Diabetes Awareness Week 2008
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28 August 2008
No ban on food advertising to children
 
There will be little change to the regulations covering food and beverage television advertising to children
 
26 August 2008
Shirley lives life by supporting Buzz Day
 
Riverwood local Shirley Davidson will be at a train station in Sydney this September helping the fight against diabetes.
 
28 August 2008
Environmental factors may explain increasing type 1 diabetes
 
Environmental rather than genetic factors appear to be the cause of the increasing incidence of type 1 diabetes in children in Australia, according to a new study.
 
25 August 2008
Long term benefits of lower GI diet for type 2 diabetes
 
Beta-cells that produce insulin function more effectively on a lower Glycemic Index (GI) diet than a low carbohydrate diet.
 

Media Guide

Myths

Myth #1 Sugar causes diabetes.
Sugar does not cause diabetes. Type 2 diabetes is caused by a combination of genetic and lifestyle factors. While it is important to limit foods which are concentrated sources of sugar, or high in added refined sugar (eg soft drinks, lollies and syrups), small amounts of sugar can be included as part of a lower fat, high fibre meal plan for people with diabetes. Type 1 diabetes is thought to be caused by genetic factors and possibly environmental triggers.

Myth #2 People with diabetes can’t eat chocolates or sweets.
Occasionally, chocolates and sweets can be consumed in small quantities by a person with diabetes as part of a healthy eating and physical activity plan.

Myth #3 People with diabetes have to eat special foods.
People with diabetes are encouraged to follow the Dietary Guidelines for Australia, which encourage a diet low in saturated fat, high in fibre, wholegrain foods and includes sugar in moderation. This is the same diet recommended for everyone.

Myth #4 You can catch diabetes.
Diabetes is not contagious. It is one of the world’s most common, non-communicable chronic diseases.

Myth #5 People can have a ‘touch of diabetes’.
A phrase often heard but there is no such condition as a touch of diabetes, mild or borderline diabetes. All diabetes is serious and if not properly managed can lead to serious complications.

A term we avoid
“Oh, she’s a diabetic”. It’s a phrase that’s guaranteed to upset many people with diabetes. As an organisation dedicated to looking after the rights and interests of people with diabetes, we don’t define or label people by their disease. This is not a question of being ‘PC’. Someone with cancer is not called a ‘canceric’.

We describe someone who has diabetes as simply - ‘a person with diabetes’.

The Epidemic

THE DIABETES EPIDEMIC - explained in numbers
Diabetes is the fastest growing chronic disease in the world. Type 2 diabetes, which is closely linked to lifestyle, is doubling every 10 years in Australia and has now reached epidemic proportions around the world. Type 1 diabetes is increasing at about 3 per cent a year and affects about 130,000 Australians.

AusDiab, the largest population based study in Australia, found that 7.4 per cent of Australians have diabetes. Only 3.7 per cent are diagnosed. Diabetes Australia-NSW figures, based on the number of diagnosed cases, show that about 750,000 Australians have diabetes. Using the AusDiab research that for every person diagnosed, another is undiagnosed, Diabetes Australia-NSW says more than 1.5 million Australians have diabetes. If current rates continue, the number of people with diabetes will reach four million by 2012

In New South Wales alone, 530,000 people have diabetes but if the current rate of one person being diagnosed every seven minutes continues, the number will reach one and a half million people by 2012.

Worldwide, diabetes affects more than 230 million people and is expected to affect 380 million by 2025.

Australians at high risk of diabetes
Indigenous Australians are 10 times as likely to have diabetes than other Australians. In some rural and remote communities, up to 50 per cent of Indigenous people have diabetes. Death rates among Indigenous Australians are almost 15 times higher than other Australians.

Certain overseas born Australians also have a higher prevalence of diabetes. These are people from Southern and Central Asia, North Africa, the Middle East and the Pacific Islands.

