Diabetes prevalence and management in Australia

Diabetes in Australia

The Australian government and the relevant Health agencies have for many years strived to put the diabetes menace under close observation and management. There have been massive researches and huge sums directed towards good management and possible elimination of diabetes at the national levels. This commitment is exhibited by the specialized funds and efforts like the Juvenile Diabetes Research Fund (JDRF) that has been committed to striving to mitigate the effects of diabetes from the render age of the Australians.

Since diabetes is such a big challenge to Australia as a whole, diabetes mellitus was declared a National Health Priority Area in 1996 during the Australian Health Minister's Conference and this was as recognition to the high levels of diabetes prevalence within Australia, the mortality rates that were due to it, the impact it had on morbidity and the possibility of the health improvements that can be achieved from the various prevention and treatment programs that were thereafter launched (Australian Government, Department of Health and Ageing, 2012).

What then is diabetes? This disease is described by Department of Health (ditto) as "a chronic disease characterized by high levels of glucose in the blood." Normally, the blood sugar is controlled by insulin that is dispensed into the blood and body system in general and this insulin is a hormone produced by the pancreas. Diabetes therefore occurs when the pancreas, that should be producing the sufficient quantities of insulin, is then unable to produce enough of it, or when the human body grows resistance to insulin and does not utilize it as required, or in some instances both cases above.

There are three main types of diabetes commonly referred to; Type 1 diabetes where the body immune system attacks the cells of the pancreas responsible for production of insulin. Type 2 that is activated by lifestyle and eating habits and the third is the gestational diabetes that occurs mainly during pregnancy (Diabetes Australia, 2013).

Prevalence of diabetes in Australia

Diabetes in Australia has been closely followed, the trends keenly recorded in terms of the age and regional demographics. Regular data is collected, analyzed and presented in the most basic and easy to underrated modes as possible through the various agencies and government websites. This is in a bid to enable as many people as possible to have access and easy understanding of the trends that diabetes takes hence contribute their share in controlling it as well as educate others on the ways that it can be managed effectively.

According to the statistics presented to the Australian government and consequently hosted on various websites by the Australian Institute of Health and Welfare (2011), in 2007-2008, there was an estimated 898,800 Australians diagnosed with diabetes and this figure excluded the gestational diabetes. It also indicates that at a given time in their life, a significant 87,100 people had been diagnosed with Type 1 diabetes and another 787,500 with Type 2 diabetes. It is also estimated that 56% of the people diagnosed in this case with diabetes in general were male and the other 44% were female. It is also indicated within the same source that 96% of the people diagnosed with diabetes in this case were 35 years of age and above and yet another 43% were seen to be 65 years old and above. The general spread of the prevalence was found to be similar in all states and territories and that is after the difference in age has been catered for. It is also noted that after accounting for the age differences, the proportion of people with diabetes was similar in major cities, regional areas as well as the remote areas.

Out of the total number of people with diabetes I Australia, an estimated 557,700 which represented 52% of this population were found to be living in Australia's major cities. Another 230,700 a representative of 26% were studied to be in the inner regional areas and yet another 110, 400 which represent 12% were seen to be living in the outer regional areas or the remote areas. The Australian Bureau of Statistics -National Health Survey did not however include the very remote areas. Also worth noting in the regional proportionality in the prevalence is that, there was a similarity in proportion between the inner regional areas (with 5.2% of the population having diabetes) and the outer regional or remote areas (with 5.1% of the population living there having diabetes) but a slight decrease in proportionality detected in the major cities with 4.0% of the population suffering diabetes. It is worth noting however here that, statistically speaking, after the difference in age has been accounted for, the difference in prevalence between the major cities and the inner regions as well as the outer regions was not statistically significant. This was an indication that the difference between the city and the other regions was partly due to the fact that the dwellers of the other two regions apart from the city were relatively older on average.

In terms of the two major types of diabetes, 87,000 have been diagnosed with Type 1 diabetes which is representative of 0.4% of all Australians. Of this population, 53% of them were seen to be 45 years of age and above. 53% of the Type 1 diabetes patients were male with 47% remaining for the females for the data of 2007-2008. The geographic spread of the Type 1 diabetes was found to be similar between people living within the cities and those living in the remote areas. From these numbers in the Type 1 diabetes, it is worth noting that the number of Australians suffering the Type 1 diabetes is very low as compared against the total number of people suffering from diabetes in general. Indeed even this number is presumed to be higher than it should be since there is possibility that some respondents suffering Type 2 diabetes might have presumed they suffer Type 1 diabetes merely from the fact that they were using insulin to control the effects.

