You could have Type 2 diabetes and not know.

Rebecca Myers, MSN, RN for MEHOP

Key Points

  • About 30.3 million people in the U.S. have diabetes.
  • Twenty-five percent of those with diabetes have no symptoms.
  • Diabetes is caused by high blood glucose levels.
  • Left untreated or uncontrolled, diabetes can cause damage to your whole body.
  • Type 2 diabetes accounts for 90-95% of all diabetes cases.
  • Prediabetes (condition that predicts diabetes) is common in the U.S. with 88 million cases.
  • Prediabetes and Type 2 diabetes can be delayed or prevented with healthy lifestyle choices.
  • If you are at risk for diabetes, see your healthcare professional (HCP).

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that 30.3 million people in the United States (9.4% of the population) have diabetes. Of this number, 7.5 million have no idea they have diabetes2.

What is Diabetes?

Diabetes is a long-term disease that occurs when your blood glucose (also called blood sugar) level is too high. When you have diabetes, your body is unable to process the glucose in your blood and use it for energy. Insulin, a hormone produced in the pancreas, breaks glucose down so that it can enter your cells to be used for energy. Depending on the type of diabetes you have, your body either no longer produces enough insulin, or your cells start to resist the insulin your body produces. When this happens, glucose stays outside the cells in your bloodstream, and over time a high blood glucose level causes damage to your whole body1.

Symptoms of Diabetes

Symptoms of diabetes include3:

  • Increased thirst
  • Frequent urination
  • Extreme hunger
  • Unexplained weight loss
  • Fatigue
  • Irritability
  • Blurred vision
  • Slow-healing sores
  • Frequent infections, such as gums or skin infections and vaginal infections

In approximately 25% of cases, there are no symptoms2. That is why it is important to have regular medical checkups with your healthcare provider (HCP). Your HCP can diagnose diabetes through blood tests.

Types of Diabetes

The most common types of diabetes are Type 1, Type 2, and gestational diabetes.

Type 1 Diabetes

In Type 1 diabetes your body does not produce insulin. Type 1 diabetes is an autoimmune disease2. Your immune system mistakenly attacks your pancreas and destroys the cells that make insulin. About 5-10% of people with diabetes have Type 1. Type 1 is usually diagnosed in children, teens, and young adults. People with Type 1 must take insulin every day to live. There is no prevention for Type 1 diabetes.

Type 2 Diabetes – most common

About 90-95% of people with diabetes have Type 2. In Type 2 diabetes, your cells are resistant to insulin and glucose builds up in your blood. Type 2 is most often diagnosed in adults. However, you can develop Type 2 diabetes at any time of life, including in childhood or teen years. Type 2 can be delayed or possibly prevented with a healthy lifestyle that includes a healthy diet and regular exercise.

Prediabetes – Prediabetes is a condition that predicts Type 2 diabetes.

In prediabetes, your blood sugar is higher than normal but has not reached the level to be diagnosed with Type 2 diabetes. According to the Centers for Disease Control (CDC) in the United States, about 88 million people (more than 1 in 3) have prediabetes. Of the 88 million prediabetic people, 84% of them do not know they have prediabetes1. Prediabetes raises your risk for Type 2 diabetes, heart disease, and stroke. With a healthy lifestyle that includes a healthy diet and regular exercise, people with prediabetes can prevent the progression to Type 2 diabetes.

Gestational Diabetes

For information about gestational diabetes see the box below.

Risk Factors for Diabetes

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease. Risk factors for Type 1 are not as clear as other types.

Known risk factors for Type 1 diabetes are1:

  • Family history – you are more likely to have Type 1 if you have an immediate family member with the disease (parent, brother, sister)
  • Age – Type 1 is more often diagnosed in children, teens, and young adults.

Type 2 Diabetes

According to the Centers for Disease Control and Prevention (CDC), you are at risk for developing Type 2 diabetes if you1:

  • Have prediabetes.
  • Are overweight.
  • Are physically active less than 3 times a week.
  • Are 45 years or older.
  • Have a parent, brother, or sister with type 2 diabetes.
  • Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds.
  • Are African American, Hispanic/Latino American, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk)

Other risks for Type 2 include2:

  • High blood pressure (hypertension)
  • Low level of HDL (“good”) cholesterol, or a high level of triglycerides
  • History of heart disease or stroke

Prediabetes Risk Factors

  • Prediabetes risk factors are the same as Type 2 risk factors.

With a healthy lifestyle that includes a healthy diet and regular exercise, people with prediabetes can prevent the progression to Type 2 diabetes.

Testing for Diabetes

If you suspect you might have diabetes or prediabetes, you should get tested by your HCP. Tests for Type 1, Type 2, and prediabetes are the same.

A1C (glycated hemoglobin) is a simple blood test that reveals your blood sugar over the past two to three months3.

