Diabetes Q&A

November is Diabetes Awareness Month, and St. John’s Mercy is taking this opportunity to provide information about the importance of this prevalent disease.

The following questions were answered by Veronica McGregor, M.D., Mercy Endocrinology and Diabetes Management

Q: What is the difference between type 1 and type 2 diabetes?

A: Diabetes is a disease in which the body does not produce or properly use insulin. Type 1 diabetes results from the body’s failure to produce insulin, the hormone needed to convert sugar, starches and other food into energy needed for daily life. Formerly called juvenile diabetes, type 1 diabetes usually is diagnosed in children and young adults. The most common form of diabetes is type 2. More than 95 percent of people with diabetes are diagnosed with it. In type 2 diabetes, either the body doesn’t produce enough insulin or the cells ignore the insulin. It can be diagnosed at any age.

Q: Who is at risk for type 2 diabetes?

A: Type 2 diabetes typically develops among people who are overweight and age 45 or older, though recently we are seeing an increase among younger people and children, as well. Other risk factors include high blood pressure, low HDL cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes or giving birth to a baby weighing more than 9 pounds. Certain ethnic and minority groups are at a higher risk for diabetes, including African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders.

Q: How prevalent is diabetes?

A. In the United States, nearly 21 million people have diabetes and another 54 million have pre-diabetes. According to the American Diabetes Association, if present trends continue, one in three Americans born in 2000 will develop diabetes in their lifetime. In 2005 alone, 1.5 million new cases of diabetes were diagnosed among people age 20 and older. Diabetes is a chronic disease that has no cure. It is the fifth deadliest disease in the U.S. In the past 20 years, the death rate due to diabetes increased by 45 percent.

Q: Could I have diabetes and not know it?

A. Yes. There are nearly 21 million children and adults in the U.S. – about seven percent of the population – with diabetes. While about 14.6 million have been diagnosed with diabetes, nearly one-third are unaware they have the disease. The symptoms of diabetes develop so gradually that people often don’t recognize them and some people have no symptoms at all. If you are overweight, have a family history of diabetes, are age 45 or older and have a sedentary lifestyle, then have your physician check for pre-diabetes.

Q: If I have pre-diabetes will I develop type 2 diabetes?

A. Before people develop type 2 diabetes, they usually have pre-diabetes, which means their blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes. However, people with pre-diabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity. Studies have shown that some people with pre-diabetes are able to return their blood glucose levels to the normal range.

Q: If I had gestational diabetes during pregnancy, will I develop type 2 diabetes?

A. Gestational diabetes occurs when a pregnant woman who has never had diabetes develops high blood sugar levels during pregnancy. Gestational diabetes starts when the body is not able to make and use all the insulin it needs for pregnancy. While gestational diabetes goes away after pregnancy, many women who have it go on to develop type 2 diabetes years later. There are some lifestyle changes that may help prevent diabetes after gestational diabetes:

• Lose weight. Dropping even a few pounds can help, particularly if you are more than 20 percent over your ideal body weight.
• Make healthy food choices. Eat a variety of foods including fresh fruits and vegetables and limit fat intake to no more than 30 percent of your daily calorie intake.
• Exercise. Regular exercise allows your body to use glucose without extra insulin. This is extremely important because exercise improves your body’s response to insulin.

Q: Does diabetes cause heart disease?

A: Many of the health issues that can cause diabetes, such as high blood pressure and high cholesterol, also increase the risk of heart disease and stroke. More than 65 percent of people with diabetes die from heart disease or stroke. People with diabetes often have heart attacks earlier in life and the attacks are more often fatal. People with diabetes can reduce their risk of heart attacks and stroke by managing their disease, high blood pressure and cholesterol.

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