Yes, Type 2 diabetes can be difficult to cope with. But the good news it, so much of it is within your control.
More than 37 million Americans have Type 2 diabetes, about 1 in 10. Certain minority groups, including Black Americans and Latinos, are also at greater risk than white Americans because of genetics and other factors. Risk also increases with age. One-fourth of people over age 65 have diabetes.
Another 96 million – that’s 1 in 3 Americans – are prediabetic, meaning their blood sugar levels put them at risk for diabetes.
What do newly diagnosed patients say when they learn they have diabetes?
Diabetes is an incredibly prevalent problem. And we've heard about all the negative outcomes that can happen related to Type 2 diabetes. So, many people come to the discussion with a high degree of fear.
The first thing to do is take a deep breath. The second is to learn as much as you can from reliable sources. Don't go to “Dr. Google” and search diabetes. A reliable source for information is the American Diabetes Association for both Type 1 and Type 2 diabetes and to the JDRF for Type 1 (or “juvenile”) diabetes.
But, we all Google everything. What's wrong with Googling Type 2 diabetes?
It's the same problem as Googling anything. You don't know what kind of information you're going to get. Just because it's on the internet doesn't mean it's true.
And people looking for information in a heightened state of concern may not be able to filter and critically evaluate the information they're reading. Anytime you have a new health diagnosis, you should go to the most authoritative source. Your health care provider can direct you to good ones.
Another place to find good information is a diabetes education program. People with Type 2 diabetes, in particular, should get a referral to a certified diabetes educator.
We know the best thing to do post-diagnosis. What's the worst thing you can do?
The worst thing to do is panic and take on a fatalistic attitude.
For starters, work on increasing your physical activity. Any kind of physical activity can help. 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.
Patients with Type 2 diabetes should find a way to lose weight. Weight-management really is critical for controlling diabetes, and the better you control your diabetes from the beginning, the better your long-term outcome.
Finally, not everybody needs to be on medication from the beginning, but some people 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.
Can you reverse Type 2 diabetes? Or at least substantially improve your condition?
Reversing Type 2 diabetes is possible with significant lifestyle changes. Two things are key: Weight reduction 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.
What are some risk factors for Type 2 diabetes?
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. People should know what their BMI is. The Centers for Disease Control and Prevention website has a BMI calculator.
No. 2: Know 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 themselves. So, they should be screened.
And three: Age is a factor. The American Diabetes Association recommends screening people after age 45. The risk of Type 2 diabetes increases with age.
Is there a specific test for Type 2 diabetes?
The most accessible and easiest test is the hemoglobin A1C test. It tells you whether you have no blood sugar elevation or if you’re in the in-between zone, which is called pre-diabetes. It doesn’t have to be done fasting; you can do it any time of day. And it tells you what your average blood sugar has been for the last three months. Ask your healthcare provider to draw hemoglobin A1C level if you are in a high-risk group.
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, Native American or Hispanic, you're also in a higher risk category and should be screened.
What are the dangers of not taking this seriously?
While you can ignore diabetes in the short run, you can't ignore it in the long run. 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. Add 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.
What's the biggest misconception about Type 2 diabetes?
That the cause is eating too many sweets. It's a genetically determined disease. 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.