  • An A1C below 5.7 is considered normal.
  • An A1C between 5.7 and 6.4 % indicates prediabetes.
  • An A1C level of 6.5% or higher on two separate tests indicates that you have diabetes.

Random blood glucose is a blood sample taken at a random time (regardless of when you last ate).

  • A result of 200 milligrams/deciliter (mg/dL) or higher suggests diabetes.

Fasting blood glucose – for this blood test you will fast overnight (nothing to eat or drink) and a sample will be taken in the morning.

  • A fasting blood glucose of less than 100mg/dL is normal.
  • Fasting blood glucose of 100 to 125 mg/dL is positive for prediabetes.
  • Fasting blood glucose of over 125 mg/dL on two separate tests.

Oral glucose tolerance test – after fasting overnight, your blood glucose will be tested. Then you will drink a provided sugary drink and your blood glucose will be tested hourly for 3 hours.

  • A result of less than 140 mg/dL is normal.
  • A result of 140-199 mg/dL is a prediabetes level.
  • A result of over 200 mg/dL on this test indicates diabetes.

Uncontrolled or Untreated Diabetes Causes Damage to Your Body

Too much glucose in your blood causes damage to your blood vessels. You have blood vessels throughout your body. Blood vessels carry oxygen and nutrients to your organs and nerves. When blood vessels are damaged by glucose, organs and nerves cannot get the needed oxygen and nutrients. Without the proper oxygen and nutrients, organs and nerves begin to fail and can cause serious complications4.

Diabetes Complications

Learning to manage your diabetes can decrease or prevent complications including4:

  • Heart attack
  • Stroke
  • High blood pressure
  • High cholesterol
  • Nerve damage (neuropathy) causes tingling, numbness, burning and/or pain in your arms and especially legs and feet. Nerve damage can cause complications all over your body.
  • Retinopathy (eye damage) that can lead to blindness.
  • Kidney damage which, if severe, can lead to kidney failure requiring dialysis or kidney transplant.
  • Hearing loss
  • Depression
  • Dementia

Diabetes causes more damage and complications the longer you have it and the longer it stays untreated or uncontrolled3. You can manage your diabetes to decrease the problems it can cause.

Managing Diabetes

You can manage your diabetes by controlling your risk factors and keeping your weight, blood glucose, and blood pressure withing normal limits. Talk to your HCP about the best ways to manage your diabetes.

  • If you are overweight, lose weight by eating a healthy diet. The American Diabetes Association recommends using the Diabetes Plate Method.
  • If you are inactive, start by taking short walks or participating in other activities that you enjoy daily.
  • Monitor your blood glucose levels every day.
  • If you have high blood pressure – monitor your readings.
  • See your HCP regularly. Keep all appointments and get your blood checked when ordered.
  • If you smoke or use tobacco – stop.
  • If prescribed, take your insulin and other medications. Closely follow the directions for times and dosages.

Are You Over 45, Overweight, and Inactive?

Make an appointment today with your HCP to get checked for diabetes or prediabetes. You have the power to improve your health.

Gestational Diabetes

Gestational diabetes occurs in pregnant women who have never had diabetes. It goes away after their baby is born but increases your risk of developing Type 2 diabetes in the future. It also increases your baby’s risk of being obese in childhood or as a teen1. It also increases your baby’s risk of developing Type 2 diabetes. Gestational Diabetes Risk Factors You are at risk of developing gestational diabetes (diabetes when pregnant) if1:

  • You are over age 25.
  • You had gestational diabetes with a previous pregnancy.
  • You were overweight before you became pregnant.
  • You have prediabetes.
  • You have a family member with Type 2 diabetes.
  • You are Black, Hispanic, American Indian, or Asian American.
  • You had a baby with a birth weight of over 9 pounds.
  • You have a hormone disorder called polycystic ovary syndrome.

Testing for gestational diabetes may require two tests.

Glucose challenge test – you will drink a sugary liquid provided to you and your blood glucose level is checked an hour later. If the results are over 140 mg/dL, then you will take an oral glucose tolerance test.

If you are pregnant and have not been diagnosed with diabetes, you should be tested for gestational diabetes.

The Diabetes Plate Method5

Use a plate that measures 9” or less across.

Fill ½ with non-starchy vegetables like broccoli, green beans, or zucchini squash.

Fill ¼ with lean protein like chicken, fish, or eggs.

Fill ¼ with carbohydrate foods like brown rice, whole grain breads, beans, or fruits.

Drink low or no calorie drinks.

For more information on the Diabetes Plate Method go here.

References

1. Centers for Disease Control and Prevention (CDC). What is Diabetes? Last reviewed June 11, 2020

2. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Diabetes. Last reviewed December 2016

3. Mayo Clinic. Diabetes. October 30, 2020

4. Cleveland Clinic. Diabetes: An Overview. Last reviewed March 28, 2021

5. American Diabetes Association (ADA). What is the diabetes plate method? February 2020.

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