Diabetes can be a killer but it is possible to lead a normal, active life

Diabetes is a rapidly increasing problem. The two common types of diabetes are type 1 (where the body makes little or no insulin) and type 2 (insulin is produced but not used properly). Nearly 95% of those with diabetes have type 2, about 270,000 New Zealanders.

Insulin is a pancreas hormone that lets you convert sugars and starches into energy.

Diabetes leads to abnormally high levels of blood glucose (sugar). If not discovered or left uncontrolled, this can lead to severe complications for the eyes and heart, kidney failure and foot ulcers. One of the main issues is many people do not know they have it.

Type 2 diabetes tends to run in families, more so with Maori and Pacific Islands families. It is more common as you get older or if you've had diabetes in pregnancy. But physical inactivity and obesity, now seen often in young people, are the most common preventable risks. But anyone can get diabetes, even sporty people.

Some people first notice they need to pee more often, are always thirsty, get lots of infections or lose weight. Type 1 symptoms develop rapidly, particularly in children; type 2 more slowly. Your GP can arrange glucose tests.

Many people who have diabetes still lead normal, active lives but, as someone once said, it's like being expected to play piano with one hand and juggle with the other, while balancing on a tightrope.

The treatment varies, depending on needs. Type 1 diabetes requires insulin injections. Type 2 is often managed just with oral medicines but insulin injections are required to help control it in one in three people with type 2. Medicines aside, learning how to take care of yourself accounts for 98% of any success with diabetes. Not smoking, choosing the right foods, sensible exercise like walking for weight loss and learning about your medicines and blood sugar testing all help.

Your GP, practice nurse, diabetes nurse specialists and dietitians are there for advice and education. Regular checks are important, for blood pressure as well as blood sugar.

If you're taking insulin or some oral diabetes medicines, a potential problem is low blood sugar (hypoglycaemia). It's important to learn how to avoid this (it comes on suddenly), how to recognise it (it can make you feel weak, confused and sweaty, with slurred speech) and treat it by checking your blood sugar level immediately and eating something sugary (a boiled sweet or glucose tablet). Some people who get low blood sugar are also advised to carry a glucagon injection and wear a MedicAlert bracelet.

Problems due to high blood sugar (hyperglycaemia) are less common and occur more slowly but do need medical attention. Warning signs include fruity smelling breath, rapid breathing and a dry mouth.

New Zealand diabetes expert Professor Don Beaven says it is "our single most important disorder and killing 12 people daily", which is why early diagnosis is vital.

(Published in the Sunday News, 6 September 2009)

More everybody MYHEALTH columns from Barbara Docherty

Barbara Docherty is a registered nurse and clinical lecturer at the University of Auckland School of Nursing, and writer for the everybody.co.nz website. The opinions contained herein are those of the author and not necessarily those of the publisher or sponsor. Copyright UBM Medica (NZ) Ltd.