Today, on its 21st annual American Diabetes Alert Day, the American Diabetes Association wants you to take a moment to gauge your risk for having or developing type 2 diabetes with its quick-and-simple risk test. Why? Because 1 in 5 Americans is at risk for getting type 2 diabetes—in which the body fails to respond to or produce enough of the vital hormone insulin—and because roughly 25 percent of Americans living with diabetes don't even know they have it, according to ADA statistics.
"This is one of those diseases that you really can't ignore," says Richard M. Bergenstal, ADA's president-elect for medicine and science and a Minnesota-based endocrinologist. "You really need to realize its risk and take action." Diabetes, especially when untreated, can harm the eyes, nerves, kidneys, and heart. Increasingly, researchers believe it may also harm the brain; studies have been examining its link with Alzheimer's disease and cognitive decline.
Despite the fact that many Americans have heard about the factors that put them in peril of developing type 2 diabetes—such as being overweight or physically inactive, or having high blood pressure or abnormal cholesterol—many admit that they aren't doing much to improve their odds of staying diabetes free, reveals a new ADA-commissioned Harris Interactive survey of more than 2,500 adults released today to coincide with Alert Day. About half of respondents said they eat poorly, maintain an "unhealthy weight," and shun doctor's visits. Strikingly, more than half of them rated "developing a chronic illness" as the worst thing that could happen to them, worse than losing their job, getting divorced, or accruing hefty financial debt. "I don't know why there's this gap between awareness and behavior," says Bergenstal.
What's more, research has indicated that people with prediabetes—that is, those not yet diabetic but who have higher-than-normal blood sugar levels—can sharply cut their risk of going on to develop type 2 diabetes if they shed some pounds, improve their diet, and do at least 150 minutes of weekly physical activity (brisk walking counts). These lifestyle changes work better than medication, according to a study that appeared in the New England Journal of Medicine in 2002. "There are things you can do to prevent getting diabetes," or at least to delay its development, says Bergenstal. If it does progress, however, early diagnosis and treatment to stave off its consequences are best, he says: "Trying to undo complications is much harder than preventing them."
Still, many type 2 diabetics live with the disease for years before they're diagnosed, says Bergenstal. Some even develop complications—which typically take about five to 10 years to arise—by the time they're diagnosed.
Pamela Brown, 59, a database designer from Joppa, Md., has no idea how long she had the disease before a free diabetes screening revealed that her blood sugar levels were alarmingly high. Prior to that diagnosis, she had attributed all her various symptoms—increased thirst, frequent urination, and sudden-onset blurred vision—to other plausible causes. She had recently stepped up her workout routine, for example, and thus was chugging much more water; a lifetime of vision problems led her to assume that it was just time for new prescription lenses.
Though diabetes does run in her family, Brown figured she wouldn't be affected. She saw no reason to discuss her risk with her doctor. "I could have had it for five years and not known, because who checked?" she says. "It's nothing to take for granted." (With twice-daily insulin injections and some diet tweaks, Brown now has things under control.)
If the ADA's test indicates that you're at high risk for having or developing type 2 diabetes, Bergenstal advises seeing your doctor to get screened. People who have an elevated risk for type 2 diabetes include African-Americans, American Indians, Latinos, those with a family history of the disease, people older than age 45, or women who have had gestational diabetes.