Diabetes statistics
Diabetes is –
• the leading cause of heart disease, stroke, blindness, kidney disease and lower limb amputation.
• diagnosed every seven minutes.
• the sixth highest cause of death by disease in Australia.
• implicated in more than 8% of all deaths in Australia, either as the underlying cause or an associated cause.
Of those people with diabetes in 2000
• 19 per cent were hospitalised with coronary heart disease
• 15.4 per cent had retinopathy (eye damage)
• 90 per cent undergoing a lower limb amputation had a history of ulceration
• 3,404 had amputations
• 12 per cent over the age of 25 had a heart attack, 9 per cent of these had a stroke
• 22.6 per cent died from kidney disease
Further statistics in Complications / About Diabetes sections

The Cost Burden
• Type 2 diabetes costs Australia $3 billion a year.
• The cost of diabetes to the community for a person with no complications is $9,625 a year.
• For a person with complications, the cost to the community is $15,850.
• 4 per cent of people who have diagnosed diabetes account for 12 per cent of health costs in Australia.

History of Diabetes

IN THE HISTORY OF HUMAN AILMENTS, few diseases are as mysterious, misunderstood, misdiagnosed or wrongly treated as diabetes.

For 3,500 years, beginning with the early Egyptians, the remarkable story of diabetes has been surrounded by myth and legend, incantations and foul applications, nightmarish treatments and medical miracles.

Diabetes by nature is so complex and so ambiguous that ancient healers, when referring to their emaciated patients, described the condition as a ‘thirsty disease’ and ‘thirst as if scorched by fire’. In tasting their dying patients’ urine, they declared it was sweet and tasted like honey.

Written records dating to about 1500 BC, show the Egyptians tried to diagnose the problem of excessive urination and prescribed ‘a medicine to drive away the passing of too much urine’.

The ancient Hindus were the first to coin the term ‘honey urine’. In 600 BC, Susharata, the father of Indian surgery, called it Madhumeta - ‘raining of honey’ and noted that flies and ants were attracted to the urine of those affected by the disease. The Greek physician Aretaeus (right) is credited as the first to use the word diabetes.

In 150 AD, he described diabetes as ‘a wonderful affection… being the melting down of flesh and limbs into urine’.

Derived from the Greek, diabaínein, meaning siphon, the word diabetes literally means: ‘dia’ - through, ‘betes’ - to go.

Egyptian and Greek physicians devised treatments involving a variety of herbal remedies using every ingredient imaginable. They applied poultices and prescribed emetics to induce vomiting.

Apart from the Greek word diabaínein being anglicised to diabetes in about 1450, there was little change in medical understanding and practices until 1675. Thomas Willis, an English doctor considered to be the father of neurology, concluded that diabetes was a disease of the blood and noticed what the early Hindus had seen; that the urine of a person with diabetes had a sweet taste ‘as if it were imbued with honey or sugar’. Almost 100 years later, in 1769, Scottish physician, William Cullen reclassified diabetes by adding the word mellitus, Latin for honey.

It opened the way for dietary therapies, ranging from diets of ‘fat and rancid old meats’, vegetable diets, blood pudding diets and starvation diets. However, along with prescriptions for blistering and bleeding, nothing worked. Patients died.

Children who didn’t die soon after diagnosis could expect to live another year to 18 months. Adults would survive a few years longer after enduring incredible suffering.
Major gains were made in medical knowledge towards the close of the 19th century, particularly when doctors made the link between diabetes and the pancreas. They began to understand that diabetes was the result of a malfunction related to the pancreas gland. The biggest breakthrough came in Canada in 1921 when Frederick Banting and Charles Best proved that diabetes was a disease of insulin deficiency, a hormone found in the pancreas. They discovered that insulin could be extracted from the islet cells of the pancreas and injected into a patient with type 1 diabetes.

The pancreatic extract was hailed as a wonder drug and came like a bolt of lightning, suddenly commuting the death sentence that was type 1 diabetes. Within days of insulin injections, weak, emaciated and dying patients made stunning recoveries.
Australia’s connection to the story of insulin comes through Harry Adams, whose six-year-old daughter Phyllis was dying from type 1 diabetes. When news of insulin reached Harry, he pleaded for Banting to send the drug to Australia. Banting obliged and when it arrived, Harry Adams had Phyllis waiting on a wharf in Sydney to be given an immediate injection. She lived a full life, becoming the world’s longest surviving person on insulin.

The discovery of insulin divides the history of diabetes into pre-insulin and post-insulin. It ushered in the management era and transformed diabetes from a certain death sentence to a chronic disease, bringing on a lifetime of management and the risk of debilitating complications.

