The number of Americans threatened by type 2 diabetes is staggering. But
there's plenty of good news too: losing weight (even a little), exercising
more and drinking less soda can all help bring your blood sugar down to
healthy levels. So can weight-loss surgery.
When type 2 diabetes comes to mind, you may picture someone older, perhaps
overweight and not very active. While that snapshot of a diabetic is still
accurate, the scary truth is that diabetes and its precursor, prediabetes,
are now striking a much broader group of Americans. According to recent
surveys by the
U.S. Centers for Disease Control and Prevention (CDC), while type 2 diabetes was once largely diagnosed in the middle-aged and
older, doctors are increasingly seeing it in teenagers and even children.
“Blame the rise on recent increases in both obesity and the lack
of physical activity, which are often factors in type 2 diabetes and are
affecting all ages,” says
Cynthia Ro, MD, an endocrinologist affiliated with the
Torrance Memorial Physician Network.
In June 2014 the CDC reported that 29.1 million people—or 9.3% of
the U.S. population—have diabetes. Of that number, 21 million people
have been diagnosed with the condition, but more than 8 million don’t
even know they have it. That means that the undiagnosed aren’t getting
the treatment they need to manage diabetes and keep it from progressing
to very serious health complications, which can include blindness, amputations,
stroke and heart attack.
These risks are, of course, what make diabetes one of the biggest killers.
While diabetes ranks seventh among America’s leading causes of death,
it often kills through stroke (the fourth-leading killer) and heart disease (#1).
Then there are the staggering numbers of people who have prediabetes, in
which blood sugar numbers are elevated but not so high as to meet the
threshold for type 2 diabetes. Prediabetics have no symptoms, but the
condition can lead to full-blown diabetes and all its complications if
The National Institutes of Health estimates that 86 million Americans have
prediabetes, up from 79 million in 2010. That increase is also linked,
in large part, to expanding waistlines and too much time on the couch,
says Dr. Ro.
WHAT IS DIABETES, EXACTLY?
When we eat carbohydrates, including sugars, these are broken down by the
body into glucose (also called blood sugar), which our cells need for
energy. Cells rely on the pancreas, a gland below the stomach, to make
insulin—a hormone used to deliver glucose to the cells.
When the pancreas functions normally it produces the right amount of insulin
to move glucose from the bloodstream into the cells. If you have diabetes,
your pancreas either produces little or no insulin, or the cells don’t
respond as they should to the insulin that’s produced.
The result? Glucose builds up in the blood, overflows into the urine and
is excreted, leaving the cells without a source of energy. When glucose
stays in the bloodstream it can damage the heart, muscle tissue, eyes
and other parts of the body.
Some of the factors that raise your risk for developing type 2 diabetes
are ones you can control, like getting more exercise and maintaining a
healthy weight. (Doing both of these will dramatically lower your odds
of getting the disease; more on that below.)
Others, though, are things you can’t change, like your age (being
older puts you at higher risk) and having a family history of diabetes.
African-Americans and Latinos are at greater risk of diabetes, too, likely
due to genetic factors.
Having a family history or a genetic predisposition to diabetes owing to
your race or ethnicity may not, on its own, be enough to tip the scale
into developing the disease. But combined with other factors such as excess
weight and a lack of physical activity, and possibly exposure to toxins
in the environment, it can be enough to boost your blood sugar to unhealthy levels.
Since diabetes is typically caused by a variety of factors, if you’re
diagnosed with type 2 your treatment will be tailored to you specifically,
says Dani Rodriguez-Brindicci, MS, RD, a clinical/outpatient dietitian
at the Torrance Memorial Specialty Center. “Interventions that are
right for you could include medication, exercise, weight control and in
some cases bariatric—or weight control—surgery to improve
or even reverse diabetes.” Your doctor, diabetes educator or diabetologist
may bring up any of these.