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Are You at Risk for Type 2 Diabetes?

23 million Americans have Diabetes - one in three does not know it! Take this test to see if you are at risk for having diabetes. Diabetes is more common in African Americans, Hispanic and Latino Americans, American Indian and Alaska Natives, Asian Americans and Pacific Islanders. Please pay attention to this test.

Taking Steps to Lower the Risk of Getting Diabetes

 

What is Type 2 Diabetes?

Diabetes is a disease in which blood glucose levels are above normal. People with diabetes have problems converting food to energy. After a meal, food is broken down into a sugar called glucose, which is carried by the blood to cells throughout the body. Cells use the hormone insulin, made in the pancreas, to help them process blood glucose into energy.

People develop type 2 diabetes because the cells in the muscles, liver, and fat do not use insulin properly. Eventually, the pancreas cannot make enough insulin for the body's needs. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation.

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How can Type 2 Diabetes be prevented?

Although people with diabetes can prevent or delay complications by keeping blood glucose levels close to normal, preventing or delaying the development of type 2 diabetes in the first place is even better. The results of a major federally funded study, the Diabetes Prevention Program (DPP), show how to do so.

This study of 3,234 people at high risk for diabetes showed that moderate diet and exercise resulting in a 5- to 7-percent weight loss can delay and possibly prevent type 2 diabetes.

Study participants were overweight and had higher than normal levels of blood glucose, a condition called pre-diabetes (impaired glucose tolerance). Both pre-diabetes and obesity are strong risk factors for type 2 diabetes. Because of the high risk among some minority groups, about half of the DPP participants were African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino.

The DPP tested two approaches to preventing diabetes: a healthy eating and exercise program (lifestyle changes), and the diabetes drug metformin. People in the lifestyle modification group exercised about 30 minutes a day 5 days a week (usually by walking) and lowered their intake of fat and calories. Those who took the diabetes drug metformin received standard information on exercise and diet. A third group received only standard information on exercise and diet.

The results showed that people in the lifestyle modification group reduced their risk of getting type 2 diabetes by 58 percent. Average weight loss in the first year of the study was 15 pounds. Lifestyle modification was even more effective in those 60 and older. They reduced their risk by 71 percent. People receiving metformin reduced their risk by 31 percent.

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What are the signs and symptoms of type 2 diabetes?

Many people have no signs or symptoms. Symptoms can also be so mild that you might not even notice them. More than five million people in the United States have type 2 diabetes and do not know it.

Here is what to look for:

Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick. Many people do not find out they have the disease until they have diabetes complications, such as blurry vision or heart trouble. It is important to find out early if you have diabetes because treatment can prevent damage to the body from diabetes.

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Types of Diabetes

The three main kinds of diabetes are type 1, type 2, and gestational diabetes.

Type 1 Diabetes

Type 1 diabetes, formerly called juvenile diabetes or insulin-dependent diabetes, is usually first diagnosed in children, teenagers, or young adults. In this form of diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed them. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, exercising regularly, taking aspirin daily (for some), and controlling blood pressure and cholesterol.

Type 2 Diabetes

Type 2 diabetes, formerly called adult-onset or noninsulin-dependent diabetes, is the most common form of diabetes. People can develop type 2 diabetes at any age, even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. Being overweight and inactive increases the chances of developing type 2 diabetes. Treatment includes taking diabetes medicines, making wise food choices, exercising regularly, taking aspirin daily, and controlling blood pressure and cholesterol.

Gestational Diabetes

Some women develop gestational diabetes during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin.

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Should I be tested for diabetes?

Anyone 45 years old or older should consider getting tested for diabetes. If you are 45 or older and overweight (see BMI chart), it is strongly recommended that you get tested. If you are younger than 45, overweight, and have one or more of the risk factors, you should consider testing. Ask your doctor for a fasting blood glucose test or an oral glucose tolerance test. Your doctor will tell you if you have normal blood glucose, pre-diabetes, or diabetes.

