Diabetes: Are You At Risk?

Diabetes is becoming more and more common these days. To be specific, over 23 million people in the United States have diabetes, and 5.5 million are undiagnosed. So what does this mean for you? Well, you could be one of those 5.5 million or could be at risk for acquiring diabetes at some point in your life.

First and foremost, it is important to define diabetes and its three forms. Diabetes is a disorder of carbohydrate metabolism where the body produces too little or no insulin at all. When there is not enough insulin the cells in our bodies do not respond properly causing an unusually high blood glucose level (blood sugar) also called hyperglycemia.

Type 1 Diabetes occurs when the body's insulin producing cells have been destroyed typically caused by an autoimmune response. This type of diabetes accounts for 5-10% of all diagnosed cases of diabetes and develops most frequently in children and adolescents.

Type 2 Diabetes occurs when glucose (sugar) has trouble entering body cells due to not enough insulin or insulin resistance. Although it is uncertain the cause of type 2 diabetes, researchers have linked obesity, genetic factors, elevated blood pressure, and high levels of blood triglycerides (fats) as contributors. Nearly 90-95% of all Americans with diabetes have type 2 diabetes.

Gestational Diabetes occurs when women who have never had diabetes before develop impaired glucose intolerance during pregnancy. The cause of gestational diabetes in unknown, but researchers believe it has something to do with hormones produced by the placenta. Gestational diabetes affects about 4% of pregnant women in the United States each year. Women who have had gestational diabetes have a 40-60% chance of developing type 2 diabetes later in life.

Pre-diabetes is a circumstance in which blood glucose levels are higher than normal but not high enough to diagnose type 2 diabetes.

All forms of diabetes with the exception of pre-diabetes are monitored by testing blood sugars several times throughout the day and with the injection of insulin.

So how do you know if you're at risk for diabetes? Risk factors include:

Type 1 Diabetes

• Parent or sibling with type 1 diabetes

Type 2 Diabetes

• Family history of diabetes including parents, siblings, and relatives

• Overweight/Obesity (BMI of 25 or above)

• Physical inactivity

• Prior history of gestational diabetes

• Pre-diabetes

• Race or Ethnicity (African American, Latino, Native American, Asian American)

• Age 45 years or older

• High blood pressure (140/90 mmHg or above)

How is diabetes diagnosed, and what defines diagnosis?

There are 4 types of tests used to diagnose diabetes. These tests include A1C Test, Fasting Plasma Glucose Test, Random Plasma Glucose Test, and Oral Glucose Tolerance Test (OGTT). A test is usually ordered when a patient presents with symptoms of diabetes. Symptoms of diabetes include excessive urination, excessive thirst, unexplained weight loss, and sometimes excessive eating. If you would like to know what these tests are and how they are done please contact me.

Criteria for the diagnosis of diabetes includes:

• Symptoms of diabetes plus casual plasma glucose concentration of 200 mg/dL (11.1 mmol/L) or more

OR

• Fasting plasma glucose of 126 mg/dL (7 mmol/L) or more

OR

• 2-hour post-prandial glucose of 200 mg/dL (11.1 mmil/L) or more during an oral glucose tolerance test (OGTT).

So what can you do to decrease your risk of diabetes in the future?

Dietary and lifestyle factors are the single most important preventative measures for type 2 diabetes. Reducing excess body fat, and regular exercise help to improve glucose tolerance, reduce risk factors for heart disease, improve carbohydrate and lipid metabolism, and decrease blood pressure.

Unfortunately there is no way to prevent type 1 diabetes as it is linked to genetics.

Diabetes can be a scary condition to deal with especially if the condition has been undiagnosed for a long period of time. Preventative measures including diet and and exercise are the best ways to avoid diabetes, but if you are especially at risk there are medications that doctors can prescribe to decrease that risk. If you have any questions or would like to know more please contact me. I hope you found this post to be informative!

References:

1. Nelms M, Sucher K, Lacey K, Long Roth S. Nutrition therapy and pathophysiology. 2nd ed. United States: Wadsworth Cengage Learning; 2011.

2. Insel P, Ross D, McMahon K, Bernstein M. Nutrition. 4th ed. Sudbury, MA: Jones and Bartlett Publishers; 2011.

3. Mahan K, Escott-Stump S, Raymond J. Krause's food and the nutrition care process. 13th ed. St. Louis, MO: Elsevier Saunders; 2012.

4. American Diabetes Association. American diabetes association complete guide to diabetes. 5th ed. Alexandria, VA: American Diabetes Association; 2011.

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