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HEALTH TAKE-AWAY

Julie Barbour: It’s easier than ever to control diabetes — but millions don’t know they have it

Woman getting blood tested

Of the more than 37 million people in the United States who have diabetes, 20 percent — one in five — don’t know it. Another 96 million U.S. adults have prediabetes, a precursor to full-blown diabetes, but an alarming 81 percent are unaware.

Major advances in technology have made it easier than ever for people with diabetes to continuously monitor their blood sugar levels, pump the right amount of insulin into their systems and self-regulate their conditions to avoid serious complications.

Wearable medical devices that can be guided by smartphone apps are revolutionizing the way diabetes is managed.

Unfortunately, millions of people who would benefit greatly from that technology aren’t even aware they have diabetes or are at high risk of developing it. Of the more than 37 million people in the United States who have diabetes, 20 percent — one in five — don’t know it. Another 96 million U.S. adults have prediabetes, a precursor to full-blown diabetes, but an alarming 81 percent are unaware.

It’s a troubling public health disconnect. November is National Diabetes Awareness Month, and certified diabetes educators like me, along with primary care physicians nationwide, are reaching out to communicate the magnitude of this problem.

We are urging people to actively determine their own risk for diabetes, based on family, lifestyle and health history. Everyone should get their blood tested regularly and, if diagnosed with any type of diabetes, should closely follow all recommendations for controlling it.

Diabetes is a chronic condition that affects how your body turns food into energy. The body converts most of the food we eat into sugar (glucose) and releases it into the bloodstream. As your blood sugar rises naturally, it signals your pancreas to release insulin, which lets blood sugar into your cells to produce energy. With diabetes, sugar builds up in the bloodstream because the pancreas doesn’t produce enough insulin. Over time, this can cause serious health problems like heart disease, vision loss and kidney disease.

There are two main types of diabetes. Type 1 is a genetic condition that often shows up early in life. It accounts for five to 10 percent of diabetes cases. The other 90 to 95 percent of diabetes is type 2, triggered by several risk factors, mainly related to diet, weight and lifestyle. In the last 20 years, the number of adults diagnosed with diabetes has more than doubled as Americans have aged and become more overweight.

Those with prediabetes have higher than normal blood sugar — not quite enough to be considered type 2. But without lifestyle changes, adults and children with prediabetes are at high risk to develop type 2.

Knowing you’re at risk is the first step to preventing diabetes. Getting screened is important to catching prediabetes in its early stages. The current recommendations call for screening for prediabetes and type 2 diabetes in adults ages 35 to 70 who are overweight or obese. Screening can start earlier for adults under 35 who are overweight and have other risk factors.

The first tool for managing a diabetes diagnosis is always lifestyle intervention, focusing on dietary intake, weight and exercise. Patients should consult with a certified diabetes educator at least twice a year.

In addition to taking medicines prescribed to treat diabetes — and new ones constantly are being developed — patients should take advantage of the evolving technologies for managing diabetes.

Continuous glucose monitoring (CGM) devices help you manage Type 1 or Type 2 diabetes with fewer or none of the old, manual fingerstick tests. A sensor just under your skin, usually on the abdomen or arm, measures your glucose levels 24 hours a day. A transmitter sends results to a wearable device or cellphone.

Automatic insulin pumps deliver insulin via a thin tube is placed under the skin. The pump works via a computerized mechanism that administers small doses of short-acting insulin continuously, followed by a variable dose of insulin when a larger meal is ingested.

Julie Barbour is a certified diabetes educator with Berkshire Health Systems.

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