Research and prevention are key to ending the epidemic.
By Betty Drees, MD, FACP, FACE
Professor of Medicine and Dean Emerita,
University of Missouri-Kansas City School of Medicine
Diabetes is very common and is becoming more common. The number of adults with diabetes has tripled in the last 20 years, and now almost 10% of people in the USA have diabetes. Some of the increase in numbers of people with diabetes is related to increasing weight, but some of it is related to the population getting older.
As we age, we are more likely to get Type 2 diabetes, and one-fourth of people over age 65 have diabetes now. In the Kansas City metropolitan area of just over 2 million people, about 250,000 of us have diabetes. Another half-million likely have blood sugars that are higher than normal that put them at risk of developing diabetes, a condition called “prediabetes.”
That means that about 750,000 people in our region are at risk of having diabetes now or developing diabetes and its complications in the future. The more we know about Type 2 diabetes, the more we can do to prevent it, treat it early, and stop its devastating complications. The most important step we can all take is to develop healthy habits in eating, exercise, and not smoking.
Here are other facts you should understand about diabetes and pre-diabetes.
What is diabetes?
Diabetes mellitus (Type 2) causes the blood sugar to be too high. When we eat, we absorb sugar and other food that can be turned into sugar in the bloodstream that we use for energy. Our body makes insulin to bring down the blood sugar by storing it in the muscles and fat tissue. Diabetes occurs when the body either can’t make insulin, or when the body can’t use insulin. Either way, the blood sugar stays high.
Why is diabetes important to health?
Diabetes is a serious disease. It is also a “chronic disease,” meaning that it needs medical care over a lifetime. Diabetes can cause symptoms related to high sugar, such as feeling tired, blurry vision, frequent urination, and infections. It can also cause long-term health problems, such as heart disease, nerve damage, blindness, and kidney failure. Diabetes is the seventh leading cause of death, and the most common cause of blindness and leg amputations in adults. The good news is that there are ways to slow or prevent the long-term health problems by good blood sugar control, good blood pressure control, not smoking, eating healthy, and exercising.
What is prediabetes?
Prediabetes is when the blood sugar is higher than normal, but not high enough to be diagnosed as diabetes. Prediabetes is even more common than diabetes. Over a third of adults have prediabetes. People with prediabetes are at high risk to develop diabetes, but eating healthy, exercising, and losing a few pounds is very effective in preventing prediabetes going on to diabetes. Lifestyle changes reduce the risk of developing diabetes by over 50%. These lifestyle changes work even better in people over the age of 60.
Who is at risk of diabetes and prediabetes?
The people at highest risk of either prediabetes or diabetes are people over age 45, those who have relatives with diabetes, those who are not physically active, women who had diabetes during pregnancy, and people from certain racial and ethnic groups (Native Americans, African Americans, Hispanic/Latinos, and Asian Americans all have higher risk.).
Wouldn’t I already know if I have diabetes or prediabetes?
Maybe not. Both diabetes and prediabetes may be “silent,” meaning that you could have it, but not have symptoms, and not know it. About 25% of people with diabetes do not know they have it, and about 90% of people with prediabetes don’t know they have it. The problem with having undiagnosed diabetes or prediabetes is that you would not be getting treatment to prevent the long-term complications.
How can I get screened for diabetes and prediabetes?
Screening for diabetes can be done easily by checking your blood sugar or a test called an A1C. The A1C measures how your blood sugar has been doing over a few weeks. Some places that do diabetes and prediabetes screenings include doctors’ offices, health departments, health fairs, workplaces, and others. If you take one of the tests for your risk of diabetes and are high risk, you should ask your doctor to check you for diabetes, if it has not already been done.
What should I know about the A1C test?
This test is a measure of the average amount of sugar in your blood. It tells how your blood sugars have been doing over several weeks and is an important test of overall blood sugar control. A normal A1C is less than 5.7%. Prediabetes is 5.7% to 6.4%. Diabetes is 6.5% and higher. If you have diabetes, your doctor should set the A1C goal with you based on your own unique health.
What if I already have diabetes?
If you have been diagnosed with diabetes, it is important to establish regular health care to control your blood sugars and prevent complications. It is also important to learn how to take care of yourself and to be a partner with your doctors and nurses in managing your health. A healthy lifestyle and good medical care improves how you will feel, and it decreases the risk of getting complications. The goal is to help you have the best possible health living with diabetes.
Betty Drees, MD, FACP, FACE is a Professor of Medicine and Dean Emerita at University of Missouri-Kansas City School of Medicine, Department of Internal Medicine and Department of Biomedical and Health Informatics in Kansas City, MO.
Prediabetes. Centers for Disease Control and Prevention.
National Diabetes Statistics Report, 2017. Centers for Disease Control and Prevention.