What is diabetes? Diabetes is a disease in which the body either fails to produce any insulin (type 1, also called insulin-dependent or juvenile-onset), or does not produce enough insulin, or the insulin that it does produce is unable to adequately trigger the conversion of food into energy (type 2, also called non-insulin-dependent or adult-onset). Who has diabetes? Federal statistics estimate that 20.8 million children and adults in the United States — 7 percent of the population — have diabetes. An estimated 14.6 million Americans have been diagnosed, leaving 6.2 million Americans unaware that they have the disease. Most people with diabetes have type 2; an estimated 800,000 have type 1. About 1.5 million people age 20 or older will be diagnosed with diabetes this year. Diabetes is more prevalent among Native Americans, African Americans, Hispanic Americans and Asian Americans/Pacific Islanders. An estimated 54 million people in the U.S have pre-diabetes, a condition that occurs when one has higher than normal blood glucose levels, but not high enough to be diagnosed as having type 2 diabetes. (Research shows that if action is taken to control glucose levels, those with pre-diabetes can prevent or delay the onset of diabetes.) What are the symptoms of diabetes? Excessive thirst Frequent urination Weight loss Blurred vision Increased hunger Frequent skin, bladder or gum infections Irritability Tingling or numbness in hands or feet Wounds that are slow to heal Extreme unexplained fatigue Sometimes there are no symptoms (type 2 diabetes) Who is at greatest risk for developing diabetes? People who: Are 45 or over Are overweight Are habitually physically inactive Have previously been identified as having IFG (impaired fasting glucose) or IGT (impaired glucose tolerance) Have a family history of diabetes Are members of certain ethnic groups (including Asian American, African American, Hispanic American, and Native American) Have had gestational diabetes or have given birth to a child weighing more than 9 pounds Have elevated blood pressure Have an HDL cholesterol level (the good cholesterol) below 35 mg/dl and/or a triglyceride level above 250 mg/ Have polycystic ovary syndrome Have a history of vascular disease What are the long-term complications of diabetes? People with diabetes are two to four times more likely to develop heart disease or have a stroke than those who don’t have diabetes Diabetes is the leading cause of new blindness among adults between 20 and 74 years old. Diabetes is the leading cause of end-stage kidney disease in the U.S. More than 60 percent of the nontraumatic lower limb amputations in the U.S. occur among people with diabetes About 60-70 percent of the people with diabetes have mild to severe nerve damage Are YOU at Risk for Diabetes? Currently, an estimated 20.8 million Americans have diabetes, yet many don’t even realize it. Luckily, diabetes experts have determined several risk factors to help you and your healthcare provider decide whether you should be tested for diabetes. If you are 45 years old or older, it is recommended that you ask your doctor or healthcare provider if you should be tested for diabetes. If you are under 45, and if you have any of the following risk factors, it is important that you ask your healthcare provider if you should be tested for diabetes: You have a family history of diabetes You belong to a minority group, including African Americans, Hispanic Americans, Asian Americans, Native Americans, and Pacific Islanders You are consistently inactive You have been told that you have Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG) You are overweight according to BMI standards (please see our BMI chart on the back to determine whether you meet this criterion Your cholesterol is high You have hypertension You have given birth to a baby weighing more than 9 lbs., have a history of gestational diabetes or of Polycystic Ovary Syndrome Please remember to talk with your doctor or healthcare provider to determine the best course of action for you. Do You Have Pre-Diabetes? Are you one of the estimated 54 million people in this country who has pre-diabetes? If you have pre-diabetes, you are at high risk of developing type 2 diabetes and also are at increased risk of developing heart disease. Pre-diabetes is a condition in which blood glucose levels are higher than normal, but not high enough to be classified as full-blown diabetes. Those with pre-diabetes are at increased risk of developing type 2 diabetes within a decade unless they adopt a healthier lifestyle that includes weight loss and more physical activity. Among those who should be screened for pre-diabetes include overweight adults age 45 and older and those under age 45 who are overweight and who have one or more of the following risk factors: Are habitually physically inactive Have previously been identified as having IFG (impaired fasting glucose) or IGT (impaired glucose tolerance) Have a family history of diabetes Are members of certain ethnic groups (including Asian American, African-American, Hispanic American, and Native American) Have had gestational diabetes or have given birth to a child weighing more than 9 pounds Have elevated blood pressure Have an HDL cholesterol level (the good cholesterol) below 35 mg/dl and/or a triglyceride level above 250 mg/dl Have polycystic ovary syndrome Have a history of vascular disease Your doctor or healthcare provider will use one of two tests to determine if you have pre-diabetes. He or she will either use a blood test that measures fasting plasma glucose, or an oral glucose tolerance test (OGTT), during which the blood sugar level is measured before and two hours after drinking a glucose-containing solution. Both tests require that a person fast 8 to 12 hours prior to testing. A normal fasting blood glucose is below 100 mg/dl. Those with pre-diabetes have Impaired Fasting Glucose (IFG), which is a fasting blood glucose level between 100-125 mg/dl; OR they have Impaired Glucose Tolerance (IGT), a fasting glucose over 125 mg/dl and a blood glucose level of 140-199 mg/dl two hours after drinking the glucose drink in the OGTT test. If the fasting blood sugar level rises to 126 mg/dl or above, or the two-hour value during the OGTT is 200 mg/dl or greater, the person has diabetes. Be sure to ask your doctor what your exact blood glucose test results are when he or she tells you that you have "pre-diabetes." Some doctors are not as familiar as they should be with the new guidelines for diagnosing diabetes. They may be telling you that you have pre-diabetes, when in fact you have actual diabetes. The good news is that even if you are at risk for developing type 2 diabetes, you can reduce your risk by 58% through sustained modest weight loss and increased moderate-intensity physical activity, such as walking 30 minutes a day. Content provided by Joslin Diabetes Center. To learn more about diabetes, or to find a Joslin Diabetes Center Affiliated Center near you, please visit www.joslin.org Copyright © 2007 by Joslin Diabetes Center. All rights reserved. All materials contained on these pages are protected by United States copyright law and may be used for personal, noncommercial use only. Materials from these pages may not be reproduced, distributed, transmitted, displayed or published without the prior written permission of Joslin Diabetes Center (617-226-5815). 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