It is estimated that one-third of people with diabetes are unaware of their condition: sometimes there can be virtually no symptoms, and patients can have diabetes without knowing it. Most diabetes screening recommendations focus on type 2 diabetes, since symptoms of type 1 diabetes often develop suddenly and the disease is usually diagnosed soon after symptoms appear. People with type 2 diabetes can go undiagnosed for three to four years or more, making screening an important tool for catching it.
The American Diabetes Association (ADA) recommends that adults age 45 and older get screened for type 2 diabetes every three years by their health care provider: the American Association of Clinical Endocrinologists recommends that high-risk adults get screened annually beginning at age 30. Regardless of the organization, however, the message is generally the same: At some point, adults should begin getting regularly screened for type 2 diabetes, especially if they are at high risk of developing the disease.
You may need earlier or more frequent diabetes screening if you are overweight and have one or more of the following risk factors:
• Family history of diabetes (a parent or sibling with the disease)
• Sedentary lifestyle
• African-American, Hispanic-American, Native-American, Asian-American, or Pacific Islander ancestry
• History of blood glucose problems
• History of gestational diabetes or a baby weighing over nine pounds
• High blood pressure
• Cholesterol problems
• Polycystic ovary syndrome
• History of vascular disease
Type 2 diabetes was previously considered an adult disease, but with the increasing rates of childhood obesity the prevalence of type 2 diabetes in minors is also rising. The ADA recommends that overweight children who also have two or more of the following risk factors undergo diabetes screening:
• A family history of diabetes in a parent, sibling, aunt, uncle, or grandparent
• Native-American, African-American, Hispanic-American, Asian-American, or Pacific Islander ancestry
• Symptoms of insulin resistance
• Conditions associated with insulin resistance, such as acanthosis nigricans (a skin pigment disorder), high blood pressure, cholesterol problems, and polycystic ovary syndrome
There are two simple tests used in diabetes screening: the fasting plasma glucose test involves checking the level of glucose in your blood while you are fasting. If your blood glucose level is higher than 125 mg/dL, you will need to be retested at another time to confirm a diabetes diagnosis. The oral glucose tolerance test (OGTT) involves drinking a sugary solution two hours before you have your blood drawn. If your test results are 200 mg/dL or higher, you will need to have a repeat test another day to confirm that you have diabetes.
Talk with your doctor about the diabetes screening schedule best for you. If you do develop diabetes, early detection can be an important way to protect your health and prevent future complications.
The major goal in treating diabetes is to minimize any elevation of blood sugar glucose without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with insulin, exercise, and a diabetic diet. Type 2 diabetes is treated first with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugars, oral medications are used. If oral medications are still insufficient, treatment with insulin is considered.
Adherence to a diabetic diet is an important aspect of controlling elevated blood sugar in patients with diabetes. The American Diabetes Association (ADA) has provided guidelines for a diabetic diet. The ADA diet is a balanced, nutritious diet that is low in fat, cholesterol, and simple sugars. The total daily calories are evenly divided into three meals. In the past two years, the ADA has lifted the absolute ban on simple sugars. Small amounts of simple sugars are allowed when consumed with a complex meal.
Weight reduction and exercise are important treatments for diabetes. Weight reduction and exercise increase the body's sensitivity to insulin, thus helping to control blood sugar elevations.
It's important to remember that if a drug can provide more than one benefit (lower blood sugar and have a beneficial effect on cholesterol, for example), it should be preferred. It's also important to bear in mind that the cost of drug therapy is relatively small compared to the cost of managing the long-term complications associated with poorly controlled diabetes.
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