The cells in your body need a steady source of energy to function. They get it from a simple sugar called glucose that is released when the food you eat is broken down. But glucose can’t get into your cells on its own. It needs the help of insulin, a hormone produced by the beta cells of your pancreas.

Diabetes is a chronic metabolic disease that develops when your pancreas doesn’t produce insulin or your body can’t use insulin efficiently, a condition called insulin resistance. Without insulin, glucose builds up in your bloodstream and your cells are starved of the energy they need to survive. This can lead to complications with your eyes, heart, kidneys and nerves. In severe cases, it can lead to coma and death.

The National Diabetes Statistics Report 2020, released by the CDC’s Division of Diabetes Translation, revealed that 34.2 million Americans – just over 1 in 10 – have diabetes. Another 88 million – approximately 1 in 3 American adults – have prediabetes, a condition in which your blood glucose level is high but not high enough for a diagnosis of diabetes. More than 84 percent of people with prediabetes don’t know they have it.

There are three main types of diabetes: type 1, type 2 and gestational.

With type 1 diabetes, your pancreas doesn’t produce insulin because your immune system mistakenly attacks and destroys its beta cells. People with this type must take supplemental insulin every day. Type 1 is typically diagnosed in children, adolescents and young adults, but can occur at any age. About 5 to 10 percent of people with diabetes have type 1.

Gestational diabetes develops during pregnancy. It affects up to 10 percent of pregnant women in the US each year. With gestational diabetes, the placenta — which provides oxygen and nutrients for the growing baby – produces hormones that block the action of the mother’s insulin. It can lead to complications for the mother and baby.

In many cases, gestational diabetes can be treated effectively with diet and exercise alone. But in other cases, the mother must take oral diabetes medications or insulin injections to stabilize her blood glucose levels. Gestational diabetes typically resolves after the mother gives birth, but she is at a higher risk for developing type 2 diabetes later in life.

Type 2 diabetes is the most common type, affecting 90 to 95 percent of people with diabetes. It is typically diagnosed in people 45 years old and older and is characterized by insulin resistance. This type is caused by a combination of genetic and environmental factors. You are at a higher risk for type 2 diabetes if you have a family history of diabetes, are overweight or obese, are physically inactive or have prediabetes.

Symptoms of type 2 diabetes include: increased hunger or thirst, frequent urination, weight loss, blurry vision, extreme fatigue and sores that are slow to heal. The diagnosis is generally made using a fasting plasma glucose (FPG) test, A1C test or random plasma glucose (RPG) test. These tests measure the level of glucose in your blood. A consistently high level indicates diabetes.

Treatment for type 2 diabetes begins with lifestyle changes. These include eating a healthy diet full of fruits and vegetables, whole grains and lean protein such as poultry and fish. You should also avoid saturated and trans fats, exercise regularly, maintain a healthy weight and stop smoking. If lifestyle changes aren’t enough to lower your glucose level, you may need to take medication or insulin.

By living a healthy lifestyle – eating properly, exercising regularly, not smoking and taking your medication as needed – you can manage your blood glucose and defeat diabetes!

Do you have diabetes? If so, you’re certainly not alone. The American Diabetes Association estimates that 30.3 million Americans have diabetes and another 8.1 million have it but haven’t been diagnosed. Another 84.1 million people in the US have prediabetes, and nine out of ten aren’t aware of it. Still, 1.2 million new cases of diabetes are diagnosed in this country every year.

Maintaining healthy glucose (sugar) levels in your blood is a constant concern if you’ve got diabetes. Consistently high blood glucose can damage many parts of the body, such as the heart, kidneys and blood vessels. That includes the tiny blood vessels in the eyes, which can affect the retina, macula, lens and optic nerve.

When high glucose levels negatively affect the blood vessels in the retina, which is an area of light-sensitive tissue located in the back if the eye, it leads to a condition called diabetic retinopathy. There are two main types of retinopathy, nonproliferative and proliferative.

Nonproliferative retinopathy has several stages. It progresses from mild to moderate to severe. It starts as small areas of balloon-like swelling in the tiny blood vessels. These areas may start leaking fluid into the retina. In the moderate stage, the blood vessels that feed the retina may start swelling and distorting, losing their ability to transport blood.

In severe nonproliferative retinopathy, many blood vessels become blocked, which deprives the retina of its nourishing blood supply. Growth factors are also released during this stage. These factors initiate the development of new blood vessels.