Since the 1920s, newer, more refined, longer lasting insulins have been developed and oral medications introduced to manage type 2 diabetes.

Dramatic changes have occurred in knowledge, management and medical practice.
New technologies enabled the introduction of home glucose monitoring in the 1970s giving people with diabetes the unprecedented ability to self manage their disease. Better injection systems, including an insulin inhaler, have arrived, along with continuous insulin pumps attached to the body.

A greater understanding of biological differences has identified a clear distinction between the different forms of diabetes; type 1, type 2, (insulin dependent and non-insulin dependent) and gestational diabetes.

Despite great leaps in medical knowledge and technological advances, the last 30 years have seen the startling emergence of an epidemic in type 2 diabetes - a lifestyle disease driven by obesity and fuelled by over-abundance.

In the last few years, type 2 diabetes, once considered an ‘old persons’ disease is occurring in young people, compelling them to a lifetime of management and potential complications.

A major US trial in 2002 announced that type 2 diabetes could be prevented through a healthy lifestyle – 2,000 years after Hippocrates proclaimed the concept of preventive medicine, stressing the influence of diet, exercise and lifestyle on health.

Type 1 diabetes can still not be cured but scientists are confident that through advances in new research, ranging from islet transplantation and gene therapy to stem cells, a cure is close at hand.

Diabetes Australia-NSW & Contacts

WE ARE A CHARITY
DIABETES AUSTRALIA-NSW is part of a federation of member States and Territories with a national secretariat based in Canberra. The organisation is also made up of other major diabetes organisations covering medical, educational, and scientific research. The federation also includes health professional and research supporting arms.

The only charity helping all people with diabetes
We are a non-profit, non-government, consumer based organisation. Our mission is to help people by working to reduce the impact of diabetes on their lives. We achieve this through members’ financial support and community donations. Funds are spent on research, education programs, public awareness campaigns and advocacy to protect the rights of people with diabetes.

53,000 voices
Diabetes Australia-NSW is the third oldest diabetes organisation in the world and one of the largest member based groups in Australia. Established in 1937, we have more than 53,000 members.

As the organisation closest to the problem of diabetes we -
• administer the government’s National Diabetes Services Scheme, which provides subsidised products to Australians who have diabetes
• provide personalised and practical health and education assistance to benefit people with diabetes and their carers. Our Call Centre in NSW receives more than 600 telephone calls a day
• run seminars for GPs and health professionals
• produce thousands of articles of print material in the form of fact sheets, pamphlets and books
• inform members of the latest news and medical research information through our magazines and website
• produce special publications for children and teenagers
• take up member’s complaints and advocate on their behalf if they have been discriminated against
• run special camps for children and young people
• target high-risk groups such as Aboriginal and non-English speaking communities
• raise funds through innovative and creative event-based programs such as ‘Buzz Day’ and the ‘Great Australian Bite’
• run corporate and community-based lifestyle programs
• seek and gain sponsorship to help meet the cost of our awareness, education, research and advocacy activities.

Dollars for diabetes
The Business Enterprise Division of Diabetes Australia-NSW markets selected and innovative diabetes-related products to provide people with diabetes a wider choice of the latest technology and products at affordable prices. Profits go to our education, awareness, research and advocacy programs.

Optimistic and upbeat
One of the problems characterising diabetes is that to survive, people must adopt a lifetime commitment to managing their disease. For those with type 1 diabetes, this means injections every day of their lives, closely watching their diet and their lifestyle and coping with the threat of complications… blindness, kidney failure, loss of limbs, heart disease and stroke.

Diabetes is psychologically, physically and emotionally draining. It can fill the young with indignation and resentment. It can build walls of loneliness around the elderly.
For these reasons, Diabetes Australia-NSW fully appreciates the need to maintain a positive and optimistic outlook on life. Ever since the invention of insulin, every person with type 1 diabetes has been waiting and hoping for the cure that will change their lives.

While every new medical development keeps hope alive, we constantly encourage people that they can lead long, fulfilling and rewarding lives by maintaining a healthy lifestyle and a positive attitude.

