Diabetes
Diabetes is the seventh leading cause of death in the United States. The Centers for Disease Control and Prevention (CDC) estimates that 25.6 million people age 20 and older, or 11.3% of all people in this age group, have diagnosed or undiagnosed diabetes. Type 2 diabetes accounts for 90-95% of all diagnosed cases of diabetes among adults. Unhealthy weight and physical inactivity, also significant national health problems, are both contributing factors to the rising incidence of type 2 diabetes.
Another 79 million American adults aged 20 years or older have pre-diabetes, meaning that their blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes. Detecting pre-diabetes allows individuals take steps to stop or slow the development of type 2 diabetes and its complications. These include heart attack, stroke, hypertension, blindness and eye problems, kidney disease, and nervous system maladies. More than 60% of lower limb amputations occur in diabetics.
Another complication is hearing loss. It is twice as common in people with diabetes as it is in those who don't have the disease. Among adults with pre-diabetes, the rate of hearing loss is 30% higher than in those with normal blood sugar levels, according to the American Diabetes Association (ADA).
Risk Factors
Being overweight – having a body mass index (BMI) equal to or greater than 25 kg/m2) – is a major risk factor for type 2 diabetes.
Other risk factors related to your own health include:
- Physical inactivity
- Having hypertension, meaning blood pressure 140/90 mmHg or higher or receiving therapy for hypertension
- History of cardiovascular disease
- Having a HDL-cholesterol level less than 35 mg/dL (0.90 mmol/L) and/or a triglyceride level greater than 250 mg/dL (2.82 mmol/L)
- Having a previous A1c test result equal to or greater than 5.7%, impaired glucose tolerance, or impaired fasting glucose
- Having other conditions associated with insulin resistance, such as severe obesity and acanthosis nigracans
Family-related risk factors are:
- Having a parent or sibling with diabetes
- Being of African American, Latino, Native American, Asian American, or Pacific Islander descent
Women's risk factors include:
- Delivering a baby weighing more than 9 pounds or having had gestational diabetes
- Having polycystic ovarian syndrome
Recommendations
The ADA recommends that all people age 50 and older get screening for type 2 diabetes, even if they have no symptoms or risk factors other than age. If you have additional risk factors, screening is especially important.
- If you are an overweight adult and have at least one other risk factor, get diabetes screening with an A1c, fasting plasma glucose, or 2-hour 75g oral glucose tolerance test.
- If results are normal, get repeat testing at least every 3 years.
- If you have been diagnosed with pre-diabetes, get tested yearly.
The American Association of Clinical Endocrinologists (AACE) also recommends diabetes screening for asymptomatic people with these risk factors, as well as those on antipsychotic therapy for schizophrenia or who have severe bipolar disease.
The U.S. Preventive Services Task Force (USPSTF) identifies just one risk factor, high blood pressure, and sets a lower threshold for type 2 diabetes at 135/80 mm Hg.
As public health experts work to educate Americans on what to do to avoid this disease and its serious complications, be aware that healthy eating habits and activity choices can lower your risk of developing type 2 diabetes and of suffering complications from the disease.
Links
NIDDK: Am I at Risk for Type 2 Diabetes?
American Diabetes Association
College of American Pathologists: MyHealthTestReminder.com - Diabetes Tests
Sources Used in Current Review
Centers for Disease Control and Prevention. National Diabetes Fact Sheet, 2011. PDF available for download at http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf through http://www.cdc.gov. Published 2011. Accessed August 24, 2012.
American Diabetes Association. Standards of Medical Care in Diabetes – 2012. Diabetes Care. Available online at http://care.diabetesjournals.org/content/35/Supplement_1/S11.full.pdf+html through http://care.diabetesjournals.org. Published January 2012. Accessed August 27, 2012
American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for Developing a Diabetes Mellitus Comprehensive Care Plan. PDF available for download at https://www.aace.com/files/dm-guidelines-ccp.pdf through https://www.aace.com. Published March/April 2011. Accessed September 7, 2012.
U.S. Preventive Services Task Force. Screening for Type 2 Diabetes Mellitus in Adults. Available online at http://www.uspreventiveservicestaskforce.org/uspstf/uspsdiab.htm#summary through http://www.uspreventiveservicestaskforce.org. Published June 2008. Accessed September 7, 2012.
National Center for Health Statistics Data Brief. Prevalence of Obesity in the United States, 2009–2010. PDF available for download at http://www.cdc.gov/nchs/data/databriefs/db82.pdf through http://www.cdc.gov. Published January 2012. Accessed September 10, 2012.
American Diabetes Association. Living with Diabetes: Diabetes and Hearing Loss. Available online at http://www.diabetes.org/living-with-diabetes/seniors/hearing-loss/ through http://www.diabetes.org. No publish data given. Accessed September 11, 2012.
