Risk Factors, Diagnosis and Complications

Risk Factors

One out of every three people with diabetes is unaware they have this chronic condition. The American Diabetes Association estimates that amounts to 8 million Americans. Are you one of them?

Risk Factors for type 1 diabetes

With type 1 diabetes the pancreas abruptly stops producing insulin. Insulin is the hormone your body uses to use the energy—glucose—found in food. The primary risk factor for type 1 diabetes is family history.

• Genetics and family history. Having family members with diabetes is a major risk factor. The American Diabetes Association recommends that anyone with a first-degree relative with type 1 diabetes -- a mother, father, sister, or brother -- should get screened for diabetes. A simple blood test can diagnose type 1 diabetes.
• Diseases of the pancreas. Injury or diseases of the pancreas can inhibit its ability to produce insulin and lead to type 1 diabetes.
• Infection or illness. A range of relatively rare infections and illnesses can damage the pancreas and cause type 1 diabetes.

Risk Factors for type 2 diabetes

• Age greater than 45 years
• Family history of diabetes.
• Being overweight Inactive lifestyle (exercising less than 3 times a week)
• Certain racial and ethnic groups –African Americans, Hispanic/Latino Americans, Asian Americans and Pacific Islanders and American Indian and Alaska Natives.
• People with low HDL cholesterol or high triglycerides, high blood pressure.
• Woman who had gestational diabetes or who have had a baby weighing 9 pounds or more at birth.
• HDL cholesterol under 35 mg/dL.
• High blood levels of triglycerides, a type of fat molecule (250 mg/dL or more).
• High blood pressure (greater than or equal to 140/90 mmHg).
• Metabolic syndrome (A cluster of conditions — increased blood pressure, elevated insulin levels, excess body fat around the waist or abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.)
• Polycystic ovarian syndrome
• A condition called acanthosis nigricans, which causes dark, thickened skin around the neck or armpits

Everyone over 45 should have a blood sugar (glucose) test at least every 3 years. Regular testing of blood sugar levels should begin at a younger age, and be performed more often if you are at higher risk for diabetes.

Symptoms

Symptoms of diabetes can be subtle and many of the symptoms can seem harmless. You could have diabetes for months or even years and not have any symptoms at all. The American Diabetes Association estimates that more than 6 million people in the United States alone are unaware they have the disease.

Understanding possible risks and symptoms can lead to early diagnosis and treatment—and a lifetime of better health! If you or someone you love have one or more of these symptoms see your doctor and ask to get tested.

Blurry vision-High levels of sugar (glucose) in the blood pull fluid from your tissues, including the lenses of your eyes, affecting your ability to focus. Left untreated, diabetes can cause serious damage to the eyes which can lead to vision loss and blindness.

Excessive thirst and increased urination-These are classic diabetes symptoms. When you have diabetes, excessive sugar (glucose) builds up in your blood. Your kidneys work overtime to filter and absorb the excess sugar. The sugar is excreted into you urine along with fluids drawn from your tissues. This triggers more frequent urination, which can leave you dehydrated. As you drink more fluids to quench your thirst, you’ll urinate even more.

Being very hungry-With diabetes, your body cannot move the sugar into your cells to be used as energy. This leads to hunger.

Being more tired than usual-You may feel fatigued or even irritable. Many factors contribute to this including dehydrations from increased urination and your body’s inability to use sugar for energy.

Losing weight when you are not on a diet-Diabetes keeps the sugar (glucose) in the food you eat from reaching your cells. The excess sugar is eventually excreted in your urine.

Cuts/bruises that are slow to heal-High levels of blood sugar may impair your body's natural healing process and your ability to fight infections.

Dry skin and mouth

Frequent infections-High levels of blood sugar may impair your body's natural healing process and your ability to fight infections. For women vaginal and bladder infections are especially common.

Tingling/numbness in the hands/feet-Excess sugar in your blood can lead to nerve damage. You may notice tingling and loss of sensation in your hands and feet, as well as burning pain in your arms, hands, legs and feet.

Keep in mind that like many people with type 2 diabetes you may have NO symptoms.

Diagnosis

Your doctor can test your blood to see if you have diabetes. There are several tests that measure the amount of glucose in your blood including:

Fasting Plasma Glucose Test —this is the simplest and fastest way to measure blood glucose and diagnose diabetes. Your doctor will ask you to fast (having nothing to eat or drink except water) for 8-12 hours before the test. Blood is drawn and the level of glucose in the blood is measured.

• Results of 99/mg/dl or less is normal
• Results of 100-125 mg/dl mean you may have pre-diabetes
• Results of 126mg/dl or higher means that you probably have diabetes. If your test comes back with a number of 126mg/dl or higher your doctor will repeat the test on a different day to be sure the reading is right. You are diagnosed with diabetes if your blood glucose level is 126 mg/dl or greater on two separate tests.

Oral Glucose Tolerance Test —this test measures how your body responds to a set amount of glucose (sugar) in beverage form. The level of glucose in your blood is measured after fasting for 8-12 hours and after drinking a sweet beverage containing 75 grams of glucose. Your blood is tested 1, 2 and possibly three hours later. A urine test may also be done with each blood test.

• Results of 140mg/dl or less after 2 hours is normal
• Results of 140-199 md/dl after two hours mean you may have pre-diabetes.
• You are diagnosed with diabetes if your blood glucose level is 200 mg/dl or greater.

The Fasting Plasma Glucose test is the preferred test for diagnosing diabetes because of its convenience and low cost. However, it will miss some diabetes or pre-diabetes that can be found with the Oral Glucose Tolerance Test. The Fasting Plasma Glucose test is most reliable when done in the morning.

Complications

Living well with diabetes requires both good medical care and effective self-management. The key is knowing and controlling your blood sugar levels. There is a lot that health care providers can do but you must take an active role in managing in managing your diabetes.

Poorly controlled diabetes can lead to many serious health conditions affecting nearly every organ in your body. Complications include heart disease, stroke, high blood pressure, blindness, kidney disease, complicated pregnancy, sexual dysfunction, nerve diseases, and amputation. If you don’t take the time for diabetes now, diabetes will make you take the time later. Work with your doctor and other members of your health care team to decrease your risk for these complications.

Learn more about Possible Complications from the American Diabetes Association.