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Diabetes is a long-term health condition that affects how your body turns food into energy. A person’s lifestyle, as well as their ethnicity and family history, increases the risk for diabetes. Whether it is Type 1 or Type 2 diabetes, it is chronic. Although there is no cure, treatment can keep blood glucose in a healthy range.
The number of Americans diagnosed with diabetes has doubled in the last 20 years, according to the CDC.
Cecilia Jamieson is a clinical diabetes educator with UCHealth Diabetes and Endocrinology Care in northern Colorado. She lays out the basics about diabetes, from genetics and lifestyle risks to prevention, so you can better understand — and hopefully prevent — this chronic disease.
Yes, there are 4 types of diabetes: Type 1, Prediabetes, Type 2, and gestational diabetes.
Type 1 diabetes is an autoimmune disease where the body attacks the cells that produce insulin. People with Type 1 diabetes need to replace the needed insulin by injection.
Type 2 diabetes tends to be related more to insulin resistance. While there often is a decrease in insulin production, the body still produces some insulin. People with Type 2 diabetes often can manage their blood glucose (sugar) levels through healthy eating, exercise and medications. Since Type 2 diabetes is a progressive disease, sometimes insulin is needed as part of treatment.
Gestational diabetes is when blood glucose becomes elevated during pregnancy. The management of gestational diabetes also involves healthy eating, exercise, and sometimes medications or insulin. The goal is to keep blood glucose in the target range throughout the pregnancy to provide the best environment for the developing baby.
Prediabetes is when you have higher-than-normal blood sugar levels but are not yet high enough to be considered Type 2 diabetes. It is still a serious health condition but allows you to get your blood sugar levels under control, therefore, delaying or avoiding Type 2 diabetes. Just 5-7% weight loss can lower your risk of developing Type 2 diabetes by 58%, which jumps to 71% if you’re over 60. UCHealth offers a Diabetes Prevention Program for prediabetes, which Medicare and some insurance plans cover.
There are approximately 26 million Americans who currently live with diabetes. Almost 95% have Type 2, while only 5% (or about 1.3 million) have Type 1.
Type 1 diabetes primarily affects Caucasians but can also affect Latinos and other ethnicities.
African American, Hispanic/Latino American, American Indian, Alaska Native, some Pacific Islanders and Asian American ethnicities have a higher risk for Type 2 diabetes.
Prediabetes is extremely common, she said.
“One in every three Americans has prediabetes, and 90% of them don’t know it,” Jamieson said. “The risk factors for developing prediabetes are the same as for Type 2 diabetes. The lifestyle changes that prevent or delay Type 2 diabetes can also help prevent prediabetes.”
The CDC-led National Diabetes Prevention Program can help people make healthy changes that have lasting results. The Diabetes Prevention Program is facilitated by Lifestyle coaches and is available at UCHealth.
Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks its insulin-producing cells). Risk factors for Type 1 diabetes are not as straightforward as prediabetes and Type 2 diabetes.
“In the United States, Caucasians are more likely to develop Type 1 diabetes than African Americans and Hispanic/Latino Americans. Currently, there is no method for preventing Type 1 diabetes,” Jamieson said.
The same ethnic groups at higher risk for the development of prediabetes and Type 2 diabetes also have a higher risk for gestational diabetes.
“Gestational diabetes usually goes away after the baby’s birth but increases the risk for having Type 2 diabetes later in life,” Jamieson said. “The baby is more likely to be overweight or obese as a child or teen and is more likely to develop Type 2 diabetes later in life.”
Before getting pregnant, healthy lifestyle changes including diet, physical activity and maintaining a healthy weight can decrease the risk of developing gestational diabetes.
Jamieson said that specific ethnic populations, including Hispanics/Latinos, have a higher rate of prediabetes and Type 2 diabetes. Family history is also an important risk factor and should lead to earlier screening.
“The risk is especially high if the family member with diabetes is a first-degree relative – meaning a mother, father, or sibling,” she said. “That does not mean the development of diabetes is inevitable–even if you have a first-degree relative with diabetes. Lifestyle changes such as changing your diet, increasing physical activity and sometimes losing weight can significantly decrease your risk for developing prediabetes and Type 2 diabetes.”
“Having said that, genetics can play a large part in the development. Even if the person follows a healthy lifestyle, some people may still develop diabetes at some point in their lives. But those that have healthy lifestyles tend to develop diabetes later in life and sometimes not at all.”
“You can manage diabetes and control the blood glucose values. You may even get the values back into a normal range. But once you have been diagnosed with diabetes, it will not go away,” Jamieson said.
Diabetes increases the risk of heart disease and stroke. It can lead to other serious complications, such as kidney failure, blindness and amputation of a toe, foot or leg.
“People with diabetes spend more on health care, have fewer productive years, and miss more workdays than people who don’t have diabetes,” she said.
Whether someone has Type 1 or Type 2, quality of life is significantly better if the person effectively manages their diabetes. If they do not, the risk for serious complications is higher. Learn more about managing your diabetes.
Symptoms of diabetes may include feeling tired, sluggish and low on energy. Other symptoms can include excessive thirst, frequent urination, and blurry vision.
The only definitive way to know is to get tested. Your primary care clinic can help you with this.
Establishing a primary care physician can help you avoid or manage diabetes. Annual wellness visits with your primary care doctor, including blood work, will catch early signs of diabetes and prediabetes. Your doctor can then help you create a plan for the prevention or management of the disease.
Screening for diabetes can include a fasting glucose test (not eating or drinking anything but water for 8-12 hours prior to the test) or an A1C blood test. If fasting values are above 100 or A1C is higher than 5.6%, that may indicate prediabetes. If fasting values are above 126 or A1C is higher than 6.4%. That may mean Type 2 diabetes.
“There are many misconceptions about what leads to the development of diabetes,” Jamieson said. “A prevalent misconception is that eating too much sugar will cause or lead to diabetes.”
Diabetes is often genetic and can occur in otherwise healthy people. Unhealthy lifestyles can also increase the risk of developing diabetes.
“But, no one who develops diabetes should feel guilty or beat themselves up about it,” she said. “There are many people who follow unhealthy lifestyles and have several risk factors but never develop it.
“It is most important for people to get the education they need to manage it. Those who actively manage their diabetes can live long, healthy lives.”