Is your family at risk for diabetes? The answer is probably yes. This article explains diabetes symptoms, health complications it can cause and 12 tops tips to prevent or manage the disease.

More than half of all Arkansans who have diabetes do not know it. Another 25 percent of Arkansans have prediabetes and about 90 percent of them do not know it. One in three Americans will develop diabetes during their life. The rapid increase in this uncurable disease over the past 20 years has pushed it to an epidemic level. Almost half a million Americans die every year from diabetes complications. Diabetes care costs the U.S. health system more than $245 billion a year.

It’s impossible to control this potentially deadly disease unless you know you have it. The only reliable way to find out is to have a fasting blood test. Screening may include a urine test. If you’ve never been tested for diabetes and are over age 45, contact your health care provider to get tested.

The symptoms of diabetes/prediabetes aren’t the same for everyone, and some people never have symptoms. If you have more than two of the following symptoms, contact your doctor right away.

The symptoms of diabetes include:

  • Extreme thirst or hunger
  • Frequent need to urinate
  • Fatigue or drowsiness
  • Weight loss without dieting and despite increased hunger
  • Slow healing of wounds, sores or bruises
  • Dry, itchy skin
  • Loss of feeling or tingling in the feet or hands
  • Blurry eyesight or vision loss
  • Frequent skin, gums, bladder or vaginal-yeast infections

How do you get diabetes?

You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chances of developing diabetes. Having prediabetes or gestational diabetes during pregnancy also increase your risk of developing diabetes.

Type 2 diabetes (may be called adult-onset diabetes) is caused by blood glucose (blood sugar) that is too high. It begins with insulin resistance. For a variety of reasons, your muscles, liver and fat cells start losing the ability to use insulin well. Insulin is a hormone made by your body that lets glucose enter body cells, so glucose can be used for energy. Glucose comes from the food we eat. Insulin resistance pushes your body to produce more insulin to help glucose enter cells. However, over time your body cannot make enough insulin, so glucose cannot get into cells. Glucose stays in your blood and increases to a level that can cause damage to multiple areas of your body.

Why would I need to know if I have diabetes?

Faster treatment – Finding out if you have diabetes or prediabetes lets you begin self-management and treatment right away. The sooner you start, the better your chances of avoiding complications, disabilities and a shortened lifespan. Finding out if you have prediabetes helps you take action right away to keep it from progressing to diabetes.

Avoid disabilities –Adults with diabetes not only die at a younger age, they also live with disabilities longer than non-diabetics. Diabetes can cause long-term damage to your eyes, kidneys, nerves and blood vessels; cause heart attacks, heart disease, stroke and amputations; and cause gum problems and tooth loss.

Avoid complications – Getting an early diagnosis helps you avoid the devastating complications that can result from untreated diabetes.

What are the complications of diabetes?

Blindness – Diabetes is the leading cause of blindness in adults ages 20 to 74. Nearly half of all people with diabetes will develop vision problems without prompt treatment. Early diagnosis and treatment of diabetes could eliminate 95 percent of severe vision loss.

Diabetic retinopathy damages the small blood vessels in the eye’s retina, the part that’s sensitive to light and sends messages to your brain about what you see. Most people with diabetic retinopathy have no symptoms. Your eyes can be badly damaged before you notice a change in vision. People with diabetes have a 40 percent greater chance of developing glaucoma, which causes a gradual loss of vision. Cataracts are also more common in people with diabetes and are much more difficult to treat.

The following symptoms could mean serious eye problems that may lead to blindness, according to the American Diabetes Association (ADA). Report them immediately to your doctor.

  • Blurry vision for more than two days
  • Double vision
  • Sudden loss of vision in one or both eyes
  • Flashing lights in your field of vision that aren’t there, especially noticeable in a dark room
  • Floaters – spots, cobwebs or strings that move or drift when you move your eyes
  • Seeing rings around lights or dark spots
  • Eye pain or pressure
  • Eyes get red and stay that way
  • Straight lines don’t look straight
  • Problems with side vision

Kidney damage or failure – Diabetes can damage the blood vessels in your kidneys, so they can’t filter out waste. This can mean the eventual need for kidney dialysis or a kidney transplant. Symptoms of damage are rare until almost all kidney function is lost.