Those diagnosed with Type 2 diabetes was pegged at 787,500 in Australia based on the self reports within the 2007-2008 report as above. Of this number, 444,300 were observed to be males, representing 56% and the remaining 343,200 to be females. It was also noted that 92% of those suffering the Type 2 diabetes were 45 years old and above and yet out of this, another 45% being 65 years and above. It is indicated that 3.8% of all Australians were diagnosed with the Type 2 diabetes with a higher proportion being the males. 4.3% of the Australian males were diagnosed with Type 2 diabetes and 2.2% of the females diagnosed with the same. It is also noted that the proportion of people with Type 2 diabetes increased with the increase in age, this give 0.1% of ages 0-34 years suffering Type 2 diabetes to a high of 14.7% of ages 65-69. Amazingly the proportion goes down again to 12.4% among the ages 80 years and above.

These are outstanding statistics and numbers that should attract ever y person's attention and hence the government has in a major way gone out of its way to ensure there is control of the disease. This effort must be kept up bearing the mortality rates fro diabetes related complications and will be analyzed hereafter.

Type 2 diabetes and Chronic Kidney Disease

It has been noted that the number one cause of Chronic Kidney Disease (CKD) is diabetes which causes damage to the tiny blood vessels in the kidney over a number of years (National Kidney Foundation, 2007). This is a condition that is caused by both types of diabetes and not restricted to Type 2 diabetes alone.

Basically, the kidney is made up of up to one million nephrons which are the filter units of the kidneys. Within the nephrons are the glomerulus which are tiny blood vessels. Damage to these filters is what is referred to as the CKD or diabetic nephropathy. At this state the kidney cannot filer blood as efficiently as it should. Early detection and treatment can help save the kidneys from further damages. Since Type 2 diabetes is characterized by high blood glucose levels, the sugar in the blood, passing through the kidney can cause the blood vessels within the nephrons to be clogged hence get narrower than usual. This deprives the kidney of blood hence damaging the kidney. Therefore, albumin, a type of protein, passes through the kidney and the filters ending up in the urine yet this should not be case. Diabetes is also known to damage the nerves within the body, yet it is the nerves that are responsible for the passing of information between the brain and the various body sections, the bladder included. The nerves informs the brain when the bladder is full and hence the need to empty it. Upon the damage of the nerves, such information on the bladder is not passed to the brain hence continued retention of the urine within the body. This builds up pressure and this pressure from the bladder can damage the kidney. The other effect is that, when the urine stays for abnormally long time within the bladder, it may cause urinary tract infection due to the bacteria in the urine.

Diabetes is a predisposing factor to CKD since it is estimated that a third of the people with diabetes end up with CKD. However, there are other factors that can contribute to the development of the disease such as the age (65 years and onwards), if one has high blood pressure, family history of CKD and also race such as if one is African-American, Hispanic-American, Pacific Islander or American Indian then the risks are higher than the others. It is important generally to keep the blood sugar low and to manage the blood pressure too.

The symptoms of CKD are not very specific though one of the most predominant is the fluid buildup within the body. Other symptoms observed are stomach upset, poor appetite, loss of sleep, weakness and lack of concentration (Kidney Health Australia, 2008).

Management of Diabetes

Being that it is a disease that can predispose the person to other forms of diseases, it is significant for the person to know how to manage the diabetes, having known the type, so that he can avoid further complications.

Of particular case study here is the Type 2 diabetes and how to manage it, bearing the fact that it is the most prevalent type yet it is the one that can be avoided and even managed effectively till it clears off.

Management of Type 2 diabetes can take two major approaches among other;

Diet modification- The patient needs to know that the excessive sugar in the blood is responsible for the Type 2 diabetes. Hence, the tight control of sugar levels within the diet of the individual will reduce significantly the risk of microalbuminuria. The patient should also be encouraged to take very low protein diet. This is in recognition of the fact that a lot of protein strains the kidney and the kidney has to work extra hard hence subsequent ineffectiveness (American Diabetes Association, 2013). Foods that are high on fats should also be avoided since they lead to weight gain and that is a predisposing factor to diabetes. The patient should also be encouraged to eat high fiber carbohydrates instead of the refined ones that have no fiber.

Lifestyle changes -- the docile lifestyle is a central factor to people gaining weight hence predisposing themselves to diabetes. Type 2 diabetes can easily be managed by regular exercises. The regular exercises ensures the control of the blood sugar as it gets metabolized in the process and also, taking into account the weight of most Type 2 diabetes victims, to prevent the possibility of cardiovascular disease (The Global Diabetes Community, 2013). The central reasoning behind the exercise and active lifestyle is that, the muscles that are active and are working use up more glucose that docile muscles. The strained and exercising muscles lead to higher uptake of sugar by the muscle cells and the consequent lowering of the blood sugar.