Diabetes research
There is no cure for either type 1 or type 2 diabetes. The hope for a cure lies in research. Diabetes Australia-NSW supports research through the Diabetes Australia Research Trust (DART). For 2007, Dart provided about $3.5 million in grants for some 60 new and continuing diabetes research projects.

Main publications
Issues - member journal published every three months
JellyBean Scene - magazine for children aged 1-12
You Said What!? - magazine for teenagers
Invigorate - magazine for people with pre-diabetes

Websites
www.diabetesnsw.com.au
www.diabeteskidsandteens.com.au

Significant events
NSW Corporate Games- March
Diabetes Awareness Week - begins second Sunday in July
Camps / GP and Allied Health Update Day

Fund raising –
The Great Australian Bite - April
The Buzz Ball - July
Buzz Day – SeptemberFinish Friday at 4- November

Contacts
Media Inquiries:
Aaron Parnell Phone - 9552 9941 or 0437 969 207
Claudia Haddad Phone - 9552 9984 or 0416 110 822
Trevor Tye Phone- 9552 9943 or 0410 624 055

Income Development:
Sarah Ferguson Phone - 9552 9952
Amanda Stokes Phone- 9552 9918

Source of Statistics:
Diabetes Australia-NSW and partner organisations, AusDiab 2005, AIHW-2002, NDSS, Diabcost 2003, Vision Australia Foundation, International Diabetes Federation. References can be provided on request.

Complications & Prevention

DIABETES COMPLICATIONS
Over time, high blood glucose levels can damage the body’s organs. However, good diabetes care and management can prevent or delay the onset of serious complications. The most common complications are damage to the big blood vessels leading to heart attack or stroke. Damage can occur to the small blood vessels, causing problems in the eyes, kidneys, feet and nerves.

Heart disease/stroke. People with diabetes are almost three times more likely to have high blood pressure, obesity or elevated blood fats, eg cholesterol and triglycerides. Close to 80 per cent of people with diabetes will die from a heart attack or stroke.

Eye disease. Retinopathy is a major long-term complication of diabetes. It affects about 1 in 4 people with diabetes. The development of retinopathy is strongly related to the length of time diabetes has been present and the degree of blood glucose control. Regular eye checks and treatment can help prevent retinopathy-caused blindness.

Kidney disease. Diabetes is the fastest growing cause of kidney failure. It is the leading cause of end stage renal disease (ESRD). About 30 per cent of people with diabetes will develop kidney disease.

Lower limbs. Neuropathy or peripheral nerve disease and blood vessel damage may lead to leg ulcers and serious foot problems from which limb amputation may result.

DIABETES PREVENTION
While type 1 diabetes cannot be prevented, type 2 diabetes, which is strongly linked to obesity and lack of physical activity can be prevented or delayed. Eighty per cent to 90 per cent of people diagnosed with type 2 diabetes are overweight or obese. The key is early detection and a healthy lifestyle. The time to act is before pre-diabetes progresses to type 2 diabetes.

International studies found that modest weight loss of 5 per cent to 7 per cent and regular physical activity at a moderate intensity of 30 minutes five times a week, lowered the risk of developing diabetes by nearly 60 per cent.

Management

DIABETES MANAGEMENT
Medications
People with type 1 diabetes require daily insulin injections, several times a day.
People with type 2 diabetes can manage their blood glucose levels through lifestyle changes, such as healthy eating, regular physical activity and weight reduction. However, many require oral medications to lower their BGLs and in time may progress to insulin therapy.

The aim of good diabetes management is to keep blood glucose levels as close to normal as possible and requires a long-term commitment. This means maintaining a healthy lifestyle that includes regular physical activity, healthy eating and regular appointments with the person’s diabetes team. The team is made up of the doctor, diabetes educator, dietitian, exercise physiologist, ophthalmologist, optometrist, podiatrist, pharmacist and importantly – the person with diabetes.

Physical Activity
By becoming more active, people with diabetes can improve their general health, quality of life and diabetes management.