Amputations – Poor circulation from diabetes can cause amputations. Diabetes can lead to peripheral artery disease (PAD), causing your blood vessels to narrow, and reduce blood flow to your legs and feet. PAD, plus peripheral neuropathy, can prevent you from feeling pain. You may not realize you have a wound or injury on your foot or that it has become infected. Reduced blood circulation also slows wound healing. If the wound won’t heal, tissue damage or death (gangrene) can occur. If the infection spreads to your bone, amputation may be necessary. The most common diabetes-related amputations are toes, feet and lower legs. People with diabetes/prediabetes should do a daily foot check. Look for redness, wounds, bruising, blisters, discoloration and hot or cold skin temperature.

Disabilities – Many people with diabetes spend a significant amount of their lives with disabilities caused by diabetes. Disabilities can include difficulty walking, standing, or using their hands; severe nerve pain; vision loss; regular dialysis or paralysis from a stroke. These disabilities are a key reason why people with diabetes have a shorter lifespan. Diabetes shortens the life of a 50-year-old person by more than three years; and more of their remaining years will include living with disabilities.

Heart and blood vessel disease – Having diabetes doubles your risk of heart disease and stroke. Two out of three people with diabetes will die due to heart problems, including heart attack, hardening of the arteries (coronary artery disease), congestive heart failure, stroke and PAD.

Nerve problems and numbness in hands and feet – Called diabetic neuropathy, this type of nerve damage makes it hard for nerves to send messages to other parts of your body, especially your brain. Neuropathy usually causes painful tingling or burning in hands, legs or feet. It can cause muscle weakness, numbness or loss of feeling in some parts of the body. Loss of feeling may prevent you from noticing a sore on your foot or the pain of a damaged joint. Diabetic neuropathy can also cause or contribute to erectile dysfunction in men and vaginal dryness in women.

Bone and joint problems – Diabetic neuropathy can also cause your joints to deteriorate, according to the National Institutes of Health (NIH). People with diabetes are at a higher risk for foot deformities, osteoporosis and arthritis.

Mouth and gum problems – Diabetes makes you more prone to gum infections because glucose is present in your saliva. When diabetes is not well controlled, high glucose in your saliva helps harmful bacteria grow. When combined with food, bacteria grow into a sticky film on your teeth called plaque. Plaque causes tooth decay, gum disease and bad breath. Brushing your teeth twice a day and flossing every day removes plaque.

Untreated gum disease can cause long-lasting infections, bad breath, lost teeth, and changes in your bite and ability to chew food. Uncontrolled blood glucose levels can cause a burning sensation in the mouth, dry mouth or a bitter taste.

Thrush or candidiasis happens when the body cannot control a naturally occurring fungus that leaves your mouth sore, with white (sometimes red) patches on your gums, tongue, roof or sides of your mouth. Always contact your dentist or doctor for medicine to control thrush.

Tell your doctor or dentist about these symptoms:

  • Mouth sore or ulcer that does not heal
  • Gums that bleed, look red or are swollen
  • Pain in your mouth, face or jaw that doesn’t go away
  • Loose teeth
  • Pain when chewing
  • Changes in your sense of taste or a bad taste in your mouth
  • Bad breath remains after brushing teeth and flossing

Skin problems – The most common diabetic skin symptoms are dry, itchy skin and sores that heal slowly. Diabetes also makes it easier to get bacterial or fungal skin infections. There are several skin problems that happen only to people with diabetes, according to the ADA.

Mental health problems – Receiving a diagnosis of diabetes, trying to accept that diagnosis and learning how to manage the disease is a lot to absorb. When diabetes first enters your life, it’s common to be emotionally upset, angry, deny the diagnosis, have anxiety or become depressed. Much of this emotional upset stems from stress. Unmanaged stress can make diabetes worse by causing you to neglect your treatment routine. Prolonged stress can produce hormones that may prevent insulin from working properly, making matters worse.

Some people who are newly diagnosed will deny they have diabetes as a way of coping with the bad news. Denial can show up in a variety of ways: not making lifestyle changes, not bothering to check your blood glucose, eating foods that aren’t good for you, ignoring daily foot checks or continuing to smoke.

