By Deborah Kotz
More than 29 million American adults have diabetes — up from 26 million in 2010 — yet one in four of them don’t know it, according to a report issued Tuesday from the federal Centers for Disease Control and Prevention. Rates of both type 1 and type 2 diabetes have been increasing for years; while the obesity epidemic has been blamed on the rising rates of type 2 diabetes, the reasons for the rise in type 1 diabetes, an autoimmune condition that typically strikes in childhood, remain unknown.
CDC researchers also can’t explain why so many diabetics remain undiagnosed. Certainly, many without health insurance don’t see doctors until they develop severe complications like kidney problems, nerve damage, and vision loss. But even those with access to healthcare often fail to recognize symptoms like increased thirst, urination, and fatigue — or fail to attribute such symptoms to diabetes.
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“We need people to be more aware of the symptoms and to get screened if they have certain risk factors or are over the age of 45,” said Ann Albright, director of the CDC’s Division of Diabetes Translation.
The American Diabetes Association recommends a screening blood test — to measure the marker hemoglobin A1C or a fasting one to measure blood glucose — for everyone over age 45 every three years. Screening should be done at a younger age in those with certain risk factors like high blood pressure or obesity.
Albright, a registered dietitian, said it’s just as more important for people to know when they’re on the road to diabetes so they can take steps to prevent it. An estimated 1 out of 3 American adults have a condition called prediabetes where their bodies have become less responsive to the hormone insulin. Without taking action to lose weight or increase physical activity, 15 to 30 percent of people with prediabetes will develop type 2 diabetes within 5 years.
“Some of the strongest evidence suggests that small changes — like losing 5 to 7 percent of your body weight if you’re overweight — can make the biggest difference,” Albright said. She’s not a fan of radical eating plans like the low glycemic diet, which eliminates a lot of carbohydrates like certain fruits, cereal, and breads. “White bread isn’t the villain,” she said. “I’d rather see people making calorie adjustments as if they were deciding how to spend money.”
Cutting down on frivolous foods such as sweetened beverages, chips, or candy bars, is akin to cutting out frivolous purchases. “Invest in foods that are nutritious,” Albright said, “like fruits, vegetables, and whole grains.”
The CDC’s National Diabetes Prevention program that teaches nutrition and exercise classes is offered at more than a dozen sites in Massachusetts at little or no cost to participants. Clinical studies suggest that participating in the program often prevents or delays the onset of type 2 diabetes among people with prediabetes.