According to the Centers for Disease Control and Prevention, about 7 million people in the U.S. have undiagnosed diabetes. While symptoms are often present, some people have no signs of the disease.
Common signs and symptoms include:
- Extreme thirst
- Urinating more than usual
- Unexplained weight loss or losing weight without trying
- Blurry vision
- Wounds or blisters that don’t heal well
- Tingling or numbness in your hands or feet, or both
- Feeling very tired
- Dry, itchy skin
- Red, swollen, tender gums
- Frequent infections
What Increases Your Risk?
Several things can make someone more likely to develop type 2 diabetes. For example:
- Being overweight or obese—the more weight you carry, especially around your midsection, typically the more resistant your body is to insulin
- Having high blood pressure generally or during pregnancy (called preeclampsia)
- Eating an unhealthy diet that is high in fat, calories, cholesterol and processed food
- Not exercising regularly
- Being older than 45, although it can occur in younger people
- Having a parent, brother or sister who has diabetes
- If you are a woman, a few more factors can increase your risk:
- Being diagnosed with gestational diabetes
- Up to 3 out of 5 women who had this during pregnancy will go on to develop diabetes within 15 years
- Giving birth to a baby that weighed more than 9 pounds
- Having polycystic ovarian syndrome (PCOS)
- Being diagnosed with gestational diabetes
Type 2 diabetes is also more common among certain ethnic or racial groups including African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders.
It’s important to talk with your health care professional about all your personal risk factors.
Exams and Tests
Diabetes is diagnosed by taking a detailed medical history, including a report of symptoms, and blood tests that measure the amount of glucose in the blood or how your body handles it.
There are several types of blood tests to check your sugar level:
- Hemoglobin A1c (HbA1c or A1c), or simple A1c gives an overall picture of your blood sugar level over the past two to three months
- Fasting glucose test measures the amount of glucose in your blood after you haven’t had anything to eat or drink for eight hours
- Random blood glucose test measures the amount of glucose in your blood at any point during the day. Eating does not affect this test
- Oral glucose tolerance test checks your blood glucose levels before and two hours after you drink a special sweet drink to show how well your body processes glucose,
Treatment
There are a few things you can do to help manage your diabetes and live a healthier life. It’s very important to take steps that will help prevent high blood sugar levels. This is most often achieved through a combination of:
- Healthy eating
- Exercise
- Insulin therapy and/or diabetes medication, and
- Routine blood sugar monitoring
Treatment Goals
Diabetes treatments aim to:
- Lower high blood glucose levels
- Manage blood pressure, cholesterol and other health issues
- Reduce the risk of cardiovascular disease and related deaths
- Prevent problems such as nerve damage, high blood pressure, issues digesting food, or gum disease and others
The American Diabetes Association has set the following blood glucose targets for people with diabetes. Your health care team will work with you to set your personal blood glucose goals and map out a course of treatment that’s best for you.
| Target Blood Glucose Levels for Most People with Diabetes | |
| Before Meals | 70 mg/dL to 130 mg/dL |
| 1 to 2 Hours After Start of Meal | Less than 180 mg/dL |
HbA1c/A1c is also used to give an average blood glucose level over the past three months. Target A1c for most people with diabetes should be less than 7%. Talk with your health care professional about your specific goal.
| American Diabetes Association Guidelines | |
| Result | A1c |
| Normal | Less than 5.7% |
| Prediabetes | 5.7% to 6.4% |
| Diabetes | 6.5% or higher |
Your treatment plan will likely include:
❱❱ Making healthier choices overall
- Get regular exercise
- Maintain a healthy weight
- Eat a healthy diet that is lower in salt, fat and refined carbohydrates; it’s also helpful to meal plan, read labels and to learn how to substitute saturated and trans fats for healthier fats
- Avoid cigarettes and alcohol
❱❱ Taking medications
Several medications are used to help control your blood sugar levels. The type of medicine you take—insulin therapy and/or diabetes medications—will depend on your type of diabetes, as well as other health conditions.
Some medications are given by mouth; others may be given by injection or by using an insulin pen or pump. Many people with diabetes take multiple medications. Some of the newer diabetes medications also have been shown to lower the risk of heart disease, stroke and related deaths.
❱❱ Ongoing care and monitoring
Taking care of yourself, going to necessary medical appointments, getting lab tests, including a yearly urine test, and knowing your blood glucose number are all important to managing diabetes.
As mentioned, maintaining a healthy weight, staying physically active and eating a healthy diet are also key to controlling blood sugar levels and lowering your risk of heart disease and stroke.
Talk with your doctor about:
❱❱ Checking your blood sugar level
Ask your care team how often you need to check and record your blood glucose, and if you should use a glucose meter at home. Knowing your glucose levels can help you and your doctor make decisions about your medicines, meals and exercise regimen.
If your glucose level is not where it should be, changes can be made to your treatment plan. Random blood sugar testing may also be done or recommended when you have symptoms.
❱❱ Controlling your blood pressure and cholesterol levels, if needed
❱❱ Knowing what to look for
Ask your doctor about possible complications from diabetes and what to watch for. For example:
- Nerve damage (called diabetic neuropathy), which most often shows as a numbness, tingling or burning in your hands or feet
- Eye problems such as blurry vision
- Kidney issues
- Cuts, blisters or sores on your feet
- Heart disease and stroke
Call 911 if you have chest pain, fainting or shortness of breath.
❱❱ Getting immunizations
Ask your doctor about getting vaccinated to help prevent illnesses such as the flu, pneumococcal disease and shingles.
Understand the Connection
If you’re like most people, you may not know that diabetes and heart disease often go hand-in-hand.
Diabetes is a major risk factor for cardiovascular disease, including:
- Coronary heart disease
- Heart attack
- Stroke
- Weakening of the heart muscle (cardiomyopathy)
- Heart failure
The ways in which diabetes affects cardiovascular health are complex. But we do know that high levels of sugar in the blood can, over time, damage the blood vessels and nerves. These changes can make your blood vessels stiff and narrowed. As a result, blood may not flow as easily to your heart, brain or body.
Unfortunately, by the time someone learns they have diabetes, changes or injuries to the large (macro) or small (micro) blood vessels in the body have often already started. Talking with your care team about these changes is important.
- Microvascular complications include diabetes-related kidney disease, vision and nerve problems
- Macrovascular complications include heart attack, stroke and peripheral artery disease
People with diabetes are also more apt to have other heart disease risk factors. For example:
- High blood pressure
- Elevated levels of low density lipoprotein (LDL) cholesterol
- Chronic kidney disease that can lead to dialysis
- Being overweight or obese
By the Numbers
- 1 out of 10: Americans living with diabetes
- 2X-4X: How much more likely people with diabetes are to develop heart disease or stroke compared with people who don’t have diabetes
- 2 out of 3: Proportion of deaths due to heart disease among people older than 65 with diabetes