Regular physical activity helps to -
• Improve insulin sensitivity (makes insulin work better and lowers blood glucose levels)
• Improve blood pressure and lowers blood fats, which reduces the risk of heart
disease
• Achieve and maintain a healthy body weight
• Increase bone strength and reduce the risk of osteoporosis
• Improve quality of life and sense of well being
• Slow down the ageing process

Healthy Eating
There is no such thing as special foods for people with diabetes but they need to spend some time planning healthy meals and snacks which improve their diabetes management. They should:
• Eat regular meals spread evenly over the day to help control blood glucose levels (BGLs).
• Include carbohydrate foods at each meal - Carbohydrate foods are the best source of energy for the body. When carbohydrates are digested they are broken down to glucose in the bloodstream. Carbohydrates include breads, cereals, pasta, rice, starchy vegetables (potato, sweet potato and corn), fruit, legumes and milk based dairy products or alternatives (milk, yoghurt and dairy desserts). The type and amount of carbohydrate consumed is important for people with diabetes. The amount will depend on many factors including age, body weight and activity levels.
• The Glycemic Index, or GI, is a ranking of carbohydrates in foods according to how they affect blood glucose levels. Foods with a low GI raise BGLs more slowly and steadily than foods with a high GI. People with diabetes can benefit from eating low GI foods throughout the day, ideally one at each meal. Low GI foods include heavy grain breads, rolled oats and muesli, pasta, corn, low fat milk and yoghurt as well as most fruits.
• Choose foods lower in total fat and in particular low in saturated fats. Eating too much fat in the diet can result in weight gain. Saturated fats in particular need to be limited as they can increase the ‘bad’ cholesterol increasing the risk of heart disease.
• Choose high fibre foods. Fibre has many benefits including keeping bowels healthy, protecting against bowel cancer and high cholesterol levels. A high fibre meal is also more filling, which can assist with weight loss.

About Diabetes

DIABETES IS A CONDITION...
... where there is too much glucose (sugar) in the blood. Glucose is the main source of energy for the body and comes from carbohydrate foods we eat. Carbohydrate foods include bread, pasta, rice, cereals, fruits, starchy vegetables and milk and yoghurt. The body breaks carbohydrates down to glucose which then enters the blood stream. For glucose to enter the cells and be used for energy, a hormone called insulin must be available. Diabetes occurs when the body does not make insulin or when the insulin that is made is not working properly. This leads to increased blood glucose levels and diabetes.

Major types of diabetes
Type 1 diabetes is an autoimmune disease. Previously known as juvenile onset or insulin dependent diabetes. Type 2 diabetes is a metabolic disorder, previously known as mature onset diabetes. Gestational diabetes is a risk factor for type 2 diabetes and occurs only in pregnancy.

Type 1 diabetes
• Represents 10 to 15% of all cases of diabetes
• Occurs when the pancreas no longer produces the insulin needed, making insulin injections essential for life
• Is not caused by lifestyle factors
• Is one of the most common chronic childhood diseases in developed nations
Symptoms
• Usually abrupt onset. Symptoms can include excessive thirst and urination, unexplained weight loss, weakness, fatigue and irritability.
Diagnosis
• Usually in childhood or young adulthood, although it can occur at any age.
Management
• Lifelong daily insulin injections, regular blood glucose level testing, healthy eating and regular physical activity.

Type 2 diabetes
• Represents 85 to 90% of all cases of diabetes
• Sometimes referred to as mature onset or non-insulin dependent diabetes
• It is more commonly diagnosed in adults over the age of 45, although children and teenagers are increasingly developing type 2 diabetes
• Occurs when the pancreas is not producing enough insulin or the insulin is not working effectively
• Physical activity, healthy eating and sometimes medications and/or insulin may be needed to keep blood glucose levels (BGLs) in the ideal range
• Lifestyle factors such as unhealthy diet and lack of exercise can contribute to the development of type 2 diabetes.

Symptoms
Sometimes symptoms go unnoticed as the disease develops gradually or the individual assumes the symptoms are part of the normal ageing process. Symptoms may include frequent urination, thirst, blurred vision, skin infections, slow healing, tingling and numbness in the feet. Both major types of diabetes can lead to complications.

Diagnosis
Diagnosis is made by either a Fasting Blood Glucose (FBG) or Oral Glucose Tolerance Test (OGTT) which are ordered by a doctor and conducted by a pathology laboratory.

