Getting Checked for Diabetes

     Because the symptoms of diabetes often go unnoticed or are mistaken for other things, such as getting older or not getting enough sleep, experts recommend that all adults get checked for diabetes at age 45 and then every 3 years thereafter -- and that people who are at increased risk for developing diabetes start getting checked for diabetes at an even earlier age and get checked more frequently, too.

     People who are considered at increased risk for developing diabetes have some common characteristics, including any of the following:

• being over age 40
• having a family history of diabetes or diabetic relatives
• being overweight  (more than 20% over ideal weight)
• having a minority ethnic heritage (African-American, Mexican-American, Hispanic, Native American Indian, or Asian) 
• having high blood pressure (over 140/90)
• having high LDL ("bad") or total cholesterol levels  
• having low HDL ("good") cholesterol levels
• having high triglyceride levels
• having a history of impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) or "pre-diabetes"
• having a history of gestational diabetes
• having delivered a chlld weighing 9 lbs or more at birth
• having polycystic ovary syndrome (PCOS)

How Diabetes Is Diagnosed

     Although some health fairs offer screening for diabetes by checking a sample of blood from a fingertip, this is not an adequate way to check for diabetes.  Similarly, there is no way that we can check for diabetes by ourselves at home because the available tools are just not accurate enough.

     The only way to be properly checked for diabetes is to have a sample of blood drawn from the arm and sent to a laboratory for testing.   The test can be done either after fasting (in this case, this means no caloric intake for the previous 8 hours) or at any time (no matter what or when someone last ate), but in order to correctly interpret the results of the test, a doctor needs to know whether the test was done while the person was fasting or not.

     The blood test is not particularly expensive and is usually covered by private insurance and Medicare, when someone is suspected of having diabetes.  Doctors usually have the test result back within a day or two and may be able to obtain the result within hours, if necessary.

 Abnormal Blood Sugar Levels in Tests

    In non-pregnant adults, normal fasting blood sugar levels remain below 100 mg/dl (5.6 mmol/l) and do not exceed 200 mg/dl (11.1 mmol/l) at any time -- no matter how much a person recently ate. 

     When test results come back within the abnormal ranges shown above, doctors can often diagnose either diabetes or a condition called "pre-diabetes," which indicates a high risk for developing diabetes that needs to be addressed.  

     If the test shows that the blood sugar level is elevated into the diabetic range and the person has classic symptoms of diabetes (such as increased thirst, increased urination, or unexpected weight loss), a doctor may choose to diagnose diabetes without more testing.  If a person does not seem to have classic symptoms of diabetes, experts recommend that  abnormal test results be confirmed by testing again on a different day.  

     Testing for gestational diabetes among pregnant women is usually done with an Oral Glucose Tolerance Test (OGTT), with abnormal results considered to be a fasting glucose level of 95 mg/dl (5.3 mmol/l) or higher, a 1 hr glucose level of 180 mg/dl (10.0 mmol) or higher, a 2 hr reading of 155 mg/dl (8.6 mmol/l) or higher, and a 3 hr reading of 140 mg/dl (7.8 mmol/l).  The diagnosis of gestational diabetes depends upon two or more abnormal results and consideration of other factors.  

      If you're wondering about your risk for developing diabetes or about getting tested for diabetes, please be sure to post a note -- there are many folks here who'd be glad to share some good information and a friendly, helping hand! 

      Paula

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Statistics About Diabetes in the U.S.

     The U.S. Centers for Disease Control and Prevention estimates that about 20.8 million people in the U.S. have diabetes.  14.6 million people have been diagnosed with diabetes and 6.2 million people are still undiagnosed and do not know that they have diabetes.  

Who has diabetes?

