This disease can strike at any age but is most commonly diagnosed in
children and young adults and tends to be more dramatic in that
symptoms come on extremely quickly.
This form is to be treated
with a controlled diet and regular exercise and usually requires one
or more injections of insulin a day.
How is diabetes treated?
The main aim of treatment for both type 1 and type II diabetes is
to keep blood glucose levels as close as possible to normal to
minimise the risk of developing complications.
Whereas part of the treatment for type 1 diabetes involves
regular insulin injections, treatment for type II diabetes is
generally achieved with the use of tablets as well as changes to
lifestyle.
The tablets given to type II diabetics to lower blood sugar
levels include the sulphonylurea drugs that stimulate the pancreas
to produce more insulin and make the insulin work better once it
gets to the cells; and the biguanide drug, metformin, that boosts
the effectiveness of insulin in the body.
Lifestyle changes include
a healthier diet, high in fibre, low in refined carbohydrates and
low in saturated fats, as well as taking more exercise.
For people with type 1 diabetes, lifelong daily insulin
injections, regular blood glucose tests using a finger-pricking
device, and a disciplined eating plan
and regular exercise are
usually required. Fortunately research continues on pancreas
transplantation as well as the transplant of the specific
insulin-producing cells.
Those with type II
diabetes may go back to normal levels of blood sugar as they get
back to normal weight and start to exercise regularly.
What's the best way to avoid developing diabetes?
Finnish and US studies in the last 18 months both clearly show
that those who are susceptible to developing diabetes can
dramatically reduce their risk
with aggressive lifestyle
intervention, aiming for seven per cent of body weight loss and
150 minutes of exercise per week, according to Dr Twigg.
"If you have pre-diabetes, your risk of developing diabetes is
roughly five to 10 per cent per year," explains Dr Twigg. "Without
aggressive intervention, after five years, up to half of the group
will have developed diabetes. We know we can reduce the risk by more
than half in this group with significant weight loss and
regular exercise."
How's the future looking for diabetes?
The focus is on prevention rather than cure, says Dr Twigg. "The
earlier diabetes is diagnosed the better. We're also trying to
detect tissue damage as early as possible to prevent complications."
As far as treatment goes, there are new types of medication being
developed, including a drug that tries to stop the adverse effect of
glucose on cells. "There's also a new drug being trialled in
Australia based on the saliva from the gila monster, a lizard found
in the Arizona desert," says Dr Zimmet. The saliva, it turns out,
lowers blood sugar levels. Safer, more reliable forms of insulin are
also being trialled, including inhaled insulin; while companies are
trying to produce insulin in tablet form.
Trials are underway at Sydney's Westmead Hospital to transplant
insulin-producing cells into people with type 1 diabetes. "It's
early days with this one, but the results are looking quite
hopeful," says Dr Twigg. "Down the track, it may be possible to
infuse insulin producing cells into people with type II diabetes as
well."
The International Diabetes Institute and Deakin University have
discovered a gene that may have enormous implications for not only
diabetes, but also ageing, cancer and a number of chronic diseases.
"That's very exciting," says
Professor Zimmet. "We're the only group in the world working
on that." The group is also looking at the role of potato toxin and
other food toxins in causing type 1 diabetes.
All in all, the outlook for anyone with diabetes is much brighter
than it was 15 or 20 years ago. "We used to be pretty negative about
diabetes because there weren't good studies to show that good
control reduced the risk of complications, and we didn't have the
ways of treating diabetes that we do now," says Professor Zimmet.
But rather than viewing
it as purely a chronic condition, type II diabetes can be seen as a
wake-up call, as an opportunity to ditch or improve your bad habits,
so leading to a much better quality of life as well as a longer
life.