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Test your diabetes IQ

By Ned M. Weiss, M.D.


Did you know that more than 23 million Americans are currently living with diabetes and more than a quarter of them don’t even know it?

It’s true. Doctors estimate that nearly 5.7 million people have the disease, but have not yet been diagnosed.

New cases, however, are being discovered at a very fast rate. According to the Centers for Disease Control and Prevention, 1.6 million new cases — more than 4,300 a day — were diagnosed in 2007.

That’s why diabetes education is more important than ever. Whether or not you’ve been diagnosed with the disease, here are some basic questions and answers to test your diabetes IQ.

Q. First things first, what exactly is diabetes?
A. The American Diabetes Association defines diabetes as a disease in which your body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.

Q. What causes diabetes?

A. Diabetes has no known cause. Genetics and immune system disorders, as well as being overweight or obese, have been identified as factors contributing to the diabetes.

Q. Am I at risk for diabetes?

A. You may be at risk for diabetes if you are overweight or obese and/or have a family history of the disease. In addition, diabetes is more prevalent among the elderly and in African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders. Other risk factors include high blood pressure, high cholesterol, prior incidence of gestational diabetes or delivering a baby weighing greater than nine pounds.

Q. What symptoms should I be looking for?

A. Unfortunately, diabetes has no symptoms until its advanced stages. Symptoms then may include extreme thirst, frequent urination, unusual weight loss, extreme hunger, fatigue, irritability and blurred vision. If you experience any of these symptoms, contact your health care provider immediately.

Q. If diabetes has no symptoms, how can I tell if I have the disease before it’s too late?

A. The best way to catch diabetes in its early stages is to go for an annual physical exam that includes a blood test to measure your glucose levels. Normal fasting blood sugar levels are 100 or below. A level between 101 and 125 indicates pre-diabetes, and 126 or above signals diabetes.

Q. What does it mean if I’ve been diagnosed with pre-diabetes?

A. More than 57 million Americans have pre-diabetes, blood sugar levels that are higher than normal but not high enough to be diagnosed as diabetes. The good news is that with lifestyle changes such as losing weight and exercising, you may be able to delay or even prevent the development of diabetes.

Q. What are the complications of diabetes?

A. Diabetes puts greater stress on your blood vessels and arteries, increasing your risk for heart disease, stroke and other circulatory problems. Diabetes also makes your kidneys work harder and can lead to kidney failure if not controlled properly. Eye problems such as bleeding of the retina and blindness can occur if the levels of blood sugar are not well controlled. Glaucoma and cataracts are more common in people with diabetes. And people with diabetes often suffer from diabetic neuropathy or nerve damage that can cause tingling in the hands and feet, as well as digestive problems and problems with sexual function.

Q. I’ve been diagnosed with diabetes; what are my treatment options?

A. Some people are able to manage their diabetes through diet and exercise. If you are overweight or obese, the best way to treat your diabetes is by shedding pounds. A modest amount of weight loss has been proven to decrease blood sugar levels and in some people has brought the levels down into the normal range. If your blood sugar can’t be controlled well enough through diet and exercise, medication may be necessary.
Q. What is the safest way to lose weight?

A. If you have diabetes or pre-diabetes, any weight loss plan needs to be supervised by your physician, who will likely recommend you increase your physical activity and modify your diet. Many patients succeed in losing weight by following a meal replacement plan prescribed by their doctor or nutritionist. When selecting foods, it’s important to focus on those that are low in calories and high in volume. Additionally, exercising at least 30 minutes a day can often lower blood sugar levels by 40 or 50 points.

Q. Do I need to cut out my favorite foods like pasta and ice cream?

A. Years ago, the answer to this question would have been “absolutely,” but diabetes care and research has evolved to the point where you can still enjoy your favorite foods in moderation and manage your diabetes at the same time.

Q. What are some effective tools to help me manage and control my diabetes?

A. At-home finger stick tests provide you with the ability to know your blood sugar levels daily and make modifications to your diet if necessary. Many people test their levels prior to eating some or all of their meals. Moreover, some of the more sophisticated electronic blood glucose meters store the results of tests, enabling you to determine your average blood sugar level over a three-month period, helping to provide a more accurate assessment of your diabetes.

Patients also can benefit by attending diabetes management programs such as the one at University Medical Center at Princeton and participating in diabetes support groups.

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