As obesity rates climb, so has the incidence of type 2 diabetes.

By Madeline Vann, MPH

Medically reviewed by Pat F. Bass III, MD, MPH

Just over 1 in 10 people is likely to have type 2 diabetes, a condition with elevated blood sugar that increases risk for heart disease and stroke. According to national data, 13 percent of adults over the age of 20 have diabetes, and an additional 30 percent have prediabetes, a condition in which blood sugar levels are higher than normal but do not meet criteria for a diabetes diagnosis.

“Diabetes is an elevation in blood sugar associated with certain long-term complications,” says Vivian Fonseca, MD, professor of medicine and pharmacology and chief of the section of endocrinology at Tulane University Health Sciences Center in New Orleans.

Diabetes is the sixth leading cause of death in the United States and is the reason for 23.8 million doctor’s office visits very year. The incidence of adult diabetes has grown significantly in the last two decades — from 5 percent in 1988-1994 to nearly 8 percent in 2005-2006.

Diabetes develops when your body can no longer properly process blood sugar (glucose) out of your blood. Normally, your pancreas makes a hormone called insulin which helps cells turn blood sugar into fuel. However, if your pancreas doesn’t make enough insulin or your cells can’t use insulin correctly, your blood sugar levels rise.

When your tissues cannot use insulin to process blood sugar, this is called insulin resistance. Over time, uncontrolled high blood sugar levels lead to tissue damage throughout your body, from your eyes to your toes. Possible complications of diabetes include:

• Gum disease and infections
• Nerve damage in your hands and feet
• Blindness or decreased eyesight
• Limb amputations (feet, legs)
• Stroke
• Heart disease

Unfortunately, many people don’t have any symptoms of increasing blood sugar levels. One of the most common misconceptions among diabetes patients is “that it’s something that’s trivial if you don’t feel things, because it is very much a silent condition,” says Dr. Fonseca. “Even [diabetes in its early stages] with no symptoms can continuously do damage over the years, so that’s where the problem lies.”

Type 2 Diabetes: Who is at Risk?

Even though type 2 diabetes is often called adult-onset diabetes, it can begin at any age and in any person. However, there are several risk factors that might put you at greater risk for developing type 2 diabetes:

• Being overweight or obese
• Being physically inactive
• Family history (especially a parent or sibling with diabetes)
• Native American, African-American, or Hispanic heritage
• Prior gestational (pregnancy-related) diabetes
• Birth of a baby over nine pounds in weight
• High blood pressure or treatment for high blood pressure
• Low HDL or “good” cholesterol (below 35 milligrams per deciliter)
• Polycystic ovarian syndrome diagnosis (a hormone imbalance in women)
• Dark, velvety rash around the armpits or neck, called acanthosis nigricans
• History of heart disease

Type 2 Diabetes: Getting Tested

If you are over 45, you should get tested for diabetes. Diabetes is initially diagnosed with a blood test after you haven’t eaten for about eight hours, usually overnight. If the results of that test are normal, you can wait three years before getting tested again. If your blood sugar levels are high, you and your doctor can start to bring them down through changes in diet and exercise, and if necessary, with the help of medications.

If you are younger than 45, you can still ask to be tested for diabetes. You should make getting tested a priority if you are overweight or obese and have one or more of the risk factors listed above.

Understanding what type 2 diabetes is and whether you are at risk will help you make decisions about your long-term health needs.

Last Updated: 04/16/2009

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