2011 Diabetes Report: Are you at Risk?

By Etie Moghissi, MD, FACP, FACE

According to the 2011 CDC (Center for Disease Control and Prevention) report diabetes mellitus affects nearly 26 million Americans. About seven million Americans are undiagnosed. Another 79 million Americans over age 19 have prediabetes, a condition in which blood sugar (glucose) levels are higher than normal but still not high enough to be diagnosed as diabetes. This condition is now believed to affect 30% of Americans who are over 20 years old. Prediabetes raises a person’s risk of type 2 diabetes, heart disease, and stroke. About 27% of people 65 years and older have diabetes and 50% have prediabetes. The rate of diabetes and pre-diabetes are even higher in many racial and ethnic minorities.

These are alarming statistics. As a society and as individuals we need to find a way to prevent diabetes and to manage the illness in those already affected.

The good news is, diabetes can be prevented!

Diabetes can be prevented by changes in lifestyle, good nutrition, increased physical activity, and moderate weight loss. Clinical trials show that losing 5%-7% of body weight—that’s 10 to 14 pounds for a 200-pound person—and getting at least 2½ hours of moderate physical activity each week reduces the risk of type 2 diabetes by nearly 60% in those at high risk for the disease. We know that remaining smoke free, increasing intake of whole grains (such as whole wheat bulgur, whole wheat couscous, brown rice, steel-cut oats, rolled oats and whole rye) and cutting back on refined carbohydrates and sugary drinks can help lower your risk for diabetes. White bread, white rice, white pasta, and potatoes cause increases in blood sugar, as do sugary soft drinks, fruit punch, and fruit juice. Over time, eating a lot of these may increase your risk for type 2 diabetes.

What are the risk factors for diabetes?

Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of diabetes during pregnancy, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.

Take charge of your health! - Get Tested!

It is important to find out early if you have prediabetes or type 2 diabetes because early treatment can prevent the serious problems caused by high blood sugar.

Remember that there is no such a thing as “borderline diabetes.” That would be like being “borderline pregnant!” Ask your doctor if your blood sugar is normal or in the diabetes or prediabetes range.

Here is what you can do to stay healthy:

If you are in the prediabetes category:

Modify your lifestyle, eat a little less at meal time, plan your meals ahead of time so you do not grab rich snacks on the road, and eat more fruits and vegetables and less salt and saturated fat. Replace soft drinks with water and limit juices. Increase your physical activity to moderate intensity for at least 30 minutes on five or more days of the week. Make sure your blood pressure and your cholesterol are in the normal range. Talk to your doctor and set goals.

If you have been diagnosed with type 2 diabetes:

It is important to know that by controlling your blood sugar early and aggressively you may be able to preserve your insulin-producing cells in the pancreas, called beta cells, so your diabetes will not progress. By the time diabetes is diagnosed almost half of the beta cell function is gone and over time people with type 2 diabetes will need to take insulin to control their blood sugar.

People with diabetes must take charge of their day-to-day care and keep their blood sugar levels from going too low or too high. Staying informed is essential in managing your diabetes to prevent long-term complications.

The Basics:

  1. Healthy eating and physical activity are the cornerstones of managing type 2 diabetes. See a nutritionist to help you create a meal plan that is right for you. Many people with type 2 diabetes need to take diabetes medication, too. There are many choices of medications. Some are taken by mouth and some are injectable. Ask your doctor which one is best for you. Understand the risks and the benefits of what he or she recommends.
  2. Know your “numbers.” Ask your doctor
    • What are my blood sugar, blood pressure, and cholesterol numbers?
    • What should they be?
    • What actions can I take to reach my goals?
  3. Check your progress by keeping track of your blood sugar and your A1c.
  4. See your doctors regularly and get ready for each visit by writing down your questions ahead of time so you make the most of your visit.
  5. Get your eyes examined on a yearly basis if your eyes are healthy. If you have problems with your eyes, work with your eye doctor to make sure they remain stable.
  6. Protect your kidneys: Keep your blood pressure under control and get screened for kidney problems. A blood test called glomerular [gloh-MER-yuh-ler] filtration rate (GFR) and a urine test for protein called microalbumin [migh-kro-al-BYOO-min] are important as a part of your annual check-up (See the Kidney Connection article in this magazine for more information).
  7. Protect your heart: Make sure that your cholesterol is under control. Stop smoking and ask your doctor if you should take a daily aspirin.
  8. Get an annual flu shot and make regular visits to the dentist.
  9. Take your medications as prescribed.
  10. Stay in touch with your support system, family and friends, and smile often!

For more information visit http://www.cdc.gov/diabetes/consumer/learn.htm and http://www.yourdiabetesinfo.org

Dr. Etie Moghissi is board certified in endocrinology, diabetes and metabolism and is in private practice in Marina del Rey, California. She is a Clinical Associate Professor of Medicine at UCLA. Dr. Moghissi is a recognized expert in the field of diabetes and is actively involved in direct patient care as well as in professional medical education. She has published in peer-reviewed medical journals including Endocrine Practice and Diabetes Care. She serves as Vice President of the American Association of Clinical Endocrinologists.