Diabetes guide: Facts about type 1, type 2, gestational & prediabetes

World diabetes day awareness. Woman hand with a blue circle with blood drop, symbol of the diabetes.

More than 34 million Americans have diabetes, yet 1 in 5 don’t know they have it. Another 88 million — 1 in 3 — have prediabetes. This is a condition where blood sugar is higher than normal but not yet high enough to be diabetes.

Because of the way diabetes evolves, it’s crucial to understand how the disease works. This is especially true here in Tennessee where more than 30% of us will be affected by it at some point, says Dr. Daniel Cusator, a BlueCross BlueShield of Tennessee medical director.

“It’s imperative to catch prediabetes early. Once you’re diagnosed with type 2 diabetes, you can’t really reverse it,” says Dr. Cusator. “Even if you eventually get your blood sugar under control, we don’t know how much damage can be undone. It’s better not to do that damage in the first place. And the good news is you can reduce many risk factors through simple lifestyle changes.”

Here’s what you need to know about diabetes in Tennessee now.

What is diabetes?

Diabetes is a chronic disease that affects how your body turns food, specifically carbohydrates, into energy.

If you don’t have diabetes: If you do have diabetes:
·  Most carbohydrates you eat are broken down into sugar (glucose) and released into your bloodstream.

·  When your blood sugar goes up, your body tells your pancreas to release insulin, which helps your cells turn blood sugar into energy.

·  Your body either doesn’t make enough insulin or can’t use the insulin properly.

·  When that happens, too much blood sugar stays in your bloodstream.

·  Over time, that causes health problems such as heart disease, vision loss and kidney disease.

Blood sugar 101: What it can tell you about your health

Types of diabetes

There are 3 main types of diabetes:

Type 1

Type 1 diabetes happens when the body attacks itself by mistake and destroys the insulin-producing cells in the pancreas. The pancreas can no longer produce insulin. This means a person must take insulin every day to survive. Up to 10% of people with diabetes have type 1, and it’s usually diagnosed in children, teens and young adults. Type 1 diabetes is not preventable or curable.

Type 2

Roughly 90-95% of people with diabetes have type 2. If you have type 2 diabetes, your body can’t keep blood sugar at normal levels due to problems producing or using insulin. Type 2 diabetes can be prevented or delayed with lifestyle changes.

Gestational diabetes

Gestational diabetes affects pregnant women who’ve never had diabetes. It typically goes away after the baby is born. But it can put the baby at higher risk for health problems and increase the mother’s risk for type 2 diabetes later in life.

How common is diabetes in Tennessee?

More than 800,000 people in Tennessee — nearly 15% of adults — have diabetes.

  • Of these, 161,000 have diabetes but don’t know it.
  • Each year, 38,000 Tennesseans are diagnosed with diabetes.
  • 7 million Tennesseans — 35.8% of adults — have prediabetes but don’t know it.

Over the past 20 years, diabetes diagnoses have more than doubled.

What does it mean to be prediabetic?

Prediabetes happens when a person’s blood sugar level is higher than normal which is a bit of a warning sign for a full diabetes diagnosis,” says Dr. Cusator. “Without lifestyle changes, 70% of prediabetic people will develop type 2 diabetes — most within 5-6 years.”

Not everyone who is prediabetic is overweight, and not everyone has symptoms.

“Prediabetes is a prime example of why you shouldn’t skip your annual wellness exam just because you appear young or healthy,” says Dr. Cusator. “An annual wellness exam with your primary care provider and a simple blood test can give you the information you need to make changes to dramatically improve your health long-term.”

What are the symptoms of diabetes?

People who have diabetes may:

  • Urinate often, especially at night
  • Be very thirsty and hungry
  • Lose weight without trying
  • Experience blurry vision
  • Have numb or tingling hands or feet
  • Feel fatigued
  • Have very dry skin
  • Have a compromised immune system (sores heal slowly, infections increase)

What are the risk factors for diabetes?

Risk factors for diabetes vary by type.

Type 1 Type 2 / Prediabetes Gestational
– Have a parent or sibling with type 1 diabetes

– Are a child, teen or young adult (Type 1 diabetes is often diagnosed in youth.)

– Are overweight

– Are age 45+

– Have a parent or sibling with type 2 diabetes

– Are physically active less than 3 times a week

– Had gestational diabetes or gave birth to a baby weighing 9+ pounds

– Are African American, Hispanic, American Indian or Alaska Native

– Are overweight

– Are age 25+

– Had gestational diabetes previously

– Gave birth to a baby weighing 9+ pounds

– Have a family history of type 2 diabetes

– Have a hormone disorder called polycystic ovary syndrome (PCOS)

– Are African American, Hispanic, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander

Note: Having prediabetes is also a risk factor for type 2 diabetes.

What can you do to prevent diabetes?

“Lifestyle changes are the single most important thing you can do to prevent or control diabetes. This includes a healthy diet, exercise and weight loss.” says Dr. Cusator.

Try to:

  • Get 150 minutes of physical activity a week
  • Keep your weight in a range that’s healthy for you
  • Eat healthy foods (i.e. fewer refined/processed meals high in simple carbohydrates)
  • Drink more water and fewer sugary drinks
  • Quit smoking

More information on diabetes from WellTuned

Ashley Brantley

Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).

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Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.

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Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).