Type 2 Diabetes Awareness, Prevention and Management

In just 60 seconds, you can learn if you are at risk for type 2 diabetes, the high blood sugar disease that affects more than 30 million Americans—12 million of them age 65 and older, according to the American Diabetes Association^® (ADA). The ADA also reports that nine out of 10 Americans at highest risk for type 2 diabetes do not know about their health risk.¹ Every fourth Tuesday in March, American Diabetes Association Alert Day^® invites adults and youth to take the free, anonymous Type 2 Diabetes Risk Test. The online questions such as “Do you have a family history of diabetes?” are straightforward with easy yes/no answers. This year’s Alert Day on March 26 is the ideal time to learn how to lower your risk for type 2 diabetes and encourage family and friends to take the risk test, too.

Risk Factors for Type 2 Diabetes

Diabetes mellitus is a group of diseases that affect how the body produces or uses insulin, a hormone that helps turn digested food into energy, called blood sugar or glucose. Too much glucose in your blood can lead to significant health problems, including cardiovascular disease and damage to nerves, kidneys and eyes.

The two main chronic types of diabetes are type 1 and type 2. Prediabetes and gestational (pregnancy) diabetes, two other types, are typically reversible. Type 1 diabetes, formerly known as juvenile diabetes, can occur in adults and happens when the pancreas can no longer produce insulin on its own. Type 2 diabetes means the body does not properly process insulin or does not produce enough insulin. Commonly called adult-onset diabetes, type 2 diabetes accounts for 90 percent or more of diabetes cases, says DaVita, a leading provider of kidney care services in the U.S.²

The risk factors for type 2 diabetes include:

• Weight. Excess fatty tissue makes cells resistant to using insulin properly.
• Family history. If a parent or sibling has type 2 diabetes, your risk increases.
• Inactivity. A more sedentary lifestyle lowers the use of glucose as energy and makes cells less sensitive to insulin levels.
• Ethnicity. Although the cause is unknown, being African-American, Hispanic, Native American, Alaska Native, Pacific Islander or Asian-American boosts the risk for becoming diabetic.
• Age. Being age 45 or older increases the risk of diabetes, perhaps because older adults tend to lose muscle mass, exercise less and gain more weight than when younger.
• High blood pressure. An increased risk for type 2 diabetes is linked to blood pressure over 140/90 mmHg (millimeters of mercury).
• Depression. Having depression in midlife or later in life can occur with medical conditions including diabetes, cancer and heart disease.
• Abnormal cholesterol and triglyceride levels. The risk for type 2 diabetes elevates when high-density lipoprotein (HDL) cholesterol, known as the “good” cholesterol, is low, and triglycerides (a type of fat in the blood) are high.
• Gestational diabetes. Women who develop gestational diabetes during pregnancy or give birth to a baby more than nine pounds run a higher risk for developing type 2 diabetes later in life.
• Polycystic ovary syndrome. Women who have this condition, which produces irregular menstrual periods, obesity and excess hair growth, incur increased risk of diabetes.

Misconceptions About Diabetes Risks

A number of erroneous facts and myths about diabetes risks can affect whether people get screened for diabetes and properly treated if they do have diabetes. Misconceptions about diabetes include the following:

“I don’t have a family history of diabetes, so there’s no need to worry.”
Having family members with diabetes is only one increased risk factor for getting the disease. Even without a hereditary factor, anyone can still be vulnerable to the disease, especially if obesity, inactivity, race and older age are present risk factors.

“Diabetes has no symptoms and only a doctor can detect it.”
With more than 7 million Americans not knowing that they have diabetes³, as reported by the ADA, it is understandable that the more subtle symptoms of diabetes can be easily missed. But if an individual is aware of the telltale signs of diabetes, they can seek medical help sooner. Common diabetes symptoms include frequent urination, increased thirst, excessive hunger, weight loss, blurry vision, extreme fatigue, and tingling and numbness in the hands and feet.

