Being diagnosed with a chronic condition like diabetes can be a life-changing experience.
Urlin Clark, 63, was tested for type 2 diabetes after an annual checkup in early 2012. The Colorado man fell into several high-risk categories. He's African-American. He's older than 45. He's a little overweight. He has a family history of diabetes. He is being treated for high blood pressure and high cholesterol. And he had a heart attack a few years back.
Given those risk factors, his doctor wanted him to be tested. His tests came back positive. This began a new and unexpected journey in Urlin's life: living with diabetes.
A diabetes diagnosis must be taken seriously. Diabetes is the seventh leading cause of death in America. It is also the leading cause of blindness, kidney failure and lower limb amputations in adults. Having diabetes raises your risk for heart disease, stroke and nerve damage.
The disease is incurable, but it can be managed.
Some scary statistics
The statistics tell a frightening story. Almost 26 million Americans have diabetes. That's about 8 percent of the U.S. population. The rate is even higher among those over 20. About 2 million new cases of adult diabetes are diagnosed each year.
Then, add 79 million more people who have prediabetes. By 2050, as many as 1 in 3 adults could have diabetes if current trends continue, according to the Centers for Disease Control and Prevention.
Yet this may be the most sobering fact: You can have diabetes or prediabetes and not even know it. Many people have no symptoms. There are an estimated 7 million American adults with undiagnosed diabetes today.
The message is clear: diabetes is a dangerous disease that affects a lot of people.
What is diabetes?
Most of the food we eat is turned into glucose, or sugar. Our bodies use this sugar for energy. Insulin is an enzyme that breaks down the sugar. When you have diabetes, your body cannot produce insulin or it can't make or use it properly. Therefore, sugar builds up in your blood instead of being broken down for energy.
Here are the two main types of diabetes:
- Type 1. In this less common form, your body cannot produce insulin. People with type 1 need insulin therapy. Type 1 is typically diagnosed early in life and only makes up about 5 percent of all diabetes cases.
- Type 2. In this most common type, your body either does not make enough insulin or cannot properly use what it does produce. In some cases, you can live with type 2 without insulin therapy. Management will involve diet, nutrition and often medications. Sometimes insulin is used but often oral agents and other injectables are used.
Medical costs for someone with diabetes can be twice as high as someone without the condition, according to the CDC.
What puts you at risk?
You are at an increased risk for diabetes if you:
- Are overweight
- Are not physically active
- Have a family history of diabetes
- Are African-American, Hispanic, American-Indian, Asian-American or Pacific Islander
- Are older than 45
- Have high blood pressure or high cholesterol
- Have a history of heart disease or stroke
- Had abnormal results on a previous diabetes test
- Had gestational diabetes (diabetes during pregnancy)
- Gave birth to a baby who weighed 9 pounds or more
- Have another condition that affects how your body uses insulin, such as polycystic ovarian syndrome
Some people with diabetes have no symptoms. This makes it hard to know if you should be tested. Other people may have one or more of the following signs:
- Frequent urination
- Excessive thirst
- Unexplained weight loss
- Extreme hunger
- Sudden vision changes
- Tingling or numbness in hands or feet
- Feeling very tired much of the time
- Very dry skin
- Sores that are slow to heal
- More infections than usual
Getting tested for diabetes
Only a health care professional can tell you for sure if you have diabetes.
If your doctor suspects you have diabetes, he or she will order a blood test. This might be a fasting plasma glucose test (FPG), an oral glucose tolerance test (OGTT) or a hemoglobin A1C Test (HbA1C). A high reading on any of these tests may mean you have diabetes.
Glucose measuring methods used in a doctor's office, such as a finger prick, are not accurate enough for diagnosis but may be used as a quick indicator, health experts say.
Here is an explanation of the three most common tests. Health experts strongly recommend that if you get a positive result you undergo another test confirm the diagnosis, unless your doctor has no doubt about it.
