Diabetes Basics

Q What is diabetes?

A Diabetes is a group of diseases marked by high levels of glucose in the blood. This can result from not having enough insulin, insulin not being used properly , or both. Left untreated, diabetes can lead to serious complications (health problems like blindness and kidney disease), and even early death. But, there is good news: people with diabetes can take steps to control the disease and lower their risk for complications.

Q How many Americans have diabetes?

A Twenty six million Americans have diabetes. Of these, around 7 million do not even know they have the disease! The number of people diagnosed with diabetes has risen from 1.5 million in 1958 to 18.8 million in 2010, a major increase in a short amount of time.

Q What is prediabetes?

A It is estimated that 79 million American adults aged 20 and older have prediabetes, a condition where blood glucose levels are higher than normal but not high enough to be diabetes. Studies have shown that by losing weight and increasing physical activity, people can prevent or delay prediabetes from progressing to the full disease. Exercise helps your body to use glucose better, which prevents it from getting too high in your blood.

Q What are the different types of diabetes, and how common are they?

A Type 1 (previously called “insulin-dependent” or “juvenile-onset”) diabetes accounts for only about 5 to 10% of all cases of diabetes in adults. In type 1 diabetes, the pancreas stops making insulin, the hormone that helps your body use glucose from food for energy.

Type 2 (previously called “non-insulin-dependent” or “adult-onset”) diabetes accounts for the majority (90 to 95%) of all diagnosed cases in adults. More and more children and teenagers are getting type 2 diabetes, as well. Type 2 diabetes is diagnosed when the body does not make or use insulin well. People with type 2 diabetes often need to take pills or insulin shots to control their blood glucose levels.

Gestational diabetes occurs in a small number of pregnancies. Women who have had gestational diabetes have a higher chance of developing type 2 diabetes10 to 20 years after their pregnancy.

Q Is diabetes more common in men or women?

A Diabetes is more common in men, but not by very much. About 13 million men over 20 have diabetes, compared to about 12.6 million women over 20.

Q Do young people get diabetes?

A About 215,000 Americans under 20 have diabetes. Most of these kids and teenagers have type 1 diabetes.

Q Are certain races or ethnicities more likely to get diabetes?

A Diabetes is common among most racial and ethnic groups in America, but some are at a higher risk than others. These include Hispanics, African Americans, American Indians, Alaska Natives and Pacific Islanders. If you are a member of one of these groups, see your healthcare provider regularly to get checked for diabetes and find out how you can lower your risk.

Q How many deaths are linked to diabetes?

A Diabetes is the 7th leading cause of death in the United States, and heart disease is the leading cause of death among people with diabetes. Unfortunately, the overall risk of death among people with diabetes is about double that of people without who do not have the disease. But, working closely with your diabetes care team and making healthy lifestyle changes can greatly reduce your risk.

Q How serious is a diagnosis of diabetes?

A You may have heard people say they have “a touch of diabetes” or “your sugar is a little high.” These words make it sound as if diabetes is not a serious disease. This is not true at all. Diabetes is serious, but by making healthy lifestyle changes, and taking medicine, if needed, you can manage your diabetes and lead a healthy life. All people with diabetes should eat the right foods, stay at a healthy weight, and be physically active every day.

Q What is a complication?

A A complication is a condition or injury that happens as a result of a pre-existing chronic illness, such as diabetes. Common diabetes complications include:

  • Heart disease
  • Stroke
  • Eye problems, including blurred vision and blindness
  • Nerve damage
  • Amputation, usually of a foot or leg
  • Kidney problems
  • Gum disease
  • Tooth loss



Know your diabetes ABCs

When you are diagnosed with diabetes, you may hear or read the words “A1C,” “blood pressure,” and “cholesterol.” Understanding what these words mean can help you make good decisions about your health. Here’s what you need to know about diabetes ABCs:

A is for A1C: A1C is a blood test that measures your average blood glucose level over the previous 2-3 months. It is different from the blood glucose checks you do each day, because it can give you a bigger picture of how well your blood glucose is being controlled. If your A1C is too high, you may be more likely to have problems with your heart and blood vessels, kidneys, feet or eyes. The A1C goal for most people with diabetes is less than 7 percent. Ask your healthcare provider what your personal goal should be.

B for Blood pressure: Blood pressure is the force of your blood against the wall of your blood vessels. If your blood pressure gets too high, it makes your heart work too hard. This can cause heart attack, stroke, and kidney disease.

You should aim for a blood pressure of less than140/80 , unless your healthcare provider has set a different goal for you.

C for Cholesterol: There are two kinds of cholesterol in your blood: LDL and HDL. LDL, or “bad” cholesterol, can build up and clog your blood vessels. Over time, this can cause a heart attack or stroke. HDL, or “good” cholesterol, helps remove the “bad” cholesterol from your blood vessels and lowers your heart disease risk. Ask your healthcare provider what your cholesterol numbers should be.

How to reach your ABC goals

Your ABC goals will depend on how long you have had diabetes, if you have any other health problems, and how well-controlled your diabetes is. No matter where your health is right now, there are a few steps you can take to improve your ABC numbers.

