November is American Diabetes Month

Over 20 million Americans have diabetes, putting them at risk for complications such as cardiovascular disease, blindness, kidney disease, and lower –limb extremity amputations.

Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes. The risk for stroke is 2 to 4 times higher for all people with diabetes. Diabetes is also the leading cause of kidney failure and, among adults aged 20–74 years, the leading cause of new cases of blindness.

Of the 20 million people living with diabetes, over 6 million do not know they have it.

The lifetime risk for diabetes for people born in the United States in 2000 is:

• For all Americans: 1 of 3

• For African Americans and Hispanics: 2 of 5

• For Hispanic females: 1 of 2

Types of Diabetes

Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Many people with diabetes also need to take medications to control their cholesterol and blood pressure. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may include autoimmune, genetic, and environmental factors.

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce insulin. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or other Pacific Islanders are at particularly high risk for type 2 diabetes. Type 2 diabetes is increasingly being diagnosed in children and adolescents.

Gestational diabetes is a form of glucose intolerance that is diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5–10 years.

Ways You Can Help Prevent Diabetes

Prediabetes is a condition that raises the risk of developing type 2 diabetes, heart disease, stroke and eye disease.

People with prediabetes have impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or both—conditions where blood glucose levels are higher than normal but not high enough to be classified as diabetes.

Progression to diabetes among those with prediabetes is not inevitable. Recent studies have shown that people at high risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight. You can do it by eating healthier and getting 30 minutes of physical activity 5 days a week.

Diabetes Management and Control

Diabetes can lead to serious complications and premature death, but people with diabetes can take steps¹ to control the disease and lower the risk of complications.

• Talk to your health care provider about how to manage your blood glucose (A1C), blood pressure, and cholesterol.

• Learning how to eat right is an important part of controlling your diabetes. F ood such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese are recommended as part of a healthy diet. Eating the right portions of healthy foods is also important.

• Engage in physical activity for 30–60 minutes on most days of the week. Physical activity can help you control your blood glucose, weight, and blood pressure, as well as raise your "good" cholesterol and lower your "bad" cholesterol.

• Stay at a healthy weight.

• Check your feet every day for cuts, blisters, red spots, and swelling. Call your doctor immediately if you have sores that will not heal.

• Check your blood glucose and take medicines the way you doctor tells you to.

• Get routine care. See your health care team at least twice a year to find and treat problems.

¹Source: 4 Steps to Control Your Diabetes. For Life. National Diabetes Education Program.

Diabetes Education and Resources

The National Diabetes Education Program, a joint CDC and NIH project, offers a wide range of resources around three major public education campaigns (listed below). These campaigns provide the foundation for conducting outreach activities in communities across the country. Each campaign provides a wealth of tools—brochures, tip sheets, provider kits, public service advertising, and more—that you can use to reach out to people with diabetes, people at risk, or healthcare providers.

• Control Your Diabetes. For Life.

• Be Smart about Your Heart. Control the ABCs of Diabetes. (a booklet in Spanish is available)

• Small Steps. Big Rewards. Prevent type 2 Diabetes.

"We Can Be Stronger than Diabetes" Podcasts
The National Diabetes Education Program also developed a podcast series on diabetes. This series, titled "We Can Be Stronger than Diabetes," offers short audio files that you can listen to on your computer or download to a mobile device like an iPod or other portable player. Check for daily podcast updates at Podcasts at CDC.

Additional Information

• November 2007 MMWR Articles:

• "Trends in Prevalence of Self-Reported Cardiovascular Disease Among Adults with Diabetes Aged 35 Years or Older, United States, 1997–2005"

• "Self-Monitoring of Blood Glucose Among Adults with Diabetes — United States, 1997–2006"

• Diabetes (also available in Spanish)

• Prevent Diabetes

• Pregnancy and Diabetes

• Frequently Asked Questions: Staying Healthy with Diabetes

• National Diabetes Education Program

• American Diabetes Month*