Diabetes, Pre-diabetes, Metabolic Syndrome

Over 800,000 people in Australia have diagnosed diabetes – this is three times higher than 25 years ago! Diabetes is often under-diagnosed; many people are on the cusp of diabetes or don’t know that they have it.

What is Diabetes?

Diabetes is a condition where there is too much glucose (a sugar) in the blood. Blood glucose levels are regulated with the help of “insulin”, a hormone made in the pancreas. Diabetes is caused by a problem with insulin and how it controls blood glucose levels.


In people without diabetes, the body controls glucose in the following way:

  1.  Glucose comes from food that contains carbohydrates (starch and sugar), and from stores in the liver. After eating, blood glucose levels start to rise.
  2.  Glucose is absorbed into the blood stream and carried to the muscle and other body cells or the brain. Glucose provides the energy to perform everyday tasks, such as thinking, walking, talking and breathing.
  3. Insulin is “the key” that glucose needs to enter body cells. Insulin is released from the pancreas to allow glucose to move from the blood to the muscles where it can be used and to stop glucose levels in the blood from rising too high.



  • Develops when the pancreas stop producing insulin, preventingglucose from entering the muscle or other body cells.
  • This is caused by the body’s immune system attacking and destroying the cells in the pancreas that make insulin.
  • Is less common than type 2 diabetes and usually occurs under the age of 30, but can occur at any age.
  • Usually comes on quickly and can be severe and life-threatening if treatment is delayed.


  • Develops due to a combination of not producing enough insulin and the body not responding properly to insulin (insulin resistance)
  • This may be caused by genetic factors but can be triggered or made worse by being overweight and lack of exercise
  • Is the most common type of diabetes and usually occur in people over the age of 30 but is now being seen in younger people due to the increase in obesity.
  • The onset is usually slow and sometimes difficult to recognise.


  • Is a temporary form of diabetes that occurs during the second half of pregnancy when certain hormones stop insulin from working properly
  • Is usually detected during a routine screening test at 28 weeks gestation
  • Is treated with healthy eating, gentle physical activity and if required, insulin injections.
  • Women who had gestational diabetes are at higher risk of developing type 2 diabetes, so annual blood glucose checks are advised.


All types of diabetes show similar symptoms but the severity is usually greater in type 1 diabetes. Many people with type 2 diabetes have no symptoms which is why regular medical check-ups are recommended, especially for those who are more at risk.

The symptoms of diabetes include:

  • Irritability
  • Tiredness/lack of energy
  • Extreme hunger
  • Blurred vision
  • Excessive thirst

Please seek medical advice if you experience or suffer any of these signs or symptoms.


Type 1 diabetes is treated with insulin injections, usually several times a day. For type 2 diabetes, a healthy diet and regular exercise are essential. Several different types of medication, including insulin injections, are available for treating type 2 diabetes.

Other important parts of treatment of both types of diabetes include:

  • Regularly monitoring your blood pressure and blood cholesterol levels.
  • Having regular checks of your eyes, feet and kidneys to pick up early signs of diabetes complications.


“The most beautiful people we have known are those who have known defeat, known struggle, known suffering, known loss, and found their ways out of the depths. These persons have an appreciation, a sensitivity and an understanding of life that fills them with compassion, gentleness and a deep loving concern. Beautiful people do not just happen.” – Elizabeth Kubler-Ross

Coeliac disease is a lifelong condition that requires  strict adherence to a gluten free diet.

It is genetically based (so often runs in families and is also linked to Type 1 diabetes and Hashimotos Thyroiditis) and is the result of the bodies own immune system attacking the lining of the small bowel (vili)  resulting in less absorptive surface and fewer digestive enzymes. This often leads to malabsorption of food, and to the symptoms many people experience – diarrhoea, abdominal distension, bloating, fatigue, weight loss, anaemias, steatorrhea (fatty diarrhoea) and/or peripheral neuropathy.


All people with GI symptoms should be tested for Coeliac disease. While approximately 1% of the population have coeliac disease, it is estimated 80% of people who have coeliac disease remain undiagnosed.

Because eating Gluten – found in wheat, barley, rye and oats – is the major trigger for the development of the disease, it is also recommended that 1st line relatives (parents, siblings, children) of those diagnosed, people with Type 1 diabetes, thyroid disorders, elevated transaminases, short stature, delayed puberty and fatal loses should be tested as well.

If you have unexplained gut symptoms and are concerned you have Coeliac Disease, either book in for a comprehensive assessment, or talk with your GP who can begin the process of testing. In the first instance this involves simple blood tests and depending on your results, may be followed by a small bowel biopsy. It is important that you are consuming adequate amounts of gluten, when these tests are being performed in order to ensure the tests are as accurate as possible.


Early diagnosis and treatment, together with regular follow-ups with a dietitian, are necessary to ensure nutritional adequacy and to prevent malnutrition while adhering to a gluten free diet. While the main “treatment” is remaining Gluten-free for life, there are often other nutritional deficiencies to correct in the short term including  Iron and calcium. Likewise, due to the removal of many grains, learning to incorporate other grains and being aware of eating enough fibre is something else I am able to give you lots of information on.

In the early stages after being diagnosed it can feel quite overwhelming, so my job as your dietitian is to break down all the information you need to know so that it doesn’t feel so daunting. I am available via email or phone to answer questions and support you through the process of going gluten free, while providing you with as many or as few resources as you need to help you feel independent.

If you have any questions or would like to book in for an appointment, call my Orange rooms on 6360 2388, or Dubbo on 6885 1696, or you can book online in Orange below: