Understanding Diabetes: Risk Factors, Types and Diagnosis
Dr. James Grant
| 4 min read
James D. Grant, M.D. is senior vice president and chief medical officer at Blue Cross Blue Shield of Michigan. Dr. Grant is a native Michiganian and graduate of Wayne State University School of Medicine. He completed his post graduate training at Northwestern University Medical Center in Chicago. He is a diplomate of the American Board of Anesthesiology, completed his recertification in 2008 and is an associate examiner for the Board.
Diabetes is one of the most prevalent and expensive chronic conditions in the United States. Roughly one in every 10 people are diagnosed with some form of diabetes, affecting people of all ages, genders and ethnicities. In the U.S. alone, diabetes costs more than $325 billion every year in medical and drug expenses and lost productivity. That’s because diabetes is a difficult-to-control chronic condition that can result in complications including cardiac disease; nerve, kidney and eye damage; and foot problems. However, there are ways to monitor and manage diabetes. It starts with understanding risk factors.
What is Diabetes?
When people digest food, carbohydrates and starches break down into blood sugar, also known as blood glucose. This triggers the body to produce insulin, a hormone naturally made by the pancreas to regulate glucose levels in the blood. When a person has diabetes, their body either doesn’t produce enough insulin or doesn’t produce any at all, leading to unregulated blood sugar. As a result, an individual managing this condition must ensure their body has enough insulin to compensate.
What are the Types?
- Type 1 Diabetes: Type 1 diabetes was previously known as juvenile diabetes because it usually develops in children and young adults. But Type 1 actually can occur at any age. With this form, the body cannot produce insulin at all. Only five percent of the population is affected by Type 1 diabetes.
- Type 2 Diabetes: This is the most common form of diabetes. With Type 2 diabetes, the body cannot produce enough insulin or the body’s insulin is unable to store excess blood sugar properly. Although there is no cure, Type 2 can be managed with exercise, diet and medications (if prescribed). Type 2 diabetes can often be prevented with healthy lifestyle changes.
- Prediabetes: In Michigan alone, it is estimated that more than 2.6 million adults have prediabetes, a precursor for Type 2 diabetes. A diagnosis for this condition is given when blood sugar levels are higher than normal, but not yet high enough to be diagnosed Type 2.
- Gestational Diabetes: This form of diabetes occurs in pregnant women when their bodies are not producing enough insulin, or they are unable to store excess blood sugar. It’s typically diagnosed around week 24 and is subject to all women regardless of their diabetic history. Women who have gestational diabetes during their first pregnancy are 66% more likely to have it in the future. However, it’s important to note that gestational diabetes can resolve itself post-birth.
Uncontrollable Risk Factors vs. Controllable Factors
When it comes to preventing diabetes, there are certain risk factors that cannot be controlled. For example, some individuals are genetically predisposed to diabetes. Other risk factors include race, ethnicity, age and medical history. Conversely, there are lifestyle choices that can help to lower the risk of diabetes. Being overweight or obese makes someone more likely to develop Type 2 diabetes. Therefore, nutritious, well-balanced and portion-controlled meals are important. Fruits, vegetables, whole grains, lean proteins and heart-healthy fats should be part of an individual’s daily meal plan. Exercise and physical activity are also keys to regulating weight and living a healthy lifestyle. High stress and sleep deprivation also can impact a variety of hormones in the body, which can in turn cause weight gain. For those who are overweight, a seven percent reduction in body weight can help prevent a diabetes diagnosis.
When the Diagnosis is Diabetes
Those who are diagnosed with either Type 1 or Type 2 diabetes must make lifestyle modifications to keep their blood sugar at optimal levels. For example, those with diabetes need to monitor their blood sugar several times each day, either through a finger stick to test their blood, or through a continuous glucose monitor attached to their skin. Those with Type 1 and some with Type 2 also take insulin every day. This is done either through an insulin pump that automatically administers insulin, or by manually injecting insulin several times a day. Because diabetes can damage blood vessels in the eye, those with diabetes should get retinal exams every year. This involves dilating the pupils so the eye doctor can see the blood vessels inside and check for damage. It’s important for people with prediabetes and diabetes to measure their hemoglobin A1c a few times each year. This is essentially an average of one’s blood sugar over the previous 60 to 90 days. The goal is to keep A1c levels under seven percent. An A1c test also can be used to diagnose prediabetes or diabetes. Those at risk for developing diabetes should talk with their doctor about when to get an A1c test. James D. Grant, M.D., is chief medical officer at Blue Cross Blue Shield of Michigan. More from MIBluesPerspectives:
- What You Can Do to Help Prevent Chronic Conditions
- The Easiest Ways to Stay On Top of Your Diabetes
- Help Your Employees Prevent and Better Manage Diabetes
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