In some people, the severe stage progresses into proliferative retinopathy. With that, new blood vessels start growing, but these vessels are very fragile and weak. They can leak blood, which can block vision. Scar tissue can also be created, which can cause the retina to pull away from the back of the eye, a condition called retinal detachment.

Another consequence of retinopathy is macular edema, which is swelling, or the build-up of fluid, in the macula. The macula is the area of the retina responsible for central vision. It’s the macula the enables you to recognize faces, read and drive. Macular edema is the most common cause of vision loss in people who have diabetic retinopathy.

If you maintain good control of your blood glucose levels and your blood pressure, you’ll be less likely to develop diabetic retinopathy or, if you do, you’ll get a milder form of it. Those are risk factors you can control. Risk factors you can’t control are your genes and how long you’ve had diabetes.

Having diabetes puts you at higher risk for other eye conditions as well, including cataracts and glaucoma. Rapidly changing blood glucose levels can affect the eye’s lens and cause it to become cloudy. This can lead to a cataract. Anyone can get cataracts, but people with diabetes tend to get them earlier, and they progress faster.

With glaucoma, pressure builds up inside the eye when fluid can’t be removed through the eye’s drainage system that includes the trabecular meshwork. High blood glucose levels damage the cells of this meshwork, so it can’t function properly. Fluid doesn’t drain and pressure builds up in the eye. If not treated, the pressure can damage the optic nerve, leading to permanent vision loss.

Diabetic retinopathy, macular edema and glaucoma usually have no early symptoms. You may not know you have these diseases until they’ve already done damage to your eyes and affected your vision. That’s why an annual examination by an eye specialist is so important. The specialist can check your eyes for signs of these disorders, so early treatment can be started.

According to the US Centers for Disease Control and Prevention, about 90 percent of diabetes-related vision loss can be prevented. Early detection is one of the ways to reach that goal, and it’s another reason for an annual eye exam. Another way to help prevent vision-stealing eye diseases is by maintaining good blood glucose and blood pressure control.

Following these simple tips can help save your vision. So can knowing these symptoms  that signal an emergency. If you notice any of these symptoms, call your doctor right away:

• Black spots in your vision
• Flashes of light
• “Holes” in your vision
• Blurred vision

Obesity is a huge problem in our country, pun intended. According to the Centers for Disease Control and Prevention, more than one third (37.9 percent) of adults aged 20 and over in the US are obese, which is defined as having a Body Mass Index of 30 or above. Obesity puts people at risk for a number of health problems, including high blood pressure, heart disease and stroke.

One of the most common health conditions associated with obesity is diabetes, specifically Type 2 diabetes. These conditions are so intricately entwined that experts have coined the term “diabesity” to describe their relationship. Type 2 diabetes accounts for 95 percent of all cases of diabetes in the US, and more than 90 percent of people with the disorder are overweight or obese.

Our bodies need energy to function, and they get that energy from the food we eat. During digestion, food is broken down into a sugar called glucose that travels through the bloodstream. Insulin, a hormone made by the pancreas, is like a key. It opens up your body’s cells to let the glucose enter to be used by the cells as fuel.

Some people’s bodies don’t make enough, or any, insulin, or they don’t use insulin appropriately, and glucose remains in the blood instead of getting into the cells. When the glucose level in your blood is too high, you’ve got diabetes. High glucose levels can damage many parts of the body, including the eyes, heart, kidneys, nerves and feet. With Type 2 diabetes, your body does not make or use insulin properly. Its onset can occur at any time, but it most often starts when people are middle-aged or older.

Many studies have demonstrated a link between obesity and diabetes, but just how diabesity occurs is complex and yet to be understood fully. What we do know is that people who are overweight or obese put added pressure on their bodies’ ability to use insulin properly to control glucose levels in their blood. This makes them more susceptible to developing diabetes.

One way obesity may lead to diabetes is by triggering changes in your metabolism, the processes that occur in your body in order to function. It’s believed that these changes cause fat tissue to release fat molecules into the blood. The increased fat in the blood affects the cells that are responsive to insulin and reduces insulin sensitivity. Calorie-dense foods leads to increased fat accumulation, and calorie-dense diets are common with overweight individuals.

When the body has to store excess fat and cannot properly control insulin levels in the blood, substances called free fatty acids are deposited in the liver, causing a condition known as fatty liver. Free fatty acids also move through the circulatory system causing reactions within other organs such as the pancreas, heart and muscles. This starts a vicious cycle of organ damage, inflammation, and deteriorating insulin resistance and insulin secretion from the pancreas.