Management
Regular physical activity, healthy eating and blood glucose monitoring are the cornerstones of diabetes management. Over time, tablets and/or insulin injections may be necessary. Ongoing education is also important in diabetes management.
Risk factors for developing type 2 diabetes
• Over 45 years of age and having high blood pressure
• Over 45 years of age and being overweight
• Family history
• Over 55 years of age
• Heart disease or heart attack
• Gestational diabetes
• Impaired Fasting Glucose (IFG) or Impaired Glucose Tolerance (IGT) also known as Pre-diabetes.
• Polycystic Ovarian Syndrome
• Over 35 years of age and of Aboriginal Torres Strait Islander, Pacific Islander, Indian or Chinese heritage

Gestational diabetes
• Is a form of diabetes that occurs during pregnancy
• The woman’s body may not be able to make enough insulin or may not be able to use it correctly during this time
• The extra stress of pregnancy on the body can cause high blood glucose levels
• It is usually found by having a blood test between 24 and 28 weeks of pregnancy
• Usually goes away after the baby is born
• Significantly increases the risk for type 2 diabetes
• Up to 50% of woman may develop type 2 diabetes within five years

Pre-diabetes
Pre-diabetes is a condition when blood glucose levels are higher than normal but not yet high enough for a diagnosis of type 2 diabetes. People with pre-diabetes have impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Some have both.
• IFG is an early sign that a person’s insulin is not working properly in moving glucose from the blood into the cells. This is known as insulin resistance and is diagnosed by a two hour Oral Glucose Tolerance Test (OGTT) when the fasting blood glucose level is higher than normal but does not rise abnormally after drinking a sweet glucose drink.
• IGT is often the next step from IFG towards developing type 2 diabetes and is diagnosed by an OGTT when the fasting blood glucose level does rise abnormally after a sweet glucose drink but is still below the diagnosis of diabetes.

An estimated two million Australians have pre-diabetes. Although not inevitable, if left untreated, pre-diabetes may develop into type 2 diabetes within five to 10 years. In addition to the risk of developing diabetes, people with prediabetes are more likely to have a heart attack or stroke and are at greater risk of premature death.

Blood Glucose Monitoring

BLOOD GLUCOSE MONITORING
Blood glucose monitoring is recommended as a valuable diabetes management tool that can help people with diabetes gain a better understanding of the relationship between their BGLs and lifestyle choices and medication i.e. insulin/ oral therapies. Regular testing provides information on how the body responds to food and other influences, enabling people to make the necessary adjustments.

Self monitoring is carried out using a blood glucose meter. The frequency, timing and recommended range, are different for everyone and should be determined by the diabetes team.

Hypoglycaemia (hypo)
Hypoglycaemia is a low blood glucose level. It is also known as a hypo and can occur in people with diabetes using insulin and certain diabetes medications. Hypos usually occur when the blood glucose level falls below 4mmol/L.

Hypos can be caused by:
• Delayed or missed meals, or a meal with too little carbohydrate
• Extra strenuous or unplanned physical activity (hypo may be delayed up to twelve hours)
• Alcohol (especially on an empty stomach)
• Too much insulin or medication for diabetes
• Vomiting (unable to tolerate food)
Signs/symptoms of a hypo
The brain relies on glucose for its energy supply and brain function deteriorates when not enough insulin is supplied.
Signs may progress from mild to severe.

Hypos can cause:
• Feeling weak, or shaky
• Sweating
• Headache
• Pallor
• Hunger
• Behaviour change - tearful/crying or aggressive/irritable
• Tingling round the lips
• Racing heart beat
• Lack of concentration
• Feeling light-headed or dizzy
• Loss of consciousness

Hypo treatments
Hypos may be dangerous so it is important to treat them immediately. People having a hypo may also be uncooperative and possibly aggressive.

If a person is conscious and cooperative, they need to be given something sweet to eat or drink, such as fruit juice, a soft drink containing sugar or jelly beans.

If they are unconscious or can’t cooperate, they should not be given anything by mouth. Instead, call an ambulance.

Diabetes Dictionary

A
Adrenal glands Glands located at the top of each kidney that secrete important hormones for the function of many organ systems in the body.
Adult stem cell Undifferentiated cell found among differentiated cells in a tissue or organ that can renew itself. The primary role in a living organism is to maintain and repair the tissue in which it is found.
Alpha Cells Alpha cells are found in the pancreas. They produce a hormone called glucagon, which raises blood glucose levels.
Antibodies / Antibody A special kind of protein made by the immune system that is released in response to something foreign in the body eg. virus. Antibodies help fight infection.
Autoimmunity Pertaining to development of an immune response to one’s own tissue.