What does it mean to have pre-diabetes?

It means you are at risk for getting type 2 diabetes and heart disease. The good news is if you have pre-diabetes you can reduce the risk of getting diabetes and even return to normal blood glucose levels. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. If your blood glucose is higher than normal but lower than the diabetes range (what we now call pre-diabetes), have your blood glucose checked in 1 to 2 years.

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Besides age and overweight, what other factors increase my risk for type 2 diabetes?

To find out your risk for type 2 diabetes, check each item that applies to you.

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I have a parent, brother, or sister with diabetes.

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My family background is African American, American Indian, Asian American, Pacific Islander, or Hispanic American/Latino.

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I have had gestational diabetes, or I gave birth to at least one baby weighing more than 9 pounds.

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My blood pressure is 140/90 or higher, or I have been told that I have high blood pressure.

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My cholesterol levels are not normal. My HDL cholesterol ("good" cholesterol) is 35 or lower, or my triglyceride level is 250 or higher.

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I am fairly inactive. I exercise fewer than three times a week.

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What can I do about my risk?

You can do a lot to lower your chances of getting diabetes. Exercising regularly, reducing fat and calorie intake, and losing weight can all help you reduce your risk of developing type 2 diabetes. Lowering blood pressure and cholesterol levels also help you stay healthy.

If you are overweight

Then take these steps:

If you checked

checkbox    I am fairly inactive.

Then take this step:

If you checked

checkbox    My blood pressure is 140/90 or higher.

Then take these steps:

If you checked

checkbox    My cholesterol levels are not normal.

Then take these steps:

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Doing My Part: Getting Started

Making big changes in your life is hard, especially if you are faced with more than one change. You can make it easier by taking these steps:

Your doctor, a dietitian, or a counselor can help you make a plan. Here are some of the areas you may wish to change to reduce your risk of diabetes.

Reach and Maintain a Reasonable Body Weight

Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. The DPP showed that losing even a few pounds can help reduce your risk of developing type 2 diabetes because it helps your body use insulin more effectively. In the DPP, people who lost between 5 and 7 percent of their body weight significantly reduced their risk of type 2 diabetes. For example, if you weigh 200 pounds, losing only 10 pounds could make a difference.

Body mass index (BMI) is a measure of body weight relative to height. You can use BMI to see whether you are underweight, normal weight, overweight, or obese. Use the body mass index table to find your BMI.

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Body Mass Index Table

 

 

Normal

Overweight

Obese

BMI

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

Height
(inches)

Body Weight (pounds)

58

91

96

100

105

110

115

119

124

129

134

138

143

148

153

158

162

167

172

59

94

99

104

109

114

119

124

128

133

138

143

148

153

158

163

168

173

178

60

97

102

107

112

118

123

128

133

138

143

148

153

158

163

168

174

179

184

61

100

106

111

116

122

127

132

137

143

148

153

158

164

169

174

180

185

190

62

104

109

115

120

126

131

136

142

147

153

158

164

169

175

180

186

191

196

63

107

113

118

124

130

135

141

146

152

158

163

169

175

180

186

191

197

203

64

110

116

122

128

134

140

145

151

157

163

169

174

180

186

192

197

204

209

65

114

120

126

132

138

144

150

156

162

168

174

180

186

192

198

204

210

216

66

118

124

130

136

142

148

155

161

167

173

179

186

192

198

204

210

216

223

67

121

127

134

140

146

153

159

166

172

178

185

191

198

204

211

217

223

230

68

125

131

138

144

151

158

164

171

177

184

190

197

203

210

216

223

230

236

69

128

135

142

149

155

162

169

176

182

189

196

203

209

216

223

230

236

243

70

132

139

146

153

160

167

174

181

188

195

202

209

216

222

229

236

243

250

71

136

143

150

157

165

172

179

186

193

200

208

215

222

229

236

243

250

257

72

140

147

154

162

169

177

184

191

199

206

213

221

228

235

242

250

258

265

73

144

151

159

166

174

182

189

197

204

212

219

227

235

242

250

257

265

272

74

148

155

163

171

179

186

194

202

210

218

225

233

241

249

256

264

272

280

75

152

160

168

176

184

192

200

208

216

224

232

240

248

256

264

272

279

287

76

156

164

172

180

189

197

205

213

221

230

238

246

254

263

271

279

287

295

 

