Diabetes is an epidemic in 21st century Australia, with 280 Australians developing the disease every day. In 2017, approximately 1.7 million Australians are living with diabetes and around 500,000 of these people are undiagnosed.
Diabetes, in both its forms, is a complex disease that affects the entire body and can cause secondary conditions such as heart and kidney disease. Diabetes in Australia has risen significantly in the past few decades and there are some fundamental differences between the two types that are important to understand. Here is what you need to know.
What is diabetes?
When a person has diabetes, their body is unable to properly manage the levels of glucose -- or sugar -- in the blood. Insulin is the hormone that helps manage blood sugar and it is produced by the pancreas.
Type one diabetes is a condition where the immune system destroys the cells in the immune system that produce insulin. So essentially, type one diabetes occurs when the pancreas does not produce insulin.
Type two diabetes is a condition where the body becomes resistant to insulin or eventually stops being able to produce enough insulin for the pancreas to function properly. This can be influenced by lifestyle and genetic factors (but we'll get to that later).
Diabetes in Australia has gone up enormously over the last few decades and and it is likely to continue to go up.
How is diabetes developed?
While the inability to manage level of glucose is the common thread from diabetes, type one and type two actually develop differently.
"In type one diabetes, what you have generally got is a failure of the pancreas to produce insulin, so you don't have enough insulin in the body and what that means is that your body sugar goes up and the sugar can't get properly into the cells and be used by the body," Neal told HuffPost Australia.
"Type two diabetes, on the other hand, is not caused by the failure of the pancreas and a failure of insulin production. It is a disease which is more to do with the inability of the insulin to act properly on cells in the body."
Who is likely to develop diabetes?
Anyone can develop diabetes, however, type one and type two typically occur in different age groups and are affected by different factors including lifestyle, genes and family medical history.
"Type one diabetes is typically a condition that occurs in younger age, it has got a stronger generic or inherited element to it," Neal explains.
Type two however, "is more commonly seen in older people and it is associated more commonly with being overweight and obesity and it is by far the most common type of diabetes in the population".
A third type of diabetes called gestational diabetes develops in women during pregnancy, however, it usually disappears after the child's birth. Between five and 10 percent of pregnant women develop gestational diabetes and while there is no one cause of this form of the disease, common causes can include being overweight, having a history of gestational diabetes and being over the age of 25.
Which type is most common?
Type two diabetes is by far the most common form of diabetes in Australia as it represents between 85 and 90 percent of all cases of diabetes. It is often associated with modifiable lifestyle factors including being overweight, poor diet and lack of exercise.
"One of the main causes for type two diabetes is being overweight or obese," Neal said.
"Obesity is now a huge problem in Australia and around the world and that is why type two diabetes is going up so rapidly."
Professor Peter Clifton from the School of Pharmacy and Medical Sciences at the University of South Australia explains that type two diabetes can also be developed due to genetic and family related risk factors.
"[Developing type two diabetes] is very genetically linked, and much more powerful than type one. So if you have got someone in your family, even if it is a distant relative of your family that has type two or type one, there is a greater chance that you'll get type two," Clifton said.
Can diabetes be prevented?
While type one diabetes cannot be prevented, prevention programs can help prevent type two diabetes in up to 58 percent of cases. Diabetes Australia recommends maintaining a healthy weight, being physically active and following a well-balanced and healthy eating plan. Type two diabetes is the fastest growing chronic illness in Australia and many people don't know that they are at risk.
The Diabetes Australia 'risk calculator' helps determine a person's likelihood of developing type two diabetes in the next five years in 11 questions.
Does diabetes get worse with time?
Yes, the symptoms of diabetes can get worse with time as the condition is associated with pancreatic failure.
"Generally, as you age your pancreas fails, so you might have good control [of diabetes] for 10 or 15 years and then you'll get progressive failure of the pancreas," Clifton said.
"Some people can remain pretty stable for a long period of time, but the general trend is that it gets worse with time."
Bruce Neal also says that diabetes can worsen with time, however, highlights that every person's experience with the disease is different.
"The adverse effects of diabetes typically accumulates over time and how problematic the condition is can be for an individual depends very much upon how well they are able to control their diabetes with treatment."
What are some of the health complications associated with diabetes?
Diabetes has serious effects on the body and as a result, can increase a person's risk of developing other medical conditions with both short and long term effects. The most common health complications that come with having diabetes include eye disease, which often results in blindness, heart disease and kidney disease.
"Basically, both diseases cause blindness, heart disease and kidney disease. In fact, kidney disease with type two diabetes is the most common course of getting on to dialysis," Clifton said.
"Heart disease is probably doubled in people with type two diabetes and that is the thing that kills the the most people. It usually takes ten years of either type one or type two diabetes until you start to see complications."
How is diabetes managed?
Diabetes requires daily management and often has to be tailored to suit each person individually.
"Diabetes management depends enormously on, first of all what kind of diabetes you've got, type one or type two, what sort of person you are, what sort of lifestyle you lead and what type of risks do you have," Neal said.
"In type one diabetes that very much focuses on the amount of sugars and carbohydrates and the ratios of them... with type one diabetes you have to make a very careful balance of how much you can have.
"In type two diabetes the primary issue is one of weight loss and getting healthy."
How can we avoid developing diabetes?
"Diabetes in Australia has gone up enormously over the last few decades and and it is likely to continue to go up for a few years," Neal said.
As diabetes is on the rise in Australia, there is a need now more then ever to be aware of how to avoid developing it. Professor Clifton explains that avoiding diabetes, especially type two, comes down to living a healthy life by keeping to a normal weight and exercising.
"Also some dietary changes, like having a relatively high fibre diet is also protective and less saturated fat, [which] is associated with type two diabetes as well and not smoking."