By Jake Davies

1. By Jake Davies

2. What is type 2 diabetes? • Diabetes is a serious condition that effects the way the body uses sugar. Diabetes is a life long disease. • Type 2 diabetes is the most common form of diabetes, affecting 85-90% percent of all people with diabetes. Diabetes affects both the young and old, although it usually effects older people, more and more younger people are being diagnosed with type 2 diabetes. • Type 2 diabetes results from a combination of genetic and environmental factors. Although there is a strong genetic predisposition, the risk is greatly increased when associated with lifestyle factors such as high blood pressure, obesity, insufficient physical activity, poor diet and the classic ‘apple shape’ body where extra weight is carried around the waist.

3. Symptoms of type 2 diabetes • With type 2 diabetes, many people have no symptoms at all. Some signs are just dismissed as a part of ‘getting older” by the time diabetes is diagnosed complications of diabetes may already be present. Symptoms include- • Being excessively thirsty • Passing more urine • Feeling tired and lethargic • Always feeling hungry • Having cuts that heal slowly • Itching, skin infections • Blurred vision • Gradually putting on weight • Mood swings • Feeling dizzy • headaches • Leg cramps.

4. Preventing Type 2 Diabetes • It is estimated that up to 60% of type 2 diabetes can be prevented. People at risk of diabetes can delay and even prevent diabetes by following a healthy lifestyle. This includes – • Maintaining a healthy lifestyle. • Regular physical activity. • Making healthy food choices. • Managing blood pressure. • Managing cholesterol levels. • Not smoking. all these steps can help prevent diabetes.

5. What happens inside your body? • Our bodies use the sugar in blood as fuel. If a person has diabetes, their body is unable to use sugar because they are missing an important substance called insulin. • FROM FOOD TO FUEL – When we eat, our food is broken down into different forms that the body can use. One group of foods, known as carbohydrates then that is turned into a sugar called glucose, which then quickly enters the bloodstream. As soon as the amount of sugar in the blood begins to rise, a gland calle1d the pancreas begins to make insulin. Its job is to help the sugar enter the body cells, which then we use it as “fuel”. As we burn this fuel by working, playing and just being alive, our sugar levels begin to fall. When this happens, the pancreas stops producing insulin until levels in the blood rise again. • THE TROUBLE WITH DIABETES - when someone has diabetes, glucose enters the bloodstream but cannot get into the body's cells. This is because the pancreas does not work properly and cannot produce insulin. So the sugar stays in the bloodstream. The level rises higher and higher. Eventually there is so much sugar in the blood that it overflows into the persons urine.

6. WHAT HAPPENS NEXT?- when extra sugar leaks into their urine, a person needs to urinate a lot. They need to drink a lot of water to make up the lost fluids. Most importantly, a person with diabetes does not make fuel from their food. They feel tired and start to lose weight. • SOLVING THE PROBLEM – people with diabetes need to give their body the insulin it cannot make itself. They do this by giving themselves injections of insulin everyday. Injected insulin does the same job as insulin made by the body, it helps glucose to enter the cells, and keeps sugar levels normal.

7. Did you know? • Diabetes mellitus is the full name for diabetes. It comes from the Greek for “fountain of honey”. This describes the sweet-smelling urine of someone with diabetes. • People with diabetes may have a blood sugar level that is up to ten times higher than normal. • In the past, doctors diagnosed diabetes by tasting a persons urine to see if it is sweet. • Every year 60,000 people in the UK are diagnosed with diabetes. • Diabetes is not caused by eating sweets or the wrong foods. • Diabetes is not a infection, you cannot catch it from somebody else, nor can you pass it on. • Fingertips are good places for blood testing because the blood vessels lie near the surface. • There are fewer nerve endings on the sides of the fingertips. This makes testing less painful. • It’s a good idea to avoid fizzy drinks or replace them with low-sugar or diet substances.

8. using insulin • Giving an injection – giving yourself an injecting might scare some people, but people with diabetes have to give themselves an injection of insulin every morning and night. People with diabetes cannot take insulin in a tablet as it is destroyed by the juices in the stomach. • Where to inject? The best places to inject insulin are in fatty areas for example, the upper arms, stomach, thighs and buttocks. But it is important to change injection sites regularly or the skin may become lumpy and sore. • About insulin - supplies of insulin last for two to three years if they are stored in the fridge. Injecting cold insulin is painful so its best to be brought to room temperature again. When you first start using insulin you are giving a starting dose as you become more experienced they then can start using more or less according to their blood sugar level.

9. How to use An insulin pen. • 1) wash your hands and make sure that the injection site is clean. • 2) dial up the units for your insulin dose. • 3) pinch a fold of skin between your thumb and finger and push the needle into the skin. • 4) put your thumb on top of the plunger and inject all the insulin. • 5) count to five. Take the needle out slowly, keeping it straight.

