November is National Diabetes Month, a good time to learn more about this growing problem. The Centers for Disease Control reports that 9.4% of the adult U.S. population, or 30.3 million people, have diabetes in 2017. Of those, 23.8%, or 7.2 million, have not yet been diagnosed. Common symptoms include frequent urination, blurry vision, increased appetite, rapid weight loss, dry itchy skin, slow healing, yeast infections, fatigue, and numb or tingling fingers or toes.
Because diabetes can be found even before it causes symptoms, screening is very important when risk factors exist. Risk factors include family history of diabetes, poor diet, abdominal obesity, older age, physical inactivity, and certain ethnicities (African American, Hispanic, Native American, Asian American). Testing simply requires an order from one’s primary care physician. Screening fasting glucose ≥126, hemoglobin A1c ≥6.5%, 2-hour glucose tolerance test ≥200, or random glucose ≥200 along with characteristic symptoms of diabetes can make the diagnosis, once confirmed by a second test.
Diabetes is the leading cause of blindness, nontraumatic amputations, and kidney failure. The sooner diabetes is controlled, the less likely one will develop complications. Adequate control would be an average glucose level below 110 fasting or below 140 two hours after meals. Fortunately there have been many breakthroughs in controlling diabetes. Treatment can be provided by primary care physicians, with referral to an endocrinologist if control is not achieved within 6-12 months.
Dr. Hoffman is a Fellow of the American College of Endocrinology at Newton Medical Center. He specializes in Diabetes & Endocrinology.