have enough insulin or their body cannot use insulin effectively, so glucose stays in the blood instead of being turned into energy, causing blood sugar levels to become high. Different insulin abnormalities cause different types of diabetes. Four main types of diabetes exist: type 1 diabetes, type 2 diabetes, gestational diabetes and other diabetes.
Type 1 diabetes
Type 2 diabetes
Other types of diabetes
Impaired glucose regulation
Type 1 diabetes mainly occurs in children or young adults, although it can occur at any age. In type 1 diabetes the body stops making insulin. Without insulin, the body cannot turn glucose (sugar) into energy so it burns its own fats as a substitute. Unless treated with insulin, people with type 1 diabetes accumulate dangerous chemicals in their blood from the burning of fat, causing a condition known as ketoacidosis. This condition is potentially life-threatening if not treated.
Most cases of type 1 diabetes are caused by the destruction of the insulin-producing cells in the pancreas by the body’s immune system. According to self-reported data from the 2007–08 National Health Survey, around 10% of people with diabetes have this form of the disease.
Type 2 diabetes is the most common form of diabetes. It occurs mostly in people aged 50 years and over and, although still uncommon in childhood, it is becoming increasingly diagnosed in younger people. People with type 2 diabetes produce insulin, but cannot use it effectively or may not produce enough. Type 2 diabetes may initially be managed with changes to diet and exercise, and/or oral glucose-lowering drugs. People with type 2 diabetes may progress to needing insulin or a combination of these therapies if their condition cannot be managed through lifestyle changes and/or oral drugs. Type 2 diabetes accounts for 87% of all people with diabetes, according to self-reported data from the 2007–08 National Health Survey.
Gestational diabetes mellitus is a form of diabetes that can develop during pregnancy. It involves high blood sugar levels appearing for the first time during pregnancy in women not previously diagnosed with other forms of diabetes. This type of diabetes is short term and, although it usually disappears after the baby is born, it can recur in later pregnancies. Gestational diabetes is also a marker of increased risk of developing type 2 diabetes later in life. Some cases of gestational diabetes are managed with changes to diet and exercise, and some require insulin treatment. About 5% of pregnant women are affected.
Other types of diabetes can occur as a result of other conditions or syndromes, such as:
Around 3% of people are affected by other types of diabetes.
Impaired glucose regulation, or intermediate hypeglycaemia, is the metabolic state between normal glucose regulation and the state of failed regulation known as diabetes. There are two categories of impaired glucose regulation:
IFG and IGT are considered risk factors for the future development of diabetes and cardiovascular disease.
AIHW 2011. Prevalence of Type 1 diabetes in Australian children, 2008
AIHW 2011. Diabetes prevalence in Australia: Detailed estimates for 2007–08
AIHW 2010. Australia’s health 2010
AIHW 2010. Diabetes in pregnancy: its impact on Australian women and their babies
AIHW 2009. Prevention of cardiovascular disease, diabetes and chronic kidney disease: targeting risk factors
AIHW 2008. Diabetes, Australian facts 2008