Where the fat accumulates on your body is also a factor in diabesity. If your fat is primarily located around your belly, which is a predictor of visceral fat that lies around your internal organs, you are at an increased risk for developing Type 2 diabetes. Like diets high in fat and carbohydrates, visceral fat is associated with worsening insulin resistance.

It’s no surprise that major factors contributing to diabesity are chronic unhealthy behaviors, including eating a high-calorie diet and avoiding physical activity. We know weight loss has a beneficial effect on blood glucose control and fat metabolism, so lifestyle modification through changes in diet and exercise is generally the first diabesity management strategy. If you are also taking diabetes medications, your doses will have to be reviewed regularly, as they may need to be adjusted as you lose weight.

In certain cases, weight loss medications may be used to assist those with diabesity achieve and sustain substantial weight reduction. For some people, a surgical weight loss option, such as a gastric band or bypass, is a good choice, especially if they’ve not achieved positive results with lifestyle modification and medication therapies.

With 90 percent of people with Type 2 diabetes being overweight or obese, diabesity is expensive, too. More than one in five US health care dollars are spent on diabetes, about $245 billion. That doesn’t include the indirect costs of absenteeism, reduced work productivity, inability to work and lost workers due to premature death, accounting for another $68.6 billion.

Because it can damage many organs and tissues, diabesity lowers quality of life as well. If you are overweight, especially if you notice any symptoms of diabetes, have your blood glucose level checked by your doctor. Type 2 diabetes doesn’t always have symptoms, but some of the possible symptoms include increased thirst, frequent urination, hunger, fatigue and blurred vision.

Don’t wait until diabesity damages your body, get tested today, and get on the road to weight loss and glucose control. And a healthier, higher quality of life!

Years ago one of my relatives developed Type 2 diabetes. I knew nothing about diabetes at the time. I accompanied him to see a hospital dietitian, where basically he was told: here’s what you can eat, here’s what you can’t; go home, follow the rules and you’ll be fine.

Since then, I’ve learned that diabetes is far from simple. Managing it requires meticulous self-care. Many people are successful, but many are not. A lot of diligence is required to stay healthy.

It’s worth taking the time to learn about Type 2 diabetes, which affects 90 to 95 percent of all diabetics.

One of the most important things to know is whether you are at risk of developing Type 2 diabetes, which affects 90 to 95 percent of diabetics.

It typically won’t appear without warning. Unfortunately, that warning is often silent and only evident in blood tests.

But it’s one you don’t want to miss because there is really good news about the warning stage of diabetes. Health professionals compare it to hazard lights that appear suddenly on an automobile dashboard. Do something instead of waiting for the problem to get worse and you’ll save time and trouble.

Type 2 diabetes occurs when the body’s use of glucose becomes impaired. Glucose, also referred to as sugar, is an energy source derived from food and normally enters cells as fuel.

When that process no longer works like it should glucose levels rise in the blood. Abnormal blood glucose levels can cause all sorts of problems over time from damaging delicate blood vessels in the eyes to blunting wound healing.

The warning stage is pre-diabetes when blood glucose levels are higher than normal but not high enough to diagnose full-blown diabetes. One in three Americans are pre-diabetic, according to the Centers for Disease Control and Prevention, and most don’t know it.

There is really good news about pre-diabetes, however, which is why it’s important to know whether you have it. Pre-diabetes can be reversed through modest amounts of weight loss and exercise.

Health professionals recommend routine screening for pre-diabetes after age 45 or earlier if you are African American or Hispanic, overweight, had the type of diabetes that occurs during pregnancy, have a family history of diabetes and other risk factors of pre-diabetes.

If tests show you’re pre-diabetic, now is the time to take action. More than a decade ago, a landmark study showed it is possible to turn things around. The study found that these two steps stop progression to actual diabetes or delay it significantly:

• Lose a relatively small amount of weight if you’re overweight or obese; just a 10 percent weight loss can make a big difference.
• Get more exercise; a brisk, half-hour walk most days can help tune up how your body processes blood sugar.

Of course, changing lifestyles is easier said than done. Humans may have been built to move and eat a variety of nutritious food that doesn’t come in a box or through a drive-thru window. But in today’s world, that can be far from simple.

And because pre-diabetes can occur without obvious symptoms, it’s easy to not think about and put off any intentions to change.

If you find that you’re stalling, there is a program that can help. It’s called the National Diabetes Prevention Program and its “lifestyle change program” offers classes and coaching through places like the YMCA and county health departments.

Check them out – and get a blood sugar test to see where you stand, if you’re at risk.