Nearly 24 million Americans have diabetes. And this number continues to rise amid the growing obesity epidemic and aging baby boomer population. Lifestyle factors—for example, being overweight, not exercising or eating poorly—and genetics play an important role in the development of this disease.

What Is Diabetes?
Diabetes is a chronic condition in which the body is unable to properly use the energy it gets from food. That’s because with diabetes the body does not either produce insulin or use it properly. Without enough insulin (a hormone produced by the pancreas), glucose—a form of sugar—can’t get to the cells. Glucose is the fuel used by cells to make energy and grow. As glucose begins to build in the bloodstream, two things happen:

• Cells are starved for energy.
• Over time, high blood sugar (glucose) can damage the eyes, kidneys and nerves. Diabetes also increases the risk of heart disease, stroke and amputation (loss of a limb).

Diabetes is a very serious health problem. But there are steps you can take to prevent diabetes. And if you or a family member has diabetes, you can live a long healthy life if the disease is well-managed by controlling sugar levels in the blood.

There are two major types of diabetes:

Type 1: Typically occurs in childhood or adolescence (but can occur at any age), when the immune system attacks and destroys insulin-producing (beta) cells. People with this form of diabetes need insulin injections to keep blood sugar levels within a normal range. This accounts for 5 to 10 percent of diabetes cases.

Type 2: The most common type of diabetes. This occurs when the body fails to use insulin properly—called insulin resistance—or the body does not produce enough insulin to keep blood sugar levels normal. Lifestyle changes and, in some cases, medications are used to control blood sugar levels.

Gestational diabetes is a third type of diabetes that can occur during pregnancy and places a woman at greater risk for type 2 diabetes later in life.

Know Your Risk
Certain health behaviors or conditions—called risk factors—increase the likelihood of developing type 2 diabetes. Your risk is higher if you have any of the following:

• Increasing age, especially over age 45
• Being overweight or obese, especially having too much fat around the waist
• Family history of diabetes, particularly a parent, brother, or sister with diabetes
• Race/ethnicity (African American, American Indian, Asian American, Hispanic Americans/Latino background)
• Low HDL, or “good” cholesterol
• High levels of LDL, “bad” cholesterol, or triglycerides, a type of fat in your blood
• High blood pressure (hypertension)
• History of gestational diabetes during pregnancy or giving birth to a baby weighing more than nine pounds
• Pre-diabetes (also called insulin resistance)
• Inactive lifestyle

Many of these factors tend to cluster. That means, if you have one, you are likely to have others. For example, someone who is obese is likely to have high cholesterol and blood pressure and not be getting enough exercise. This not only increases the likelihood of diabetes, but heart attack and stroke, too. The blood glucose, blood pressure and cholesterol should be managed together to help prevent heart attack and stroke.

Some risk factors are beyond your control—for example your age, family history of diabetes, race and ethnicity—but lifestyle choices such as losing weight and exercising can have a big impact on your risk of diabetes. Small changes can make a big difference. Adopt healthier lifestyle habits today by eating a well-balanced, low saturated-fat, high-fiber diet, exercising regularly and quitting smoking.

Signs of Diabetes
Type 2 diabetes tends to develop slowly, so many people are surprised to learn they have it. In fact, it’s estimated that up to one-third of people with diabetes don’t know they have it. But the earlier you know you have diabetes and can control it, the less likely you are to develop complications. So pay attention to the signs.

Classic signs of high blood sugar include:

• significant thirst—much more than usual
• frequent urination, especially at night
• feeling tired or ill
• blurred vision
• infections that are slow to heal
• weight loss without trying

You should see your health care professional if you have any of these symptoms. Be sure to ask whether you should have a blood glucose test to look for diabetes or signs of insulin resistance.

Screening for Diabetes
In addition to a complete physical exam and medical history, your provider will order blood tests to look at your blood sugar levels. There are two main screening tests for diabetes. Both use a simple blood test.

Special Considerations: Children, Women & Men

Adults with Pre-Diabetes
Pre-diabetes is an increasingly common condition in which blood glucose levels are higher than normal, but not high enough to be diagnosed as diabetes. An estimated 57 million Americans have pre-diabetes. Most people with pre-diabetes will develop type 2 diabetes within 10 years unless they make important lifestyle changes (for example, diet and exercise), which can help prevent or delay the onset of diabetes. According to the American Diabetes Association, just 30 minutes of moderate physical activity five days a week, coupled with a 10 to 15 pound weight loss, can cut the risk of diabetes in this group by nearly 60 percent.

Children
A growing number of children, especially those who are overweight, are developing type 2 diabetes. And unless American families changes the way they eat and live, the U.S. Centers for Disease Control and Prevention predicts one in three children born in 2000 will develop diabetes in their lifetime. Make sure your kids get plenty of outdoor play time and eat a proper diet. If your child has diabetes, continue to encourage him or her to get plenty of exercise and eat a healthy diet.

Women
Pregnant women who have high blood sugar levels during pregnancy can develop gestational diabetes. While hormones from the placenta help the baby develop, these hormones can block the action of insulin in the mother’s body. That means the woman’s body isn’t able to make or use the insulin it needs for pregnancy. Gestational diabetes affects 4 percent of all pregnant women. Although this type of diabetes is usually temporary (lasting only through pregnancy), women who have had it are more likely to develop type 2 diabetes later in life.

Men
Many men with diabetes experience worse erectile dysfunction and sexual intimacy problems than nondiabetic men, which can impact their quality of life and relationships.

Be sure to talk with your health care provider about these issues.