It seems like almost every day I hear something new about type 2 diabetes. Whether it’s a new medication or a discovery about an aspect of the biology behind the disease, our understanding of diabetes is constantly improving. But even with our increasing and evolving knowledge, I find that too many of my patients remain unaware of their risk for the disease. To help get you up to speed on the risk you — and your friends or family — may face, here’s a review of the three most common gaps I see in people’s knowledge about diabetes and the risk factors for the disease.
Watch: How Diabetes Affects You?
You Can Have Diabetes and Not Know It
When I break a new diagnosis of diabetes to a patient, I often hear these words: “But I feel fine!” Many people don’t realize that diabetes is typically a silent disease and can remain so for years — even decades. It occasionally sends out small signals, but those symptoms may not be obvious to you or may come on so gradually that you get used to them without noticing. Having diabetes isn’t like picking up the flu or having a heart attack. It develops gradually and its effects can be hidden from view until it’s too late.
Because diabetes can be so hard to diagnose just using symptoms, doctors use a variety of other questions and tests to determine if you’re at high risk and need further workup. Here’s some good news: If you’re uncertain about your risk level, you can find out more information yourself. As part of their annual Alert Day, the American Diabetes Association offers a quick quiz to see if you might be at risk. This quiz won’t reveal if you have diabetes — but it will tell you if you’re at risk, and should see a doctor for further investigation. The earlier you catch diabetes, the earlier you can stop its devastating health effects.
Diabetes Isn’t Just About Sugar
The more we research diabetes, the more we find that it’s a complicated disease with many different causes. It’s not uncommon for me to see a patient with diabetes who doesn’t seem to be eating that much sugar. To be clear, what you eat (particularly the amount of sugary foods you eat) is a big part of developing diabetes. But it’s not just about how sugary your food is. Diabetes starts out as a problem with the way your body responds to insulin, a hormone that your body uses as a signal that sugar is present in the blood that needs to be used or stored. Eating a lot of sugar can lead to spikes in the amount of sugar in your blood, which the body can have trouble keeping under control. But how your body responds to that sugar and to insulin’s signal depends on a few other things.
- Exercise plays a big role in blood sugar. The more exercise, the better your body gets at handling sugar. That’s because active muscles need more energy, which means they get better at pulling sugar out of the blood with regular use. Inactive muscles don’t do this as well, which can contribute to diabetes. (Try this one exercise to jump-start your weight loss.)
- Genes also play a role, but researchers are still trying to get a grasp on exactly how. What’s probably happening is that certain versions of genes change how your body responds to sugar, especially in situations where you’re eating a lot of it over a long period of time.
- Body weight dramatically affects how your body handles sugar. That’s why losing weight can do such good things for your diabetes. Researchers are still trying to get a handle on this as well, but what’s clear is that your fat cells are releasing a variety of signals into your blood that can bump up inflammation, increase weight gain, and make it harder for your body to respond to insulin.
Again, what you eat is very important in diabetes. Keeping your diet low in simple sugars found in sweets, pastries, soda, and other junk foods and high in fruits, vegetables, and whole grains can have a big impact on your risk. (Here’s what happens to your happens to your body after a sugar binge.) But just paying attention to your diet isn’t enough. Knowing your family history, getting active, and losing weight can all make a big difference in your health long term.
You Can Reverse Type 2 Diabetes
When I start to talk about lifestyle changes, I often hear people ask me why they should bother. Most people think a diagnosis of diabetes is unchangeable and, if anything, is only likely to get worse as they get older. Even worse, I’ve talked to people at risk who think a diagnosis is inevitable and don’t think changing their lifestyle will do any good. Nothing could be further from the truth. What we’ve realized in over the years is that type 2 diabetes is both preventable, meaning you can keep yourself from getting it in the first place, and reversible, meaning you can reduce your need for medications or even come off of medications if you work hard enough to change your lifestyle.
Keep in mind, though, that lifestyle change isn’t necessarily easy. You’ll need to do a few of the following things:
- Exercise more, at least the amount recommended by the CDC which includes 30 minutes a day, five days a week of aerobic exercise and muscle strengthening at least twice a week
- Eat a lot better, including increasing the vegetables, whole grains, fruits and lean meats in your diet while dramatically cutting down on junk food and hidden sugars
- Lose weight, which should hopefully come with more exercise and better eating, but can also come with habit changes like better sleep and less time sitting during the day
- Cut out bad habits like smoking
While these changes don’t always happen quickly, any small progress you make towards a better lifestyle can lower your risk for diabetes and improve how your body deals with sugar. This is particularly true early on in a type 2 diabetes diagnosis, which is why early detection is so important. The sooner you find out if you have diabetes or if you’re at risk for diabetes, the earlier you can change your lifestyle and reverse the illness.
Ready to get started? Find out your risk and make an appointment with your doctor to discuss whether you need to be tested and what you could be doing to improve your lifestyle.