If you’ve ever wondered whether you’re at risk for developing diabetes, you should know these numbers: nearly 2 million American adults and more than 5,000 children and adolescents will learn this year that they have Type 2 Diabetes. They will be part of almost 30 million Americans who already have the disease. But did you know that it’s a preventable disease?
Diabetes Type 2 is a common condition that affects nearly 1 in 10 Americans. There are multiple problems in the body with type 2 diabetes. For example, the body is not sensitive to the insulin it makes, the liver makes too much sugar and other organs do not process or use glucose or insulin correctly. Unfortunately, these problems are all silent and if left untreated, more than half of the body’s ability to make insulin is no longer working. This is why screening is so important.
The following are frequently asked questions that provide more information on this preventable disease:
Are you at risk for diabetes?
Chances are yes! Currently in the United States about 1 in 10 people have diabetes. This is projected to increase to 1 in 3 Americans who will have diabetes in their lifetime. This risk is even higher if you are African-American, Hispanic or a Native American.
How do I know if I am at risk?
Diabetes is a silent disease that takes years to develop. Most people with type 2 diabetes find out by accident—most by a lab test that was ordered for another reason. In fact, diabetes is commonly discovered at the time of another medical crisis. For example, 1 in 4 people who have a heart attack find out that they have diabetes at that time.
So there are no symptoms for diabetes?
Most people with type 2 diabetes have no symptoms or common symptoms that are hard to connect to diabetes. This is because the condition develops so slowly that you get used to the changes and do not notice them. Some nonspecific symptoms can include frequent urinary tract infections, yeast infections, feeling tired, blurred vision or waking up many times at night to urinate. These symptoms can mean diabetes but can mean a lot of other things as well. If you have these please ask your doctor about diabetes.
However, if you have type 1 diabetes or advanced type 2 diabetes and very, very high sugars you might present with the common symptoms of drinking a lot, urinating a lot and losing weight. This is serious as it is a sign that you don’t have insulin to get the job done.
What are risk factors for diabetes- type 2?
Risk factors that can be changed:
- Being overweight or obese
- Having high blood pressure
- Being sedentary (not being physically active)
- Smoking
Risk factors that cannot be changed:
- Your ethnicity (African-American, Hispanic, Native American have higher rates)
- Your family history—type 2 diabetes runs through families
- Your age (risk increases with age)
Type 2? Is this a different kind of diabetes?
Yes–there are actually many kinds of diabetes—type 1 is an autoimmune disease in which the person can not make insulin and needs insulin to live. This is most common in children and does not typically run through families.
Type 2 is the most common form of diabetes—about 90% if people in the U.S. have type 2. This is the form of diabetes most common in adults but now can be seen in children as well. This is largely tied to being overweight or obese.
How do I know if I am at risk?
The most common way to identify if you are at risk is to look at your risk factors.
Pre-diabetes is a step on the way to diabetes. Below is a table of normal glucose (sugar) values, those in the diabetes range and those in between which is the pre-diabetes range. When you have pre-diabetes you are at a VERY high risk of developing type 2 diabetes. The good news is that type 2 diabetes is largely preventable and wholly treatable.
If you do have pre-diabetes there is A LOT you can do to prevent from getting diabetes. There are at least three medications (metformin, pioglitazone, acarbose) that have been shown to reduce your risk. However, a lifestyle program called the Diabetes Prevention Program actually reduces your risk even more. This program is one year long and requires a significant amount of work but has been shown to reduce new onset type 2 diabetes by 58%. This program even reduced the risk in people 10 years later even though the program has long been over.
How do I find a Diabetes Prevention Program?
This program is run in many communities. You can find a list of programs at the Centers for Disease Control and Prevention website. These programs have been run in YMCA’s, in churches and in medical clinics. In this community, Touro University California is running programs for free. Please go to cdc.gov/dpp to see a list of programs or contact jay.shubrook@tu.edu if you want to join a Touro program.
High Blood Glucose
High blood glucose is a substantial risk factor for diabetes and in the long run, heart disease and stroke. The American Diabetes Association recommends using one of three testing methods.
| A1C | Fasting Plasma Glucose (FPG) | Oral Glucose Tolerance Test (OGTT) | |
| Normal | < 5.7% | < 100 mg/dl | <140 mg/dl |
| Prediabetes | 5.7%-6.4% | 100 mg/dl to 125 mg/dl | 140 mg/dl to 199 mg/dl |
| Diabetes | 6.5% or higher | 126 mg/dl or higher | 200 mg/dl or higher |
Clinical Intervention:
- Patients with prediabetes should be referred to an effective ongoing support program targeting weight loss of 7% of body weight and increasing physical activity to at least 150 min/week of moderate activity, such as walking.
- Follow up counseling appears to be important for success.
Here is a helpful ADA link: http://professional.diabetes.org/PatientEducationLibrary.aspx
Also attached is a pre-diabetes info graphic and screening test
CDC.gov diabetes is also great for facts and stats
Jay H. Shubrook, DO, FACOFP, FAAFP
Professor | Primary Care
Director of Clinical Research & Diabetes Services
Touro University California