10. Who gets diabetes? • Diabetes can affect anyone from newborn babies to the elderly. Doctors do not know why some people get diabetes and others do not. Diabetes seems to run in families, although it is hard to predict who will develop it. In other cases the condition may be cause by damage to the pancreas or even diet and stress can play a part. • Health problems - high blood sugar levels can harm the body over many years. If people don’t take proper care and control their diabetes they have more chance of developing health problems in the future. For example – heart attacks, eye damage, kidney damage, and foot and leg problems.

11. Foot care • Diabetes can narrow the blood vessels so that less blood reaches the feet. Even small injections can be very slow to heal, so that’s why its important to look after your feet. Here some simple instructions for you to achieve this – • 1) check your feet daily for cuts or blisters. • 2) wash your feet daily and dry them well. Rub cream into the skin if dry. • 3) keep feet warm. • 4) always wear well fitting shoes.

12. Checking sugar levels • The amount of sugar in our blood changes during the day, if you have diabetes it is important to be aware of these changes. • Keeping a balance- people with diabetes have to control their blood sugar themselves. This means watching what they eat, how much insulin they have and how much exercise they should have. All three things must be kept in balance. The only way to do this is by checking your sugar level by doing four or five blood tests every day. • it is important to record blood test results every time. At the clinic the doctor's and diabetes nurses use the results to check that the blood sugar levels are being kept within safe limits. Over a certain amount of time they can see whether the insulin dose is right or needs changing. For example, a teenager who suddenly starts to grow needs a larger dose of insulin.

13. The highs and lows of Diabetes. • People who have diabetes find it stressful to control blood sugar levels, sometimes it can be either too high or too low which can make them feel unwell. • The highs- having high blood sugar is known as “hyperglycaemia” the symptoms of this are the same when they first diagnosed with diabetes, they are thirsty, keep using the toilet they feel tired and they lose weight. High blood sugar may be caused by infections or by eating too many sugary foods or by not taking the right amount of insulin. It is important to fix high blood sugars as it leads to health problems in later life. • The lows- having low blood sugar is known as “hypoglycaemia” (or hypo for short”. Someone may have hypo for several reasons if they eat later then usual, have an unexpected burst of exercise, or inject too much insulin. A hypo comes on very quickly the person may look pale, feel dizzy, have a headache and may start to sweat. Sometimes a person who is having a hypo may lose their temper or find it hard to concentrate. Most people know when they are about to have a hypo but other don’t know someone else has to rise their sugar level. They might become unconscious if they don’t get help or rise their blood sugar level.

14. Food and drink • For people with diabetes they need to control what they eat and have a healthy diet. They not only have to eat the right food at mealtimes but in between too. • People with diabetes need to eat the same healthy diet recommended to everyone. Low in fat, sugar and salt, high in fibre and plenty of fruit and vegetables. • It is important to eat regularly during the day, it helps to keep blood sugar levels stable. • Carbohydrates are important for people with diabetes because these are the foods that put sugar in our body. Potatoes, rice, bread, chapattis, pasta and cereal should be eaten at every meal time. • Sugary carbohydrates such as cakes, jam, ice-cream, sweets, puddings, fizzy drinks and squash release sugar quickly. They can send sugar levels soaring which is why they are good for treating hypos. But should be only used as a daily food, before and after exercise and a treat after a meal. • Diabetics need to eat snacks between meals. Such as fresh or dried fruit, toast, yoghurt rice cakes, breadsticks a cereal bar or milk.

15. Diabetes at home. • Diabetes affects the whole family. When someone is first diagnosed planning a diet, injections, and blood tests can take hours. • In a family a child who has just been diagnosed with diabetes will become the centre of attention. Other kids in the family may start to become jealous of the attention they are getting. But children with diabetes may e upset that they have to cope with the condition when their brothers and sisters don’t. often parents of children with diabetes join a support group, this helps them to feel less isolated and more confident that they can hope. • Staying positive is the main thing, diabetes isnt that all bad it can have a positive affect on the family. It can encourage everyone to eat healthier and exercise more.

16. Sport and exercise • Using energy - when we exercise, we burn energy, which uses glucose in our blood. This can cause problems for people with diabetes which can result in a hypo. • Before exercise - people with diabetes need to eat a snack before they start any vigorous activity. Such as a mini chocolate bar, a cereal bar or a couple of biscuits. If the activity is going to be more longer and hard, then you will need to eat more. • During an activity- during exercise the blood sugar level starts to drop and someone with diabetes will need some instant sugar. It is important to have glucose tablets or sugary drink nearby to give energy boost. • After exercise - most hypos will happen after exercise, so it is important for people with diabetes to eat a snack and test their blood sugar level when they are finished.

