Around 1.7 million Australians have diabetes, and almost 6000 children under 14 have type 1 diabetes. Half of Australia’s diabetics probably don’t know they have it.
Diabetes is a group of metabolic diseases that have in common abnormal blood glucose control. Glucose is the body’s energy currency. The energy we absorb from the protein, carbohydrate and fats that we eat is converted to glucose for transport around the body. Some of this is used immediately, some of it is stored in muscle or the liver as glycogen, and some is stored as fat. The distribution of glucose to the cells of the body is regulated by the hormone insulin, so that the concentration of glucose in the blood is normally pretty finely tuned. In diabetes the body either doesn’t produce enough insulin, or the cells respond poorly to insulin, so that the level of glucose in the blood is too high.
Long-term high glucose concentrations in the blood can lead to kidney disease and renal failure, peripheral nerve damage and non-healing foot ulcers, cardiovascular disease with heart attack and stroke, and blindness from diabetic retinopathy. In diabetic retinopathy high blood glucose can cause some blood vessels in the retina (the delicate “seeing” tissue in the eye) to leak, leading to swelling and reduced central vision, and it can cause some vessels to close off, starving the retina of oxygen. The retina responds by creating new blood vessels, but the new vessels are abnormal and can bleed and scar, leading to retinal detachment and blindness.
A land-mark study published almost 20 years ago in the New England Journal of Medicine, “The Diabetes Control and Complications Trial” (DCCT), showed clearly that tight control of blood glucose can reduce the risk of complications of diabetes, especially diabetic retinopathy. But tight control is a balance between keeping glucose low enough to prevent damage, and high enough so that the body has the glucose it needs to function.
Diabetes Australia is a not-for-profit organization dedicated to supporting people with diabetes, and supporting the scientists and doctors involved in diabetes research. Much research is focussed on improving management of diabetes, and looking for a cure, and this needs ongoing funding. But raising community awareness, ensuring that the half of diabetics who don’t know they have it can get diagnosed and treated, and advocating for the lifestyle changes that may help some people avoid diabetes is also a big job, and a vital one.
The Wilson HTM Brisbane to the Gold Coast Cycle Challenge (http://b2gc.bq.org.au/) is raising money and attention for Diabetes Australia – Queensland and the Heart Foundation. I’ll be riding with a team from Queensland Eye Hospital. Please join us or consider making a donation to Diabetes Australia (https://www.diabetesaustralia.com.au/Donate/) or the Heart Foundation.