FPG test results
For the FPG, you will fast overnight and then have your blood drawn at a lab or doctor's office. A blood sugar reading of:
- 126 mg/dL or more likely means you have diabetes
- 100 mg/dL to 125 mg/dL may mean you have prediabetes
- 99 mg/dL or less means your blood sugar is normal
You will fast for at least eight hours and then have your blood drawn at a lab. Next, you will drink a sugary beverage and have blood drawn again two hours later. A blood glucose reading of:
- 200 mg/dL or more may mean you have diabetes
- 140 mg/dL to 199 mg/dL likely means you have prediabetes
- 139 mg/dL and below means your blood sugar is normal
HbA1C test results
The A1C test is a simple blood test that is usually performed in a lab. You don't need to fast or change your diet or medications before the A1C test. A small sample of blood will be drawn from a vein in your arm.
- 6.5 percent or higher may mean you have diabetes
- 5.7 to 6.4 percent means you have prediabetes
- A reading of about 5 means your blood sugar is normal
In some cases, you may get tested for diabetes during a regular health checkup. A random plasma glucose (RPG) test can be done in the doctor's office. If your RPG measures 200 mg/dL or above, and if you show symptoms of diabetes, your doctor may diagnose diabetes.
A note about tests:
Although all of these methods can be used to detect diabetes, you could find that one test indicates diabetes and a different one does not. This could mean you are in an early stage of the disease. Your doctor may repeat a test on a different day or order a different test if your results are not clear. It's common for the same test to be given twice to confirm results.
The results: If you have diabetes
If your test results come back positive for diabetes, you will work on a treatment plan with your doctor. Your doctor may suggest other specialists be part of your care team. These might include a registered dietitian, certified diabetes educator, foot care doctor (podiatrist) or eye care professional (ophthalmologist or optometrist). Sometimes a diabetes specialist, called an endocrinologist, may be recommended.
The goal of managing your diabetes is to keep your blood sugar levels in check. Your doctor will also work with you to control other very important factors like your blood pressure and blood cholesterol. It is important that you follow your treatment plan closely. Doing so will reduce your risk of complications.
If you have prediabetes
Your doctor will want to test you again, usually in a year. If your reading is high enough within the prediabetes range, you are at greater risk of developing the disease and may need to be retested sooner.
This is an important time to discuss changes in your diet, activity level and lifestyle with your doctor. Addressing these factors can help prevent or delay your condition from turning into full-scale diabetes.
If you don't have diabetes or prediabetes
If your tests results show you are negative for diabetes, you can take steps to reduce your risk of the disease:
- Lose weight if you are overweight or obese. Research shows that reducing your body weight by 5 to 7 percent can cut your diabetes risk by more than half. This means a 200-pound person could see benefits from a weight loss of just 10 to 14 pounds.
- Eat right. Your diet should be rich in vegetables, fruits, whole grains, low-fat dairy and lean protein sources. Limit foods high in saturated fat. Avoid trans fats. Limit cholesterol, sodium and added sugars.
- Exercise regularly. Work your way up to nationally-recommended exercise guidelines. For adults, these include 150 minutes of moderate-intensity aerobic activity (such as brisk walking) every week and muscle-strengthening activities on 2 or more days a week. You can substitute 75 minutes of vigorous aerobic activity in place of the moderate activity, or combine moderate and vigorous activity for an equivalent time. Additional exercise time is recommended for children. Always check with your doctor before you increase your activity level.
Managing his condition
Clark says he wasn't surprised by his diagnosis, given his family history. Now he takes six medications every day. He is eating better. And he's lost a substantial amount of weight.
He still plays basketball. At his Colorado Springs home, his three large dogs keep him on the run.
"Finding out he had diabetes was a lifestyle-altering point," says his wife, Pula. "The biggest change has been in both our diets. I am also limiting my sugar, starch and white flour intake, so he's not in this alone."
There were a few sacrifices.
"No more cookies, candy and cake in the home. Also no more zucchini bread at midnight," Pula says. "I am still trying to master cooking brown rice at our high altitude."
Clark hasn't let his diabetes diagnosis get him down.
"If you've got it or get it, just follow the advice as best you can and you will be all right," he says.
Jenilee Matz, MPH, contributed to this report.
Created on 11/08/2005
Updated on 10/29/2012
- Centers for Disease Control and Prevention. Basics about diabetes.
- National Diabetes Information Clearinghouse. How are diabetes and prediabetes diagnosed?
- Centers for Disease Control and Prevention. National diabetes fact sheet.
- Centers for Disease Control and Prevention. Deaths and mortality.