17. Diabetes at school • When a child is diagnosed with diabetes, their parents and diabetes nurse should meet with the child's teacher and discuss the risk of hypos, the need of regular snacks and how to prepare for pe. • The school will need to fill out a record card, with contact numbers and details of how to treat a hypo. Children who do their own injections will need a private place as well as a supply of fast acting carbohydrates available at all times. • Children with diabetes don’t need and real special attention. They can take part fully in school activities, including sport and pe. A teacher should always carry a spare injection kit and extra food in case of delays. • Children with diabetes can go on overnight holidays where they try out new activities like abseiling, canoeing, sailing and windsurfing. This gives them a break from home make new friends and share common experiences. It helps them realise there not the only one with diabetes and help them become more confident.

18. Frequent questions People ask. • Can I drive if I have diabetes? Yes, but you will need a special license that has to be renewed more often then an ordinary license. • Will there ever be a cure for diabetes? Maybe. Scientists at ways to transplant healthy insulin producing cells from one person to another. Or they may be able to make artificial ones. • Are there any jobs I wont be able to do? If you take insulin for diabetes, yes, there are some jobs you wont be able to do. These include working for the police, fire service, armed forces, being a pilot, working at sea, driving trucks, trains, buses or taxis. • How old do you have to be to give yourself injections? There is no right or wrong age. Children usually over the age of ten prefer to give themselves injections. Others prefer a parent to give them a injection. • Can I continue with my favourite sport now that ive got diabetes? Definitely, if you plan to ski, go climbing or swim in the sea its wise to have someone else with you at the same time.

19. Services available and An action plan • There are a range of support services in each state, through Diabetes Australia and the juvenile diabetes foundation of Australia. Like the Australian diabetes council, diabetes Australia and the baker IDI heart and disease institute. • Services available for you to go to are dieticians, special diabetic doctors, chemist, and local doctor. • ACTION PLAN – so you just found out you have diabetes, now what? Before you were diagnosed with diabetes your normal day was filled with work and family, leaving little time for pleasure or social time and now the doctor is telling you to make lifestyles changes, such as eating healthier food, and eating less food, become more physically active, and testing your blood sugar level every morning. Diabetes may seem daunting but with some simple steps diabetes can be managed and you can still have a healthy and active lifestyle. On the next slide is some simple steps to achieve this -

20. STEP 1 - inspect your health plan, so its important to find the best possible and affordable health insurance coverage. • STEP 2 – consider attending a diabetes education centre. • STEP 3 - develop a plan for physical activity which should include aerobic or cardiovascular, resistance or strength and stretching and flexibility. • STEP 4 - consider diabetes medication. • STEP 5 – Incorporate activity in your daily routine - try these simple ways to incorporate physical activity into your day * walk with your pet, baby or grandchild. * bike or walk to do neighbourhood errands * climb a couple flights of stairs instead of taking the elevator. * avoid sitting down in front of a TV for more than 30 minutes. • STEP 6 – shop for diabetes supplies which include - *blood glucose meter. * Blood glucose test strips. * lancing device. *lancet. * Medicine. * syringes. * Sharps container. * Medical identification. * Food, activity and blood glucose record book. • STEP 7 – Pick your primary care physician. • STEP 8- create a diabetes care schedule. • STEP 9 – create a diabetes food plan.

21. glossary • BLOOD VESSEL – a tube that carries blood around the body. • CARBOHYDRATE – an important source of energy that is found in starchy or sugary foods such as potatoes, rice, bread, pasta, sweets, biscuits. • GLUCOSE – a type of sugar in the food we eat and which we use as fuel. • HYPERGLYCAEMIA – a higher than normal amount of sugar in the blood. Someone with hyperglycaemia feels thirsty and has to keep going to the toilet. They also feel tired and lose weight. • HYPOGLYCAEMIA – Also called as hypo, a lower than normal amount of sugar in the blood. Someone having a hypo may look pale, feel dizzy have a headache and may start to sweat. They may also lose their temper and find it hard to concentrate. • INSULIN – a chemical made by a gland called the pancreas. It controls the level of sugar in the blood. • PANCREAS – a gland near the stomach that produces insulin, as well as juices to digest food. • VIGOROUS – energetic.

22. bibliography • http://www.nps.org.au/conditions/type_2_diabetes • http://www.mydr.com.au/default.asp?article=2437 • http://www.diabetes.com.au/diabetes.php?regionID=237 • http://www.diabetes.com.au/diabetes.php?regionID=237 • http://www.dav.org.au/allaboutdiabetes/type2.asp • http://www.diabetesaustralia.com.au/ • http://rch.org.au/diabetesmanual/manual.cfm?doc_id=2745 • http://www.mydr.com.au/default.asp?Section=diabetes • http://www.healthnetwork.com.au/diseases-conditions/diabetes-treatment.asp • http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Diabetes_Type_2?OpenDocument