More than 34 million people in the United States have diabetes, according to the Centers for Disease Control and Prevention (CDC), and 1 in 4 of them don’t know they have it. Many are millennials. In fact, it’s rising fastest among that group.

The numbers are even more staggering when you look at prediabetes. More than 88 million American adults — 1 in 3 — have prediabetes, and most (90%) of them don’t know they have it.
Prediabetes is a risk factor for Type 2 diabetes. Other risk factors include being:
  • Overweight.
  • Age 45 or older.
  • History of gestational diabetes.
  • Physically inactive (fewer than three times a week).

The staggering numbers add up to a crisis for America.

A host of complications can accompany diabetes, including nerve damage; skin disorders; eye complications including glaucoma, cataracts and blindness; cardiovascular disease; high blood pressure; stroke, and lower-limb amputations.

Dr. Cathy Rolih, the clinical physician executive for the Novant Health Diabetes Center of Excellence, has plenty to share on the topic of diabetes. Here are the top 5 things she suggests you know and do.

1. Get educated.

Know the risk factors:

  • The first is a body mass index, or BMI, over 30. BMI is the calculated number that correlates your weight with your height. The higher the BMI, the greater the risk. The CDC website has a BMI calculator.
  • The second is to understand your family history. People with a first-degree relative – a parent or sibling – with Type 2 diabetes – have an increased risk of Type 2 diabetes. If that’s you, ask your provider about a screening test.
  • Lastly, age is a factor. The risk of Type 2 diabetes increases with age. The American Diabetes Association recommends screening people after age 45.

Unsure where to start? A primary care physician can help.

Find one near you

Dr. Cathy Rolih
Dr. Cathy Rolih

The prevalence of diabetes is higher among African Americans and people of Hispanic background. So, if you have a high BMI and you're African American or Hispanic, you're also in a higher risk category and should be screened.

Know myth from reality. The biggest misconception about Type 2 diabetes is that the cause is eating too many sweets. It's a genetically determined disease, Rolih said. “Type 2 diabetes comes from your genetic predisposition, your weight, your physical activity level and your diet. So just cutting back on sweets won't necessarily eliminate diabetes, although it’s an important part of managing it.”

Learn as much as you can from reliable sources. “I refer my patients to the American Diabetes Association for both Type 1 and Type 2 diabetes and to the JDRF for Type 1 (or ‘juvenile’) diabetes,” Rolih said. Going through a formal diabetes prevention program (DPP) is a good way to get this crucial information in a way you can act on.

2. Get moving.

“Even if you're not a ‘jock,’ any kind of physical activity can help,” Rolih said. “Just baby steps. Nothing is too small. If you’re completely sedentary, walking to the end of the block and back once a day is more than a good start.” The ADA recommends 150 minutes of moderate activity a week to control both diabetes and decrease risk. Consult with your provider before embarking on a vigorous exercise program.

3. Manage – or lose – weight.

Even a little. “That's an easy thing to say and a difficult thing to do,” Rolih said. “But weight management is critical for controlling diabetes, and the better you control your diabetes from the beginning, the better your long-term outcome.”

“Two things are key,” Rolih continued. “Weight reduction – not necessarily a lot, 15 or 20 pounds, depending on where the patient is in the course of their disease – and significantly decreasing carbohydrate intake.”

“People on very high-carb diets who drink lots of sugar-sweetened beverages and eat a lot of starchy food can have significant improvement in their diabetes control by making small changes in their diet.”

4. Ask your health care provider about medication.

Not everybody needs to go on medication after a diagnosis, but some do. And sometimes that includes insulin. Oftentimes, for people with very high blood sugar elevation, insulin is the only choice to manage their blood sugar. And with time, changes in lifestyle and gradual weight loss, many patients can cut back or even eliminate their insulin therapy – even if they're on it immediately after diagnosis.

While you’re at it, ask for a referral to an ADA-recognized diabetes education group class. “We see as much improvement in glucose control with education as we do with medication,” Rolih said. “And you get the added benefit of support from you peers.”

5. Take it seriously.

“While you can ignore diabetes in the short run, you can't ignore it in the long run,” Rolih said. Diabetes that goes unaddressed will result in complications.

“You may not feel bad when your blood sugar is only a little or even moderately elevated. But elevated blood sugar that goes on for years has negative effects on the body – potential damage to the eyes, which may result in blindness. And damage to the nerves, particularly in the legs, which can result in loss of sensation. That, in turn, results in not being able to tell if you have an injury or an infection, and that can result in the need for lower extremity amputation.”

“Diabetes has a negative effect on the kidneys. And decline of kidney function, over time, can result in kidney failure. And then people end up on dialysis. People who have diabetes also have an increased risk of heart attack and stroke.”