Are you one of the millions of Americans who has diabetes or knows someone who does? Chances are high that you do. According to a 2014 report from the U.S. Centers for Disease Control and Prevention, more than 29 million Americans have diabetes—but one in four doesn’t know it. More than one in three adults has higher-than-normal blood sugar levels. Researchers are working hard to understand why so many people have diabetes and what can be done to prevent it.
Diabetes is a disease marked by too-high blood glucose (sugar) levels. The food we eat turns into sugar. Our bodies use that sugar for energy. The pancreas produces a hormone called insulin. Insulin unlocks glucose from cells in our bodies. Diabetes is caused when the pancreas either does not make enough insulin or when the body can’t use the insulin that is made. Not having enough insulin causes glucose to build up in the blood. Having too much glucose in the blood can lead to health problems. The health risks associated with diabetes can be severe. They include heart disease, blindness, kidney failure, stroke and loss of toes, feet or legs.
There are different kinds of diabetes—type 1 and type 2. People with type 1 diabetes don’t make any insulin and usually show symptoms of diabetes when they’re young. There is no way to prevent type 1 diabetes. Researchers think that type 1 diabetes may be triggered by something that goes wrong in the body’s autoimmune system (the way a body defends itself from illnesses). Type 2 diabetes occurs when the body cannot use insulin properly. In the past, type 2 diabetes was usually diagnosed in people in their 50s and up. Now, health care providers are finding younger people being diagnosed with type 2 diabetes.
Janice Zgibor, RPh, MPH, PhD, associate professor of epidemiology at the University of Pittsburgh’s Graduate School of Public Health (Pitt Public Health), offers some hope. She says that a lot of good diabetes research has been and is being done. She and other researchers are working to get that information into the hands of health care providers and patients for better disease management. Dr. Zgibor has focused recent research on primary care offices in the area. She found that quicker and more intense diabetes treatment can be effective in controlling the disease.
“A diabetes diagnosis is overwhelming,” she says. “People with the disease must manage it themselves on a daily basis. Our research has shown that it’s more effective to treat diabetes more aggressively after diagnosis rather than taking a wait-and-see approach. It seems easier for patients to find help and support when we have diabetes educators in primary care offices. Otherwise, people usually go to hospital settings for diabetes education. Sometimes that extra step can be a burden and doesn’t happen.”
Dr. Zgibor encourages people with diabetes to be as informed as possible. “The more you know about the disease, the better you can take care of yourself.”
But most researchers and health care providers would give this advice: Do what you can to prevent getting diabetes in the first place.
Trevor Orchard, MBBCh, MMEDSci, professor of epidemiology at Pitt Public Health, leads research on diabetes prevention. He says, “We’ve had some encouraging data as to how effective interventions are in preventing diabetes in the African American population in particular. African Americans do have a higher risk of developing diabetes. That risk is about 50 percent higher than in other populations. The challenge is making diabetes prevention programs more accessible so that as many people as possible can benefit from them.
“The most dramatic way to prevent diabetes is lifestyle interventions,” says Dr. Orchard. “My colleagues at Pitt’s Diabetes Prevention Support Center and I recommend an activity level of 150 minutes of exercise per week—the equivalent of brisk walking—and loss of about 7 percent of body weight. That combination reduces the risk of diabetes by 58 percent.”
Dr. Orchard also recommends that everyone know the diabetes ABCs:
1. A1C testing—Diabetes can be diagnosed with this test. It measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar.
2. Blood pressure—A lower blood pressure helps reduce the risk of heart disease.
3. Cholesterol levels—Ask a health care provider what your level should be and how you can work toward it.
As with any disease, Drs. Zgibor and Orchard recommend that people speak with their health care providers if they are worried about diabetes or getting the treatment that’s best for them.