Diabetes is a serious medical condition characterised by hyperglycaemia or high blood glucose levels and around 1.8 million Australians are affected with many more unknowingly. (1) This a complex condition and if left untreated, diabetes-related complications such as vision impairment, kidney disease, foot problems, and development of heart attacks and strokes, and limb amputations. (1)
When food is consumed, particularly carbohydrates, our body breaks this down into glucose (sugar), raising our blood glucose levels (also known as blood sugar levels). Insulin, an important hormone produced in our pancreas, is required to lower blood glucose levels and facilitate cells to convert this glucose into energy or store it away for use when needed. (2) Those with Diabetes either produce little to no insulin and cannot lower blood glucose levels. Therefore, glucose cannot be converted into energy used by the body. But instead, glucose remains in the blood causing high blood glucose levels.
The three main types of diabetes are:
Type 1 Diabetes Mellitus
This is an autoimmune condition whereby the body identifies the pancreas as an invader of the body. The immune system attacks the pancreas and the cells of the pancreas which produce insulin. (3) Those with Type 1 are generally born with the condition or develop the condition before the age of 30. They rely on insulin medication and injections to replace the insulin that their body cannot produce. The exact cause of Type 1 is currently not known, but we know that the development of this condition is not related to lifestyle choices and cannot be prevented. However, maintaining a healthy lifestyle, diet, and appropriate use of insulin medication is an important factor in managing Type 1 Diabetes.
Type 2 Diabetes Mellitus
This is the most prevalent form of Diabetes and is a progressive chronic condition, and occurs when the pancreas cannot produce enough insulin and/or the body becomes resistant to the effects of insulin (called insulin resistance). To combat insulin resistance, the pancreas responds by producing more and more insulin to try and achieve some degree of managing blood glucose levels. Type 2 is associated with family genetics and modifiable lifestyle factors, such as poor diet, insufficient exercise and being overweight or obese. This condition usually develops in adults aged 45 years and over. However, it is becoming more prevalent in younger age groups such as children, adolescents and young adults. (3) Whilst there is currently no cure for Type 2, it can be managed through a healthy diet, lifestyle modifications and medication where necessary.
Gestational Diabetes Mellitus
GDM is a form of diabetes first recognised during pregnancy. Currently, in Australia, 12-14% of women will be diagnosed with GDM during pregnancy. (4) Some risk factors include being over 40 years of age, having a family history of Type 2 or GDM, being overweight or obese, being from a certain background (Aboriginal or Torres Strait Islander, Melanesian, Polynesian, Chinese, Southeast Asian, Middle Eastern or Indian) and previously been diagnosed with GDM. (4) Gestational Diabetes is caused by hormones produced in the placenta during pregnancy blocking the action of insulin in the body, resulting in insulin resistance. (5) Uncontrolled it can result in adverse pregnancy outcomes such as large for gestational age baby (also known as macrosomia), higher rates of caesarean sections and other birth complications such as pre-eclampsia. (6) Whilst it usually subsides after pregnancy, some women may still experience high blood glucose levels after giving birth. Having Gestational Diabetes increases the risk of developing Type 2 in the future for both the mother and baby. Despite this, appropriate management through making healthy changes to diet, lifestyle modifications, and with help from medication where necessary can help regulate blood glucose levels, decrease the risk of adverse pregnancy outcomes, and develop Type 2 in the future.
How a Dietitian can help manage Diabetes
As an Accredited Practicing Dietitian (APD), I can help educate about Diabetes and the associated risks and provide personalised, evidence-based dietary advice while considering factors such as personal health, nutritional status, medication, and most importantly,,, lifestyle. During the consultation, I can assist with a range of nutritional approaches such as carbohydrate awareness and counting, healthy food choices and implementing a healthy eating regime to help manage diabetes and regulate blood glucose levels.
Diabetes Australia (7) and National Diabetes Services Scheme (8) (NDSS) recommends visiting an Accredited Practicing Dietitian (APD) for personal advice in managing Diabetes. Medicare may provide a rebate on fees with an Accredited Practicing Dietitian provided there is a valid Doctor’s referral under the Chronic Disease Management Plan. If you have Private Health, you may receive a rebate depending on your level of cover. I practice on Tuesdays, Fridays and every second Saturday of the month at the Wavell Heights Clinic and hope that I can help you with your journey to health.