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UC Davis Medical Center

UC Davis Medical Center

Know your diabetes risks

Millions have type 2 or are at serious risk – but don’t know it

grandfather and grandson
Catching high blood sugar early can help to avoid or manage it before it leads to cardiovascular disease, eye problems, nerve problems and other conditions that threaten mobility and quality of life.

By C. Jasmine Karalakulasingam, M.D.

Chances are you’ve already had your blood pressure taken at a routine medical appointment, and you’ve probably heard that it’s important to know your cholesterol level. High numbers on either measure are classic and well-known harbingers of higher risk for heart attack and stroke.

Dr. Karalakulasingam is an internist and pediatrician at UC Davis Medical Group’s Campus Commons primary care clinic.

For a large number of Americans, however, knowing the amount of sugar or glucose in the bloodstream has grown just as crucial in predicting and preventing deadly, debilitating cardiovascular conditions. 

That’s because damagingly high levels of blood sugar are now an American epidemic. According to the American Diabetes Association, 18 million Americans have been diagnosed with type 2 diabetes. It’s estimated another 7 million have the disease but are unaware.

Nearly 80 million Americans are estimated to have “prediabetes” – high blood sugar levels that do not yet indicate full diabetes, but suggest that it’s coming. According to the U.S. Centers for Disease Control and Prevention, 15 to 30 percent of people with prediabetes will develop type 2 diabetes within five years without lifestyle changes. Prediabetics are already at a 50 percent increased risk for heart disease or stroke.

Diabetes often lacks overt symptoms, and those signs that do occur can also be common to other conditions or simply to aging. That makes it especially important to “know your numbers.”

How to learn your numbers

Diabetes facts

  • Diabetes is the leading cause of blindness among most adults
  • Diabetes is the leading cause of kidney failure
  • More than 60 percent of nontraumatic lower-limb amputations occur in people with diabetes
  • Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes
  • The risk for stroke is 2 to 4 times higher among people with diabetes

The American Diabetes Association offers these testing guidelines for prediabetes and diabetes (though other guidelines exist as well):

  • If you are overweight and age 45 or older, you should be checked for prediabetes during your next routine medical office visit.
  • If your weight is normal and you're over age 45, you should ask your doctor during a routine office visit if testing is appropriate.

 If you’re under 45, but overweight, your doctor may recommend testing if you have any other risk factors for diabetes or prediabetes. These can include:

  • High blood pressure
  • Low HDL cholesterol and high triglycerides
  • A family history of diabetes
  • A history of gestational diabetes or giving birth to a baby weighing more than 9 pounds; and
  • Belonging to an ethnic or minority group at high risk for diabetes. Type 2 diabetes is more common in African Americans, Latinos, Native Americans, and Asian Americans, Native Hawaiians and other Pacific Islanders.

When to retest

If your blood glucose levels are in the normal range, the diabetes association recommends getting checked every three years, or more often if your doctor recommends it.

If you have prediabetes, you should be checked for type 2 diabetes every one or two years after you are told you have prediabetes.

Types of tests

The American Diabetes Association offers an online test that can help you determine if you are at increased risk for diabetes or prediabetes.

Your physician may choose one of three blood tests to gauge your glucose level and your diabetes status or risk. Some require fasting, but none are more painful than the pinprick needed for a blood sample.

  • The A1C hemoglobin blood test measures your long-term blood sugar, usually over the course of three months.
  • The fasting plasma glucose test is a blood test that measures glucose levels over a shorter period of time.
  • The oral glucose tolerance test is often used to test pregnant women for gestational diabetes. It can also be used to test people who have normal fasting glucose but are still suspected of being diabetic.

Symptoms to know

Diabetes often lacks overt symptoms, and those signs that do occur can be common to other conditions as well or simply to aging. That makes it especially important to “know your numbers.”

According to the CDC, symptoms of diabetes can include:

  • 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.

If you notice any of these symptoms – or if you fit the testing criteria in this article, have a family history of diabetes, or are simply curious about this common health condition – it’s worth asking your physician about your glucose.

Resources

Diabetes prevention tips: www.cdc.gov/diabetes/consumer/index.htm