B
Beta Cells Cells in the pancreas that make the hormone insulin.
Blood Glucose Level (BGL) The amount of glucose (sugar) in the blood stream.

C
Carbohydrate A nutrient in food that provides a major source of energy. Usually found in grains, fruits, starchy vegetables and milk based dairy foods. Is broken down to glucose in the blood stream and raises blood glucose levels.
Cholesterol A fatty waxy substance made by the body and also found in some foods. High levels of cholesterol in the blood stream are a risk factor for heart disease.
Coeliac Disease A condition where there is an intolerance to gluten, a protein found in foods that causes damage to the small intestine.

D
Dawn Phenomenon This occurs when BGLs rise in the early hours of the morning due to the natural release of the hormones cortisol and adrenaline.
Diabetic ketoacidosis (DKA) A sudden loss of control of type 1 diabetes with high blood glucose levels and breakdown of fat leading to a build up of acids in the blood with nausea, vomiting and dehydration. Without urgent medical attention, DKA can lead to coma and death.

E
Embryonic stem cells Derived from embryos that develop from eggs that have been fertilised in vitro and then donated for research purposes with informed consent of the donors. They are not derived from eggs fertilised in a woman’s body.
Endocrinologist A doctor who specialises in the management of diseases of the glands, including the adrenal, thyroid, pituitary, parathyroid glands, ovaries, testicles and pancreas.
Enzymes A special protein made in the body that assists with naturally occurring biological functions of the body.
Erectile Dysfunction (Impotence) The loss of a man’s ability to have an erection. Some men may become impotent after having diabetes for a long time because the nerves or blood vessels have become damaged. Sometimes the problem has nothing to do with diabetes and may be treated with counselling.

F
Fats One of the three main classes of foods and a source of energy in the body. Fats help the body use some vitamins and keep the skin healthy. They also serve as energy stores for the body. In food, there are three types of fats: saturated,
polyunsaturated and monounsaturated.
Fibre A substance found in foods that come from plants. Fibre helps in the digestive process and is thought to lower cholesterol and help control blood glucose (sugar). The two types of fibre in food are soluble and insoluble.
Fit A convulsion or seizure that can be a symptom of severe or untreated hypoglycaemia.

G
Glucose The body’s main source of energy.
Glucagon A hormone made by the pancreas that causes the liver to release glucose from body stores. Manufactured glucagon is injected to raise blood glucose levels in a person with severe hypoglycaemia.
Glycemic Index A ranking of carbohydrate foods according to their effect on blood glucose levels.
Glycemic Response The effect of different foods on blood glucose (sugar) levels over a period of time.
Glycemic Load The predicted effect of a food on blood glucose levels that takes into account glycemic index and total available carbohydrate.
Glycogen The body’s stores of glucose in the liver and muscle which release glucose (sugar) into the blood when needed by cells. Glycogen is the chief source of stored fuel in the body.

H
HbA1c A test to identify the average blood glucose level over the last 2-3 months. Also known as glycosylated haemoglobin, this test measures the amount of glucose that attaches to red blood cells which depends on how much glucose is in the bloodstream. If BGLs have been high over the 2-3 month period, more glucose will attach to the red blood cells and HbA1c will be high. If BGLs are mostly within the recommended range, then HbA1c will be closer to the desired level.
Hormone Hormones are chemicals released by special cells that tell other cells what to do. For instance, insulin is a hormone made by the beta cells in the pancreas. When released, insulin tells other cells to use glucose (sugar) for energy.
Hyperglycaemia Blood glucose levels higher than the desirable range.
Hypoglycaemia Blood glucose levels lower than the desirable range.
Hyperlipidemia Too high a level of fats (lipids) in the blood.