• 20.8 million people in the U.S. have diabetes
   ~  this is 7% of the total population of the U.S.
   ~ 14.6 million people have been diagnosed
   ~  6.2 million people have not yet been diagnosed

Diabetes by age group

• among people age 20 and younger:
   ~ 176,500 have diabetes
   ~ this is 0.22% of people aged 20 and younger
   ~ this is about 1 in 400-600 people aged 20 and younger
• among people age 20 and older:
   ~ 20.6 million have diabetes
   ~ this is 9.6% of all people aged 20 and older
• among people age 60 and older:
   ~  10.3 million have diabetes
   ~  this is 20.9 % of all people aged 60 or older

Diabetes by sex:

• men: 10.9 million men (10.5% of all men)
• women:  9.7 million women (8.8% of all women)

Diabetes by ethnic heritage:

• non-Hispanic whites:  8.7% (13.1 million people) have diabetes
• non-Hispanic blacks: 13.3% (3.2 million people) have diabetes
• Hispanic/Latino Americans: 9.5% (2.5 million people) have diabetes
• American Indian & Alaska Natives 15.1% (118,000 people) have diabetes
• Asian-Americans, Native Hawaiians, & Pacific Islanders:  in 2002, Native Hawaiian, Japanese, and Filipino residents over age 20 in Hawaii were more than twice as likely to have diagnosed diabetes as white residents of similar age.  In California, Asians are 1.5 times as likely to have diagnosed diabetes as non-Hispanic whites.

The Toll of Diabetes

      Based on death certificate records, diabetes is the 6th leading cause of death listed on death certificates in the U.S., causing more than 224,000 deaths in 2002.  Experts believe these numbers understate deaths from diabetes because studies show diabetes listed anywhere on death certificates on only 35-40% of death certificates of diabetics and only 10-15% of death certificates of diabetics list diabetes as an underlying cause of death.  

Financial costs:

• Diabetes care represented 11% of total national health care expenditures in 2002.
• Estimated cost of diabetes is $132 billion annually:
   ~ $92 billion in direct medical expenditures
   ~ $40 billion due to lost productivity
• Average yearly health care cost for a diabetic person in 2002 was $13,243, compared to $2,560 for a person without diabetes

Complications of Diabetes 

Cardiovascular disease:

• heart disease and strokes are the cause of death for 65% of people with diabetes 
• adults with diabetes have 2 to 4 times greater risk for heart disease and stroke than non-diabetics
• 73% of adult diabetics have blood pressure equal to 130/80 or higher or use blood pressure medication

Eye disease and blindness

• diabetes is the leading cause of new cases of blindness among adults age 20-74
• 12,000 to 24,000 diabetics become blind each year

Kidney disease:

• diabetes is the leading cause of kidney failure, causing 44% of cases each year
• 44,000 diabetics began treatment for kidney failure in 2002
• 153,730 diabetics were receiving dialysis or awaiting kidney transplants in 2002

Amputations:

• diabetes is the leading cause of non-accidental amputations, causing 60% of amputation surgeries each year
• 82,000 diabetics undergo leg, foot or toe amputation each year

Flu and pneumonia:

• people with diabetes are 3 times more likely to die of complications from flu and pneumonia than people without diabetes
• 10,000 to 30,000 diabetics die of complications from flu and pneumonia each year

Nerve damage:

• 60-70% of diabetics have mild to severe nervous system damage, which can lead to problems with numbness and pain in hands and feet, heart problems, digestive problems, intestinal problems, sexual dysfunction and other disabilities.
• almost 30% of diabetic adults aged 40 or older have impaired sensation or loss of feeling in their feet

Gum disease:

• periodontal (gum) disease is twice as common among young adults with diabetes than those without diabetes
• Almost 33% of diabetics have severe periodontal disease (pockets of 5 mm or more)

Pregnancy complications:

• 18,000 women with pre-existing diabetes and 135,000 women who develop gestational diabetes give birth each year
• inadequate diabetes management in the first trimester can cause major birth defects in 5-10% of pregnancies and miscarriage in 15-20% of pregnancies
• inadequate diabetes management in the second or third trimester can cause the fetus to become excessively large, posing a risk to the mother and child

(Information based upon the most recent reports from the U.S. government's  Centers for Disease Control and Prevention)

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~Arlene