By Sara Colman Carlson, RDN, CDCES
November is the month to focus on diabetes—both identification and treatment. Over 7 million people have diabetes and don’t even know it.
Diabetes mellitus is a set of chronic diseases in which the hormone insulin is deficient, or the body is unable to use insulin properly. Insulin deficiency and insulin resistance are often included in the description of the type of diabetes diagnosed. People with Type 1 diabetes (T1D) stop producing insulin are require daily insulin injections. People with Type 2 Diabetes (T2D) make insulin but their bodies are often resistant and unable to use it effectively. The majority of people with diabetes have T2D. In both types of diabetes blood glucose levels rise above normal and must be controlled with diet, exercise and medications.
Each year the number of people diagnosed with diabetes is on the rise. According to the Center for Disease Control,
diabetes cases are estimated 34.2 million in 2020, and continue to grow yearly.
Preventing Diabetes
One way to prevent diabetes is to know the risk factors and which ones may increase your risk. These include family history, over 45 years of age, overweight or obese, low physical activity and history of gestational diabetes. Some ethnic groups, African American, Hispanic/Latino American, American Indian, or Alaska Native, are at higher risk of developing diabetes.
Prediabetes, a condition with higher than normal blood sugar levels but not yet in the diabetes range, is recognized as one way to detect those at diabetes risk earlier. Prediabetes treated with lifestyle changes has shown to prevent or delay progression to diabetes. Finding out if you have prediabetes is one thing you can do. Ask your doctor about your blood glucose lab results and if you have ever had a hemoglobin A1c test as part of diabetes screening.
Treating Diabetes
T2D can occur in normal weight people, but most often occurs in overweight and obese individuals. One of the treatment goals is to lose weight, which can improve insulin resistance, allowing glucose to be removed from the blood and used by the cells. In addition, regular exercise, a minimum of 150 minutes per week, helps lower glucose levels and treat insulin resistance.
T2D is a progressive disease. It can worsen over time, requiring more intensive treatment. Supplemental insulin is required if diet, exercise and other diabetes medications do not work well enough to attain normal glucose levels.
Diabetes Screening
A yearly physical with bloodwork is one way to test for diabetes. If blood glucose level is above 126 mg/dL, your doctor will order additional glucose testing to confirm a diabetes diagnosis. A trial of lifestyle changes that includes increased exercise, healthy eating habits with lower calories for weight loss, stress and sleep management can help determine if diabetes can be managed by lifestyle changes. If glucose remains above normal, there are diabetes medications that help the body makes and use insulin. For prolonged high glucose levels, daily insulin injections may be required.
Can Diabetes Be Cured?
Although treatments for T2D have expanded greatly with more medications and gastric surgery for those who qualify, it cannot be cured. Instead, it may go into remission, or it may be well controlled with diet and exercise. Managing diabetes can help delay or prevent diabetes complications such as cardiovascular disease, chronic kidney disease, retinopathy leading to blindness, and neuropathy leading to poor circulation and nerve damage.
For more information take the Diabetes Risk Test at diabetes.org/risk-test.
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