Chances are high you know someone who has diabetes. In 2017, over 30 million Americans, or almost 10 percent of the U.S. population, had diabetes. An additional 84 million Americans have prediabetes. One in three people likely have prediabetes. Let that sink in: one in three. Worse yet, 90 percent of those people don’t know they have prediabetes. If current trends continue, the prevalence of diabetes is projected to increase 100 percent for all U.S. adults ages 18-79 by 2050 (figures from the Centers for Medicare and Medicaid Services).
People who are born with or develop diabetes can be any age, weight, race or gender and in any type of health. The diabetes patients I see every day as the diabetes specialist at Valley View, include both auto-immune type, typically considered type 1, and insulin resistance type, type 2.
Diabetes Mellitus is a group of diseases occurring when the body’s insulin production can’t keep pace with its needs, either because the pancreas is damaged and can no longer make insulin or because the body doesn’t properly use the insulin that is present (resistance). Sometimes, it’s a combination of both. Either way, without enough insulin, the body can’t get glucose from your blood into the cells, leading to high blood sugar levels.
Type 1 diabetes, classically considered “juvenile diabetes,” afflicts at least 5 percent of people with diabetes. There are likely both genetic and environmental causes for type 1 diabetes, but lifestyle factors aren’t thought to play a significant role. Insulin therapy is required for this type of diabetes.
Type 2 diabetes starts as insulin resistance, meaning your body cannot use insulin sufficiently. When this happens, it stimulates your pancreas to produce more insulin until it can no longer keep up with demand. Insulin production decreases, which leads to high blood sugar. The exact cause of type 2 diabetes is unknown, but an elevated body weight, due to unhealthy dietary choices and inadequate physical activity, is the primary risk factor. The incidence of type 2 diabetes is rising dramatically. In the past decade alone, the prevalence of type 2 diabetes has increased by 157 percent, according to the Colorado Department of Public Health and Environment.
Prediabetes is really a golden opportunity. It’s a condition occurring prior to the formal onset of type 2 diabetes. It means that blood sugar levels are higher than normal but not yet high enough to be diagnosed as a type 2 diabetes, a threshold defined based on the likelihood of experiencing complications of diabetes later in life. Having prediabetes does not make type 2 diabetes inevitable. With aggressive lifestyle changes including healthy eating, exercise, weight loss and possibly medications, it’s possible to bring slightly higher blood sugar levels back into normal ranges. Prediabetes can be reversible.
In the past five years, the Centers for Medicaid and Medicare have acknowledged the significant results were achieved when prediabetic individuals had access to programs aimed at affecting the lifestyle changes necessary to get their blood glucose levels back into a normal range. Halting the progression of type 2 diabetes has the potential to save billions of dollars a year in diabetes-related health care costs. It is estimated that in 2016, Medicare spent $42 billion more on beneficiaries diagnosed with diabetes, then if those people did not have diabetes. Due to this cost savings, there are now many programs available to patients, most covered by insurance, that address the lifestyle changes necessary to prevent prediabetic individuals from crossing that threshold into a type 2 diabetes diagnosis.
Valley View, along with other area hospitals, offers diabetes self-management education programs for individuals who have been diagnosed with diabetes. Additionally, Valley View offers a CDC-recognized diabetes prevention program as well as a unique risk factor modification program to help those who have prediabetes or are at risk.
Without lifestyle changes, prediabetes poses a big risk of progressing to type 2 diabetes within 10 years. I encourage my patients to be active participants in their health, know their risk factors, and take the necessary actions to prevent type 2 diabetes.
Rob Nelson is a certified physician assistant and is board-certified in advanced diabetes management. He serves as the clinical supervisor of Valley View’s Health4Life diabetes programs. He sees patients in clinic at internal medicine at Valley View, including services for continuous glucose monitoring and insulin pumps. For more information, visit vvh.org/internal-medicine or call 970-384-6707.