12 Things You Might Not Know About Diabetes

Diabetes is at epidemic proportions across the globe and most people know someone living with this condition. The serious physical and mental health complications associated with all types of diabetes however, are less widely known.

Here are 12 things you might not know about diabetes.

1. The personal and social costs of diabetes are enormous
If you live with diabetes you will know that it is not just about sugar. Most people associate diabetes with the sweet stuff, but it is far more complicated than that. Many people experience significant impact on their social and emotional wellbeing.

2. There are a number of types of diabetes, and while they have similar impacts on your body, they are very different diseases
There are three basic types - type 1 diabetes, type 2 diabetes and gestational diabetes (pregnancy diabetes). They have similar problems in relation to lack of insulin, but have different causes and management regimes. Type 2 diabetes never turns into type 1 diabetes, but many people with type 2 diabetes will eventually need some insulin injections to manage due to the progressive nature of the condition.

3. Type 1 diabetes is an autoimmune disease and nothing to do with lifestyle or eating too much sugar
In type 1 diabetes the pancreas does not make insulin at all because the cells that produce insulin have been destroyed by the body's own immune system. While we are getting closer, we still don't understand why this happens, but some kind of trigger sets of an autoimmune attack. It is usually diagnosed in people under 40, but can occur at any age. Insulin acts as a key to open the blood cells and release glucose from your food into your brain, muscles and organs, where it is needed to live. For people with type 1 diabetes insulin must be replaced in order to survive.

4. While it usually affects older adults, more and more younger people are developing type 2 diabetes
Type 2 is the most common form of diabetes, with around 85-90% of all people having type 2. In type 2 diabetes, the pancreas still makes some insulin, but this reduces over time. The other problem is that insulin in people with type 2 diabetes does not work effectively due to insulin resistance. There is a strong genetic link and this risk is increased when there are also lifestyle factors, such as high blood pressure, being overweight or obese, not being active enough, eating an unhealthy diet and having the classic 'apple shape' body where extra weight is carried around the waist. Other risk factors include specific cultural groups being at higher risk, being over 40 and spending a lot of time sitting and not enough time moving. It is not true that people with type 2 diabetes caused their own disease and nobody should ever be blamed or feel guilty about having diabetes.

5. Once you have diabetes, the impact on your life is relentless
Depending on the type of diabetes, people with diabetes must carry out daily self management tasks such as finger pricks several times a day to check blood glucose, counting carbohydrates in every meal, taking multiple injections and medications, or wearing and managing an insulin pump. The risks of not maintaing tight control of blood glucose include blindess, kidney failure, stroke, heart attack and nerve damage.

6. Every aspect of activity in life affects blood glucose and many people feel like they are walking a tightrope, or riding a rollercoaster
Exercise, stress, food and hormones, are just a few of the things that can wreak havoc with blood glucose when your body does not have a functioning pancreas. It can be extremely difficult to maintain and often unpredictable, isolating and frightening.

7. There is a known increased risk of depression of up to double the rest of the population and most people with diabetes suffer higher levels of reduced wellbeing .
Due to the difficulties associated with managing this sometimes unmanageable disease, a condition known as diabetes specific distress has an impact on many people. Family members are affected by this as well. This is particularly so for people living with type 1 diabetes, but affects all types and all ages of people living with diabetes.

8. Diabetes burn out is a common problem
If you have diabetes, you may recognise this problem through signs such as feelings of exhaustion and a total lack of interest in your self care tasks. Instead of sticking to your regular blood glucose checks, medications, exercise and insulin injetctions, you might only do them partially or possibly neglect them altogether for a period of time. It is more than just having a bad day. You just can't seem to muster the motivation to keep on managing and the guilt and stress about what this is doing to your body just builds up, adding to your distress. Burn out is particularly likely if you work really hard at managing your diabetes but the results are not what you would like.

It is also more likely when you have pressure or stress in other areas of your life that you feel you can not control. Diabetes burn out can last a short time, be ongoing, or can come and go. Studies have shown that a majority of people living with diabetes do experience worries, fears and negative feelings at some stage.

9. There are particularly risky times for diabetes burn out to develop
If you or a loved one has diabetes some high risk times where you may experience burn out include:
• If you are not meeting diabetes targets, frustration with lack of movement towards your goals
• Experiencing family/relationship problems
• Transition or times of change in your life
• Loss of someone you care about or other grief/loss
• Experiencing poverty or homelessness
• Drug and alcohol problems
• Problems with work and financial stress
• Other physical or mental health problems
• Pregnancy and parenting when you have diabetes yourself
• Growing older and dealing with changes to your body, your health and your diabetes
• Diagnosis of diabetes complications

10. Support is critical to managing diabetes
The challenge for people with diabetes is to walk the fine line between stress and worry about diabetes, and feeling comfortable about where diabetes sits in your life. Trying to have perspective about what your goals are and what you can manage at the present time, can help. When you balance this you are able to better manage under times of stress and prevent burn out. One of the biggest things that can help is to have good support. This is not just about support from your doctor or diabetes educator, which is vital, but also from family, friends and other people with diabetes. If you do not know anyone with diabetes or find that you need support outside of your family, the internet is a great place to find this with the online diabetes community.

11. Mindfulness can help your blood glucose levels.
Being able to feel in control and have a tool kit for what to do when things feel like they may be getting out of control in any aspect of your life really makes a difference. This includes exercise and relaxation strategies. Mindfulness, which teaches you to worry less and be present in your daily life, helps reduce anxiety and distress. Stress and problems in other areas of life will have an impact on your diabetes. It is important to stay healthy in all areas of your life and keep on top of stress.

12. The way you think and talk about diabetes also has a major impact on how you feel and manage diabetes
Using words like " high and low" blood glucose instead of "good and bad" can help and so does using CHECK instead of the word TEST when talking about blood glucose monitoring. This seems small but it can have a big impact on how you feel about yourself.

Lastly, if you live with diabetes it is important to ask for help and remember you do not have to do it alone. Sometimes you will feel totally in control of this juggle and you will marvel at how well you manage. At other times, monitoring your blood glucose levels, medications, insulin and everyday life will get in the way and become a time-sucking intrusion in your day .

In particular when you are overloaded with lots of other responsibilities and tasks, or when diabetes is not playing fair, your daily 'must do' diabetes management list can become an exhausting marathon. In your lowest moments, this can weigh heavily and feel an enormous burden, even a curse. If you find yourself facing burnout, it is helpful to be able to notice this and take steps to prevent yourself sliding all the way down that emotional slippery dip.
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