Diagnosis Of Type 2 Diabetes
Diagnosis of diabetes is made by a doctor, and is based on a blood test known as the Hemoglobin A1C. According to the United States Department of Health and Human Services, lab analysis of blood is required to ensure accurate results.
While glucose-measuring devices (finger stick tests pictured on the left) either used at home or at the doctor’s office can be used to track and manage blood glucose on a regular basis, they are not accurate enough for diagnosis.
The A1C became the standard test for the diagnosis of this disease and prediabetes in 2009 and is reported as a percentage:
- Normal reading is below 5.7%
- 7% to 6.4% indicates prediabetes, and those with a reading above 6.0% are considered at a very high risk of developing type 2 diabetes
- Any reading over 6.5% means a person has the disease
Risk Factors For Type 2 Diabetes
Anyone can get type 2 diabetes, but certain high risk factors exist:
- People age 45 and older
- Those who are obese or overweight with a BMI or 35 or more
- Those who have had gestational diabetes
- When it runs in the family
- Those who have been diagnosed with pre-diabetes
- Poor lifestyle choices, like unhealthy diet and lack of exercise
- Those who have low HDL (good) cholesterol or high triglycerides
- Those who have high blood pressure
- African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders are at higher risk for contracting this disease
Diabetes can occur at any age. The numbers below as reported by the American Diabetes Association, the Diabetes Prevention Program and other government authorities show the staggering prevalence of diabetes, and specifically the preventable type 2 diabetes which accounts for most of the cases in the United States.
- 1 million adults in the United States have diabetes, of those 90% to 95% are diagnosed with type 2. This equates to 1 in 10 adults age 20 to 64.
- Diabetes incidence increases with age. About 26% of people 65 years of age or older have diabetes, this equates to 1 in 4 senior adults.
- Of the 29 million diabetics, only 21 million have been diagnosed and 8 million remain undiagnosed and have no idea they have the disease.
- 1 out of 3 babies born in 2000 will develop diabetes.
- 86 million people age 20 years had prediabetes in 2012. That’s up from 79 million in 2010. Pre-diabetes is the occurrence of insulin resistance and mildly elevated levels of blood sugar but not enough to meet the criteria for diabetes. If a person who is diagnosed with pre-diabetes continues an unhealthy lifestyle that promotes it, they can easily tip the scales toward the diagnosis of diabetes.
- It is the 7th leading cause of death in the U.S. Diabetes alone is the cause of death in about 69,000 people per year. It is listed as a contributing factor toward death in another 234,000 death certificates.
- The incidence of diabetes varies among different ethnic groups. It makes up 7.6% of the population in Caucasians and 9% of the Asian population. The rates are higher in non-Hispanic blacks at 13.2% and American Indians or Alaskan natives at 15.9%.
- 2% of pregnancies are diagnosed with gestational diabetes. Women who develop this disease during pregnancy have a 35% to 60% chance of developing type 2 diabetes within 10 to 20 years following the pregnancy.
- Diagnosed cases of diabetes cost the United States an estimated $245 billion in 2012, and the figure is only expected to rise.
Health Consequences Of Diabetes
Regardless of the type you have, the result is high circulating blood sugars. Elevated blood sugars are not healthy for the organs and blood vessels of the body. The phenomenon of high blood sugar causes blockages of the tiny and large blood vessels of the body, damaging organs and causing several possible complications.
Heart Disease And Stroke
Diabetics die not because of simple high blood sugar, but because of heart disease or stroke. According to the World Health Organization, 50% of diabetics die from heart disease or stroke. Studies have shown that 71% of adult diabetics also have hypertension.
This disease is often associated with high cholesterol and triglycerides, which promote the formation of plaques on the walls of the arteries. These plaques begin to grow and restrict blood flow, especially to the brain and in the small vessels supplying the circulation to the heart. With enough blockage, the heart, or brain do not get enough oxygen and parts of these organs die off. If enough of the heart or brain dies off, the person dies of either a stroke of the brain or a heart attack.
Excess blood sugar spills out into the urine, which overloads the kidneys. If the kidneys become overworked from too much blood sugar, kidney failure can happen. It can also affect the blood vessels of the kidney so that the kidney does not get enough circulation. When the kidneys fail, excess fluid develops in the body and the kidneys cannot catch up. If the kidneys cannot do the job of getting rid of the waste products of the body, the toxins build up and the individual will need a kidney transplant or permanent kidney dialysis. Kidney failure can be a cause of death in diabetics, and 44% of all kidney failures in 2011 were the result of diabetes.
This disease can cause blindness by causing the tiny vessels of the retina or back of the eye to rupture and spill blood across the retinal surface; this condition is called diabetic retinopathy and leads to blind spots in vision and eventually to total blindness. Doctors have ways of coagulating the blood in the vessels using a laser; however, this does not cure the underlying process and blindness is simply delayed unless the diabetic gets the blood sugars under control. According to the National Eye Institute, 7,686 cases of diabetic retinopathy were diagnosed in 2010 that number is up from 2,063 in the year 2000. Diabetic retinopathy is the leading cause of blindness in adults age 20 to 74.
Peripheral Vascular Disease
Diabetics risk a loss of limbs, particularly the lower extremities. It can come from plaque build-up in the large arteries supplying the leg or in the smaller vessels, such as in the feet. If the blockage is significant, gangrene of the feet and legs can occur so that the gangrenous part needs to be amputated. According to the Centers For Disease Control, 60% of all non-traumatic amputations of lower limbs occur in people with diabetes due to nerve damage. This can severely limit the diabetic’s mobility and may confine them to a wheel chair.
High blood sugar damages the peripheral nerves of the body. It begins with burning or tingling of the feet and progresses to similar feelings in the hands. The feet or hands can feel cold or very painful. Isolated nerves elsewhere in the body can become inflamed by high blood sugar and the situation can become extremely painful. There are medications that can control some of the symptoms but it is also a good idea to have the diabetes in better control so that the nerves have a chance to recover.
Diabetics have two times the risk of death from any cause as compared to people of the same age without diabetes.
Healthy diet and exercise can reduce the risk for type 2 diabetes by 58% in those ages 59 or younger and by 71% in those ages 60 or older. Just a 5% to 7% percent loss in bodyweight can prevent and delay onset of type 2 diabetes indefinitely.