I
IDDM Insulin dependent diabetes mellitus, now known as type 1 diabetes.
Immune system A system of the body that provides protection from infection.
Impaired fasting glucose (IFG) Also called pre-diabetes. A condition in which a blood glucose test, taken after an 8- to 12-hour fast, shows a level of glucose higher than normal but not high enough for a diagnosis of diabetes. Based on a different fasting and oral glucose tolerance test to IGT.
Impaired glucose tolerance (IGT) IGT, also called pre-diabetes. A condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes, 2 hours after the start of an oral glucose tolerance test. Based on a different fasting and oral glucose tolerance test to IFG.
Incidence The number of new cases of a disease that develops over a period of time among people who don’t have the disease. (see Prevalence)
Inhaled insulin Taking insulin through a portable device that allows a person to breathe in insulin.
Islets Groups of cells in the pancreas that make hormones that help the body break down and use food. Also called Islets of Langerhans.
Islet transplantation Placing the islets from a donor pancreas into a person whose pancreas has stopped producing insulin. Beta cells in the islets make the insulin that the body needs for using blood glucose.
Insulin A hormone made by the pancreas that is responsible for controlling blood glucose levels.
Insulin Resistance The inability of the body to recognise and use insulin as it should.

J
Juvenile Onset Diabetes Another name for type 1 diabetes.

K
Ketones Acids in the blood formed when body fat is used instead of glucose to provide energy. High levels of ketones can lead to diabetic ketoacidosis and coma.
Ketosis A ketone build-up in the body that may lead to diabetic ketoacidosis. Signs are nausea, vomiting, and stomach pain.

L
Latent Autoimmune Diabetes in Adults (LADA) is a form of automimmune (type 1 diabetes) which is diagnosed later in life (after 30 years of age). People with LADA are often mistakenly thought to have type 2 diabetes.
Lipohypertrophy Fatty lumps that form when insulin is constantly injected into the same area.
Long acting insulin Insulin that is absorbed slowly into the body after injection. Commonly used in conjunction with short acting insulin in the management of type 1 diabetes in children.

M
Macrovascular Referring to the large blood vessels of the body.
Metabolic syndrome When several conditions occur together, including obesity, insulin resistance, diabetes or pre-diabetes, hypertension and high lipids.
Metabolism Describes the way cells chemically change food so that it can be used to store or use energy and make proteins, fats, and sugars.
Metformin A tablet that lowers blood glucose levels by blocking the release of glucose from the liver. Usually used in the treatment of type 2 diabetes, sometimes used for weight management in children with type 1 diabetes in conjunction with insulin.
Microvascular Referring to the small blood vessels of the body.
Millimole (mmol) A unit for measuring the concentration of glucose and other substances in the blood.
Microalbuminuria Leakage of small amounts of protein into the urine.
Monounsaturated fat A healthy fat that may help reduce the risk of heart disease. Found in olive and canola oil, nuts and avocadoes.

N
NDSS The National Diabetes Services Scheme (NDSS) is a Federal Government funded initiative, administered on behalf of the Government by Diabetes Australia.
Nephropathy Damage to the kidneys.
Neuropathy Damage to parts of the nervous system.
NIDDM Non Insulin Dependent Diabetes Mellitus, now known as type 2 diabetes.

O
Obesity Greater than normal amount of fat in the body; more severe than overweight. A body mass index of 30 or more.
Overweight An above-normal body weight. A body mass index of 25 to 29.9.

P
Pancreas A gland or organ behind the stomach that produces hormones such as insulin.
Polydipsia Excessive thirst and drinking large amounts of water.
Polyunsaturated fat A healthy fat that may help reduce the risk of heart disease. Found in fish, vegetable oils such as sunfl ower oil, nuts and seeds.
Polyuria Passing large amounts of urine due to excess glucose in the blood stream.
Post-prandial After a meal.
Pre-diabetes Blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes.
Prevalence The number of people in a population who have a certain disease or condition. (See Incidence)
Protein A nutrient in food that is important for growth, development and repair of tissues. Foods high in protein include meat, poultry, fish, eggs, legumes and dairy foods.

R
Retinopathy Damage to the small blood vessels at the back of the eye.

S
S aturated fat A type of fat that has been shown to increase the risk of heart disease. Found in animal foods such as butter, full fat dairy foods, and fatty meats, as well as many processed and takeaway foods.
Short acting insulin Insulin that is absorbed quickly into the body after injection. Commonly used in c