THE SILENT KILLER: DIABETES TYPE II

Take a pen to the simple questions at the end of this section. If you tick one or more boxes, you should ask for a blood-sugar test next time you see your doctor; you may be among the 350 000 Australians our health authorities are trying to trace.

This staggering number of people are happily going through their days, quietly nurturing a lifestyle disease called diabetes type II. While some have no obvious symptoms, many have symptoms they mistakenly accept as a natural part of ageing. Fatigue is a common one, as is passing urine more frequently than normal, which can, in turn, lead to a constant thirst.

Blurred vision, dizziness, recurrent skin infections that are slow to heal and erectile difficulties are also common in people with diabetes type II. The authorities are extremely keen to identify such people because, by controlling this disease, they can save individuals untold misery and the health budget billions.

Diabetes type II used to be called mature-onset diabetes because it showed up in people past the age of 40. Sadly, it is now appearing a decade earlier, particularly in high-risk groups such as our indigenous people, Pacific Islanders and people from Asia.

Once a person has diabetes type II, they have it forever. There is no cure.

It is different from type I, which is less common but equally serious; type I is usually diagnosed during childhood and must be treated with insulin injections if the sufferer is to survive.

The problem with diabetes type II is that you only know you’ve got it when it is already causing damage. The earlier you find it the better. It is an extremely powerful force for premature ageing from the inside out. Once it takes hold, it can damage the arteries, cause early heart disease, compromise vision, lead to kidney failure and initiate deterioration in the nerves.

When advanced, it can lead to loss of limbs, heart failure and death. It is the sixth major cause of death by disease in Australia.

Diabetes type II is the world’s fastest-growing disease, and every 10 minutes someone in Australia is diagnosed with it. By the year 2010, more than 1.2 million Australians will have it.

While a diagnosis of diabetes can be devastating, it is best to take the blow now and stop it in its tracks. Recent research shows that proper treatment can reverse some of the complications and even prevent them occurring. Although there is no such thing as ‘mild’ diabetes, it can be controlled so that its effects are mild or even absent. Erectile problems may be alleviated by treatment.

Diabetes occurs when the amount of sugar in the blood is too high because the body is unable to use it properly. The body can’t effectively convert the sugar into energy, which is why those with the disease feel tired. Either too little of the hormone insulin is produced, or what is produced is inefficient. Insulin’s job is to regulate sugar.

This can happen because a person has been overweight for too long, has been sedentary for too long or has a genetic tendency that is unmasked by ageing and an unhealthy diet – particularly a diet rich in animal fat and refined sugar.

During pregnancy a foetus can also be ‘reprogrammed’ to increase its risk of diabetes in adult life.

Recently, a 36-year-old, inactive, unfit doctor wrote an amusing account of his own diagnosis of diabetes type II. He described his build as classic Neanderthal: ‘Meaty limbs, heavy shoulders and a stout pelvis topped by a sagging gut.’

Some years earlier he had developed headaches and begun waking up with a hangover. Even after he cut his alcohol consumption ‘to the bone’, hangovers persisted. Last summer, his energy levels slipped fast and he started getting dizzy spells. At the same time he noticed ants around the base of the toilet. ‘In lieu of thinking, I poisoned the nest,’ he wrote.

The ants were attracted by the high level of sugar in his urine. This is standard. Ants love sweet urine. Many a man who has relieved himself in the garden and later noticed a congregation of ants on the wet patch has gone on to be diagnosed with diabetes type II.

The doctor also noticed a faint odour reminiscent of apple brandy exuding from his body. One hot night in February he realised he shouldn’t be passing so much urine. At his practice he tested himself and confirmed his fears. His blood sugar was sky high. His own general practitioner put him straight onto medication for diabetes and high blood pressure, which is commonly associated with diabetes.

With the identification of his nasty medical surprise, parts of his life suddenly made sense. He became aware of many symptoms because treatment resolved them suddenly. The acetone odour went away, but the vertigo and malaise remained.

He resolved that the disease wouldn’t have him. He wouldn’t, he said, sit on his behind like other diabetic patients, who console themselves with beer and chips and wait for the government’s help. He took charge and within 6 weeks had normalised his blood sugar and was beginning to feel his energy levels climbing. Apart from medication, this condition can be managed by eating simple, healthy food and exercising. Exercise helps the body’s insulin work better, not only during the activity, but also for 12 to 24 hours afterwards.

Management is a life-long commitment and includes regular testing of sugar levels. As the invigorated Neanderthal doctor wrote, this experience taught him just ‘how sneaky chronic diseases can be’.

TEST YOURSELF

Are you older than 50?

Are you overweight?

Do any of your close blood relatives have diabetes?

Do you belong to an ethnic group that has a high risk of diabetes (e.g. are you Aboriginal, Chinese, Indian, Maltese or Polynesian)?

Have you had any of the following symptoms on a regular basis:

severe thirst?

frequent urination?

unexplained weight loss?

blurred vision?

extreme tiredness?

* Test from Melbourne’s International Diabetes Institute.