Step 1: Learn how to cope with diabetes

It is common to feel overwhelmed, sad, or angry when you are living with diabetes. You may know the steps you should take to stay healthy, but have trouble sticking with your plan over time. But stress, whether it’s due to diabetes management, relationship troubles, or poor sleep, can raise your blood glucose.

Luckily, there are many ways to manage stress. Try deep breathing, gardening, taking a walk, meditating, working on a hobby, or listening to your favorite music. Remember that there is always someone who can help if you feel down. A mental health counselor, support group, religious leader, friend, online community or family member who will listen to your concerns may help you feel better.

Step 2: Eat well

Make a diabetes meal plan with help from your healthcare team. It’s best to choose foods that are low in unhealthy fats, sugar and salt. Try to eat foods that are high in fiber, such as whole grains and fresh fruits and vegetables.

Drink water instead of juice and regular soda, which can raise your blood glucose level.

When eating a meal, a helpful guide is to fill half of your plate with fruits and vegetables, one quarter with a lean protein (such as beans, fish or chicken), and one quarter with a whole grain like brown rice or whole-wheat pasta. You can find out more about the plate method on the MyPlate website.

Step 3: Be active

Set a goal to be more active most days of the week. You can start slowly by taking 10-minute walks, 3 times a day. You don’t have to do the full 30 minutes all at once. Twice a week, work to increase your muscle strength. Use stretch bands or hand weights, do yoga, heavy gardening (digging and planting with tools), or try push-ups. When you are stronger, you might be able to add in more activities, like swimming, hiking, dancing or cycling. Always ask your healthcare provider before trying a new activity to make sure it’s safe for you.

Step 4: Know what to do every day

It is much easier to manage your diabetes if you have a plan. Feel free to use this list as a reminder of the things you have to do each day to limit stress and complications.

  1. Take your diabetes (and any other) medicines exactly as your healthcare provider told you to, even when you feel fine.
  2. Check your feet every day for cuts, blisters, red spots, and swelling. Call your healthcare team right away about any sores that do not go away.
  3. Brush your teeth and floss every day to keep your mouth, teeth, and gums healthy.
  4. If you smoke, work on quitting. Your healthcare team will have resources to help you stop smoking; you just need to ask!
  5. Keep track of your blood glucose. You may want to check it one or more times a day. Keep a record of your blood glucose numbers. Bring your blood glucose numbers to your medical appointments.
  6. Check your blood pressure if your healthcare provider has said you should, and keep a record of the numbers. Bring your numbers to your medical appointments.

Step 5: Get routine care
Help Keep Your Heart Healthy by Keeping Your Blood Pressure on Track

See your healthcare team at least twice a year to find and treat any problems early. If you have a few different problems, ask a member of your team how often you should get them checked.

At each visit, be sure you have a:

  • Blood pressure check
  • Foot check
  • Weight check
  • Review of your self-care plan (above)

Two times each year, have an:

  • A1C test (may be checked more often if it is over 7)

Once each year, be sure you have a:

  • Cholesterol test
  • Triglyceride test
  • Complete foot exam
  • Dental exam (teeth and gums)
  • Dilated eye exam
  • Flu shot
  • Urine and blood test to check for kidney problems

At least once in your lifetime, get a:

  • Pneumonia shot
  • Hepatitis B shot


Medicare and diabetes

If you have Medicare, check to see how your plan covers diabetes care. Medicare covers some of the costs for:

  • Diabetes education
  • Diabetes supplies (such as glucose meters, test strips and syringes)
  • Diabetes medicine
  • Visits to a dietitian (to help you decide what foods to eat and manage your weight)
  • Special shoes, if you need them
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Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and www.NutritionStarringYOU.com. Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded NutritionBabes.com, a popular Health and Wellness website in 2009. NutritionBabes.com was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

Marlene Koch (pronounced ‘cook’) is a nationally recognized nutritionist, popular TV personality and New York Times bestselling author. She graduated Magna Cum Laude from UCLA with a Bachelor’s degree in Nutritional Science. She is a registered dietitian and one of a select group of dietitians to hold an advanced certificate in Child and Adolescent Weight Management from the Academy of Nutrition & Dietetics.

Marlene has taught professional chefs from the American Culinary Federation the principles of healthy cooking and eating. She has been adjunct Nutrition professor and cooking instructor for Columbus State College and the Columbus State Culinary Academy, and she is a nationally recognized expert in weight loss, diabetes, child and adolescent nutrition, and sugar substitutes.

Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

She has been interviewed and quoted in media outlets for WebMD, Atlanta Sports and Fitness, Georgia Public Broadcasting, and the Atlanta Journal and Constitution. She has partnered with V-103 Radio to lead supermarket tours as part of a community outreach during National Nutrition Month.

Cheryl helps her clients reach balance through lifestyle choices: cooking and eating, activity and purpose in life.

Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

OmnichannelHealth Media, publisher of DiabetesDigest.com, does not provide medical advice, diagnosis or treatment. See additional information.