 

Obese

Extreme Obesity

BMI

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53

54

Height
(inches)

Body Weight (pounds)

58

177

181

186

191

196

201

205

210

215

220

224

229

234

239

244

248

253

258

59

183

188

193

198

203

208

212

217

222

227

232

237

242

247

252

257

262

267

60

189

194

199

204

209

215

220

225

230

235

240

245

250

255

261

266

271

276

61

195

201

206

211

217

222

227

232

238

243

248

254

259

264

269

275

280

285

62

202

207

213

218

224

229

235

240

246

251

256

262

267

273

278

284

289

295

63

208

214

220

225

231

237

242

248

254

259

265

270

278

282

287

293

299

304

64

215

221

227

232

238

244

250

256

262

267

273

279

285

291

296

302

308

314

65

222

228

234

240

246

252

258

264

270

276

282

288

294

300

306

312

318

324

66

229

235

241

247

253

260

266

272

278

284

291

297

303

309

315

322

328

334

67

236

242

249

255

261

268

274

280

287

293

299

306

312

319

325

331

338

344

68

243

249

256

262

269

276

282

289

295

302

308

315

322

328

335

341

348

354

69

250

257

263

270

277

284

291

297

304

311

318

324

331

338

345

351

358

365

70

257

264

271

278

285

292

299

306

313

320

327

334

341

348

355

362

369

376

71

265

272

279

286

293

301

308

315

322

329

338

343

351

358

365

372

379

386

72

272

279

287

294

302

309

316

324

331

338

346

353

361

368

375

383

390

397

73

280

288

295

302

310

318

325

333

340

348

355

363

371

378

386

393

401

408

74

287

295

303

311

319

326

334

342

350

358

365

373

381

389

396

404

412

420

75

295

303

311

319

327

335

343

351

359

367

375

383

391

399

407

415

423

431

76

304

312

320

328

336

344

353

361

369

377

385

394

402

410

418

426

435

443

Source: Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.

If you are overweight or obese, choose sensible ways to get in shape:

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Make Wise Food Choices Most of the Time

What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood pressure, and cholesterol.

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Be Physically Active Every Day

Regular exercise tackles several risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin. People in the DPP who were physically active for 30 minutes a day 5 days a week reduced their risk of type 2 diabetes. Many chose brisk walking for exercise.

If you are not very active, you should start slowly, talking with your doctor first about what kinds of exercise would be safe for you. Make a plan to increase your activity level toward the goal of being active for at least 30 minutes a day most days of the week.

Choose activities you enjoy. Here are some ways to work extra activity into your daily routine:

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Take Your Prescribed Medications

Some people need medication to help control their blood pressure or cholesterol levels. If you do, take your medicines as directed. Ask your doctor whether there are any medicines you can take to prevent type 2 diabetes.

Hope Through Research

People can prevent type 2 diabetes through weight loss, regular exercise, and lowering their intake of fat and calories. Researchers are intensively studying the genetic and environmental factors that underlie the susceptibility to obesity, pre-diabetes, and diabetes. As they learn more about the molecular events that lead to diabetes, they will develop ways to prevent and cure the different stages of this disease. People with diabetes and those at risk for it now have easier access to clinical trials that test promising new approaches to treatment and prevention.

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California Diabetes Foundation
2275 Huntington Drive, #207
San Marino, CA 91108
USA

Email: info@diabetesfoundation.org

 Disclaimer

*NDEP is a Joint Program of the National Institutes of Health and the Centers for Disease Control and Prevention   

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