Am I at risk of diabetes / pre-diabetes?

One in four Australians over the age of 25 either has diabetes or a condition of pre-diabetes – Impaired Fasting Glucose (IFG) or Impaired Glucose Tolerance (IGT).

In Australia over 1 million people aged 25 years and over have diabetes – an increase of 300 per cent in 20 years.

In Tasmania there are 25,000 adults (25 years and over) with diabetes and a further 50,000 with pre-diabetes. These figures indicate that Tasmania has a higher prevalence of pre-diabetes and diabetes than the national average.

Type 1 Diabetes

We don’t yet know the exact cause of Type 1 diabetes but we do know it has a strong family link. People who have a family history of autoimmune diseases (diseases where the body attacks itself) such as thyroid disease, lupus or pernicious anaemia seem to have more chance of developing Type 1 diabetes. Diabetes can only occur when something such as a viral infection triggers the immune system to destroy the insulin-making cells in the pancreas. This is called an autoimmune reaction. We also know that many more people have the susceptibility to Type 1 diabetes than ever get diabetes. If the autoimmune system is not triggered, Type 1 diabetes does not occur.

While Type 1 diabetes is not caused by lifestyle events such as putting on weight or getting older, it is important to have a healthy lifestyle with regular exercise, adequate rest and relaxation, and nutritious food to help the injected insulin work more effectively.
A healthy lifestyle is essential for keeping well, managing diabetes effectively and lessening the chance of problems caused by diabetes.

Type 2 Diabetes

There are a number of risk factors which make a person more likely to get Type 2 diabetes These include:

Having a family history of Type 2 diabetes

Having a pre-diabetic condition (diagnosed)

Being overweight (especially around the waist for both men and women)

Growing older

Being an Aboriginal or Torres Strait Islander

Being Chinese, South East Asian, Polynesian or Melanesian or from India, Pakistan, Sri Lanka

Being a woman who has had Gestational Diabetes Mellitus (GDM), given birth to a baby weighing more than 4.5kg (9lbs) or having had a previous unexplained stillbirth

Being a woman with Polycystic Ovarian Syndrome (PCOS)

Most of the risk factors in the above list cannot be changed, but if any of those things apply to you, you can do many things to lower your chance of getting diabetes.

Discuss what your risk is for getting Type 2 diabetes with your General Practitioner.

You can also make some lifestyle changes to reduce your risk such as:

Increasing your level of daily activity and improving your physical fitness in many different ways.
Eat food containing fewer calories (i.e. cut back on take-aways, chips, chocolate, cakes and pastries, lollies, cordial and fizzy drinks, alcohol, high fat dairy products and fat meat. Eat more fresh fruit and vegetables, lean meat and low fat dairy products, pasta, rice, bread)
If you are overweight or obese reduce your weight – even a couple of kilos less makes a big difference.
Reduce your blood pressure – by eating less animal fat, getting more exercise, reducing salt intake (watch out for salt added to packaged foods in particular), drinking less alcohol, finding ways of lowering your stress levels.
Improve your blood fats by following the previous suggestions.
And finally quit smoking!

Can Type 2 diabetes be prevented?

Yes. People at risk of Type 2 diabetes can delay and even prevent getting it by following a healthy lifestyle. This includes regular physical activity, making healthy food choices and maintaining a healthy weight, especially if they have been told that they have a pre-diabetic condition. Discuss how best to reduce your risk for Type 2 diabetes with your General Practitioner.

Pre-diabetic conditions linked to Type 2 diabetes

There are two conditions termed pre-diabetes– Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT)

Impaired Fasting Glucose (IFG)

This condition is diagnosed when the fasting* blood glucose level (usually blood is taken from the arm) is higher than normal but after a sweet drink (Oral Glucose Tolerance Test) the level is not high enough to be called Impaired Glucose Tolerance or diabetes.

Impaired Glucose Tolerance (IGT)

This is diagnosed when the blood glucose (sugar) taken 2 hours after a special glucose drink is abnormally high, but not high enough to be called diabetes.

Who is most likely to get Impaired Fasting Glucose or Impaired Glucose Tolerance?

These two pre-diabetic conditions are most common in people who have a family history of Type 2 diabetes, are inactive and overweight. People who carry excess weight around the waistline are at the greatest risk. Like Type 2 diabetes, Impaired Fasting Glucose and Impaired Glucose Tolerance are a result of insulin not working as well as it should because of insulin resistance.

* ‘Fasting’ means having nothing to eat or drink for eight hours before the test is done.

Gestational Diabetes

From 3 to 8 % of all pregnant women will develop gestational diabetes usually around the 24th to 28th week of pregnancy however, women who are pregnant with more than one baby may develop GDM earlier in the pregnancy. Those most at risk include women over 30, who have a family history of Type 2 diabetes, who have had GDM in a previous pregnancy and are overweight. Aborigines and Torres Strait Islanders are at increased risk as are certain ethnic groups including Indian, Vietnamese, Chinese, Middle Eastern and Polynesian/Melanesian.

As the pregnant woman with GDM usually will not have symptoms of diabetes (passing more urine, drinking more, increased tiredness) and because, if present, they are often hidden by the normal experiences of pregnancy, it is important to ask the pregnancy care team to check for GDM. In Australia it is currently recommended that all pregnant women be screened for GDM.

GDM shows that the woman has an increased chance of developing Type 2 diabetes. In order to prevent or delay this happening, it is important to stay fit and active, eat healthy nutritious meals and not to become overweight. To check for Type 2 diabetes any woman who has had GDM should be screened every 1-3 years (depending on her test results).