“Trim people do not get type 2 diabetes.”
Harvard Health Publishing found that while most people with type 2 diabetes are overweight or obese, 15 percent of people with diabetes are at a healthy weight. While visceral fat that clings to abdominal organs may be hidden, this type of internal fat can damage the liver and pancreas and put fit-looking people at an increased risk for type 2 diabetes.

“There is no way to prevent diabetes.”
In many cases, the prediabetes stage of full-blown diabetes can be reversed through reducing one’s risk factors. For example, a person in the prediabetes stage can adopt a healthier lifestyle of better nutrition, regular exercise and weight control. Prediabetes is a warning call to lower one’s blood glucose level and stave off full-fledged diabetes.

Key Facts of Diabetes Screening

The American Diabetes Association recommends that everyone be screened for diabetes starting at age 45.⁴ Those with higher risk factors besides age should be screened earlier. A basic diabetes screening via a simple blood sugar test can alert you to indicators of diabetes before the disease begins. Free screenings for diabetes use a finger prick and glucose monitor to measure your blood sugar at that moment. Often you can find these fasting plasma glucose (FPG) diabetes screenings at pharmacies, hospitals, health fairs and big retail stores. It’s important to note that for accurate results, one must fast (no consumption of food, only water) at least eight hours before taking an FPG diabetes screening test. Patients should follow up with their doctor on any abnormal diabetes screening result.

To diagnose diabetes fully beyond an initial screening test, your physician may order a second FPG test the next day or soon after. If the FPG levels are high, your doctor will likely order a hemoglobin A1C test or an oral glucose tolerance test (OGTT), or both tests. The A1C test does not require fasting and shows your blood glucose average for the past two or three months. To see how your body processes sugar, the OGTT checks your blood glucose before the test and two hours after you drink a sugary liquid. Sometimes a three-hour or longer OGTT is ordered.

Screening guidelines for type 2 diabetes include the following:

• If you are age 45 or older, your doctor should screen you every three years.
• If you have one or more diabetes risk factors, such as being overweight, having a family history of diabetes or having high blood pressure or triglycerides, you should be screened at an earlier age.
• If you have chronic high blood pressure of 140/90 mmHg or above or you use blood pressure medication, you should consult with your doctor on the timing of diabetes screenings.

Diabetes Management at Home and Community Resources

If you’ve been diagnosed with type 2 diabetes, you can learn to be successful in managing your disease daily.

Tips for self-management of diabetes include the following:

• Checking blood sugar levels regularly.
• Watching weight.
• Eating a healthy diet.
• Resting adequately.
• Getting consistent physical exercise.
• Employing technology that tracks blood sugar.
• Seeing a healthcare provider as often as advised.

Helpful resources for diabetes prevention and management include the following:

The American Diabetes Association offers In My Community and Find Your Local Office links on their website, http://www.diabetes.org/in-my-community/. Or, call 1-800-DIABETES (800-342-2383).

The Centers for Disease Control and Prevention’s Division of Diabetes Translation funds state and local health department programs and activities “to prevent or delay the onset of type 2 diabetes and to improve health outcomes for people diagnosed with diabetes.” Visit https://www.cdc.gov/diabetes/programs/stateandlocal/index.html, or call 1-800-CDC-INFO (800-232-4636).

Local hospitals and diabetes centers often provide outpatient diabetes education programs and can put people in touch with other services such as education workshops, support groups, literature and films/videos.

¹ American Diabetes Association. Statistics About Diabetes. Retrieved from http://www.diabetes.org/diabetes-basics/statistics/.
² Davita Kidney Care. Diabetes: Definition, Causes and Symptoms. Retrieved from https://www.davita.com/education/kidney-disease/risk-factors/diabetes.
³ American Diabetes Association. Statistics About Diabetes. Retrieved from http://www.diabetes.org/diabetes-basics/statistics/.
⁴ Everyday Health. What Are the Symptoms of Type 2 Diabetes, and How Is the Condition Diagnosed? Retrieved from https://www.everydayhealth.com/type-2-diabetes/guide/symptoms/.