People with diabetes have a greater risk of depression than nondiabetics. It is time to get help if you have prolonged sadness or apathy, changes in appetite or sleep patterns, loss of energy, nervousness or even suicidal thoughts for two weeks or more. Contact your doctor because there may be a physical cause of your depression. Depression-like symptoms can be caused by poor control of blood sugar, thyroid problems, medication side effects, or alcohol/drug abuse.

What is prediabetes?

Prediabetes means the amount of glucose (blood sugar) in your blood is higher than normal but not elevated enough to be diabetes. Prediabetes means you are more likely to develop type 2 diabetes, heart disease or stroke. Risk factors for prediabetes include:

  • Overweight
  • Age 45 or older
  • Not getting enough exercise
  • Having an immediate family member with diabetes
  • Having metabolic syndrome – a combination of high blood pressure and cholesterol and being overweight
  • Developing diabetes during pregnancy or giving birth to a baby weighing over nine pounds
  • Being African-American, Alaskan Native, American Indian, Asian-American, Hispanic, Latino or Pacific Islander-American
  • Dark, velvety rash around your neck or armpits
  • Having blood vessel problems affecting your heart, brain or legs

12 tips to prevent type 2 diabetes:

Most type 2 diabetes can be prevented. Preventing diabetes complications is much easier and less expensive than treating them. Getting an early diagnosis and treating prediabetes can lower a person’s chances of developing type 2 diabetes by almost half. Eating healthier, exercising more and making certain lifestyle changes can reverse the disease, or reduce the amount of medications you must take.

In a large prevention study of people at high risk for diabetes, it was found that losing weight and increasing physical activity reduced the onset of type 2 diabetes by 58 percent over three years. This was true for all racial and ethnic groups. The reduction was 71 percent among adults over age 60.

The U.S. Preventive Services Task Force recommends that every American over age 45 be screened for both type 2 diabetes and prediabetes. Additionally, all adults over age 18 with diabetes risk factors such as obesity, family history of diabetes, high blood pressure and/or cholesterol, should also be screened.

Take these steps to prevent diabetes or manage diabetes/prediabetes if you already have it:

  • Ask your doctor if you need to be tested for diabetes (diabetes testing is a preventive service under the Affordable Care Act and most insurance considers testing part of your wellness visit)
  • Stop smoking
  • Get to a healthy weight and stay there
  • Eat a healthy diet, avoiding foods high in fat, cholesterol, salt and added sugars
  • Take your diabetes medications and follow your treatment plan
  • Control your blood sugar (A1C should be under 7, blood sugar should be under 154, fasting blood sugar should be between 80 and 130), blood pressure (below 130/80 mm Hg.) and cholesterol (under 200 mg.)
  • Exercise daily
  • Have a comprehensive eye exam at least once a year
  • Take care of your feet and check them daily
  • See your doctor regularly even if you feel fine
  • Keep up-to-date with your annual health screenings: A1C tested twice a year, cholesterol, kidneys (check urine and blood), dilated eye exam, dentist twice a year and stay up-to-date on vaccines
  • Manage your stress every day
  • Learn all you can about diabetes to better manage this complex disease. According to the American Association of diabetes Educators, diabetes self-management education (DSME) have proven to help people with diabetes and those at high risk of developing diabetes or prediabetes. DSME classes have helped to reduce a high-risk person’s chance of getting diabetes by 11 percent; had a 7 percent loss in body weight; had an 8 percent reduction of serious complications and a 2.3 percent less chance of dying from diabetes. AFMC hosts diabetes self-management education (DSME) classes statewide. To find a free diabetes class near you, call toll free 1-877-375-5700, option 2.

Health emergency

It’s important to understand that undiagnosed diabetes can lead to a health emergency. Call your doctor or go to an emergency room if you:

  • Notice your breath smells like nail polish remover (acetone)
  • Start to tremble, feel weak and drowsy, confused or dizzy, or your vision becomes blurred
  • Feel uncoordinated
  • Are nauseous or vomit more than once
  • Start breathing deeper and faster or shortness of breath
  • Have extreme thirst and urinate more than usual

If blood sugar becomes very high, a condition called diabetic ketoacidosis may develop. If left untreated, it can result in coma or death.

Show your support

To help build awareness, AFMC employees are encouraged to wear blue Wednesday, Nov. 14, in recognition of World Diabetes Day. The theme for this day is “The Family and Diabetes.” If you wear blue, you’re allowed to wear jeans on Wednesday.