National Diabetes Awareness Month
November is National Diabetes Month, a time when communities across the country team up to bring attention to diabetes. This year’s focus is on prediabetes and preventing diabetes.
Prediabetes is a serious health condition where your blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. According to the CDC, more than 1 in 3 U.S. adults have prediabetes—that’s 88 million people—but the majority of people don’t know they have it.
It is also one of the most common chronic conditions in school-age youth in the United States. The National Institute of Diabetes and Digestive and Kidney Disease suggests that roughly 193,000 youth under age 20 have diabetes.
The good news is you can prevent or delay type 2 diabetes. Here are some tips to help manage prediabetes and prevent diabetes:
- Take small steps. Making changes to your lifestyle and daily habits can be hard, but you don’t have to change everything at once. It is okay to start small. Remember that setbacks are normal and do not mean you have failed—the key is to get back on track as soon as you can.
- Move more. Limit time spent sitting and try to get at least 30 minutes of physical activity, 5 days a week. Start slowly by breaking it up throughout the day.
- Choose healthier foods and drinks most of the time. Pick foods that are high in fiber and low in fat and sugar. Build a plate that includes a balance of vegetables, protein, and carbohydrates. Drink water instead of sweetened drinks.
- Lose weight, track it, and keep it off. You may be able to prevent or delay diabetes by losing 5 to 7 percent of your starting weight.
- Seek support. It is possible to reverse prediabetes. Making a plan, tracking your progress, and getting support from your health care professional and loved ones can help you make the necessary lifestyle changes.
- Stay up to date on vaccinations. The COVID-19 (booster shot, if eligible) and flu vaccines are especially important for people who may be more likely to get very sick from COVID-19 or the flu, such as people with diabetes.
Know your risk
There are many factors you can control. Prediabetes is a condition that can lead to type 2 diabetes and even heart disease. Your chances of having prediabetes go up if you:
- Are 45 or older
- Are Black, Hispanic/Latino, American Indian, Asian American or Pacific Islander
- Have a parent, brother or sister with diabetes
- Are overweight
- Are physically inactive
- Have high blood pressure or take medicine for high blood pressure
- Have low HDL cholesterol and/or high triglycerides
- Had diabetes during pregnancy
- Have been diagnosed with polycystic ovary syndrome
You may also take the American Diabetes Association’s 60-second risk test here.
Symptoms
The following symptoms of diabetes are typical. However, some people with diabetes have symptoms so mild that they go unnoticed. The common symptoms of diabetes are:
- Urinating often
- Feeling very thirsty
- Feeling very hungry—even though you are eating
- Extreme fatigue
- Blurry vision
- Cuts/bruises that are slow to heal
- Weight loss—even though you are eating more (type 1)
- Tingling, pain, or numbness in the hands/feet (type 2)
Early detection and treatment of diabetes can decrease the risk of developing complications of diabetes, which includes the following:
- DKA (ketoacidosis) & ketones
- Neuropathy
- Skin complications
- Eye complications
- Foot complications
- Kidney disease (nephropathy)
- Cardiovascular disease
- High blood pressure
- Stroke
Although there are many similarities between type 1 and type 2 diabetes, the cause of each is very different. And the treatment is usually quite different, too. Some people, especially adults who are newly diagnosed with type 1 diabetes, may have symptoms similar to type 2 diabetes and this overlap between types can be confusing.
Can symptoms appear suddenly?
In people with type 1 diabetes, the onset of symptoms can be very sudden, while in type 2 diabetes, they tend to come about more gradually, and sometimes there are no signs at all.
Symptoms sometimes occur after a viral illness. In some cases, a person may reach the point of diabetic ketoacidosis (DKA) before a type 1 diagnosis is made. DKA occurs when blood glucose is dangerously high and the body can't get nutrients into the cells because of the absence of insulin. The body then breaks down muscle and fat for energy, causing an accumulation of ketones in the blood and urine. Symptoms of DKA include a fruity odor on the breath, heavy, taxed breathing, and vomiting. If left untreated, DKA can result in stupor, unconsciousness, and even death.
People who have symptoms—of type 1 or of DKA—should contact their health care provider immediately for an accurate diagnosis. Keep in mind that these symptoms could signal other problems, too.
Some people with type 1 have a "honeymoon" period, a brief remission of symptoms while the pancreas is still secreting some insulin. The honeymoon phase usually occurs after someone has started taking insulin. A honeymoon can last as little as a week or even up to a year. But it’s important to know that the absence of symptoms doesn't mean the diabetes is gone. The pancreas will eventually be unable to secrete insulin, and, if untreated, the symptoms will return.
If you or someone you know is diagnosed with type 2 diabetes but isn’t responding well to the typical treatments for type 2 diabetes, it may be worth a visit to an endocrinologist to determine what type of diabetes is happening. Generally, this requires antibody tests and possibly the measurement of a C-peptide level.
Observing the National Awareness Month
No matter what age you are or what type of diabetes you have, investing in your health can not only help raise awareness but have a huge impact on preventing, managing, and living a full life with diabetes.
Below you'll find some simple, yet highly effective ways that you can invest in your health or that of a loved one.
Small Steps for Healthy Habits
Diabetes can be an overwhelming disease because there is so much to think about on a daily basis: Did you take your medicine? Is it time to check your blood sugar? What will you eat today? Did you exercise enough? Why is your blood sugar elevated? It's important to try not to get overwhelmed and manage one task at a time.
And if you need help, ask for it. Whether it be asking a family member to help with the kids while you prep dinner, calling a friend to go for a walk, or reaching out to a diabetes organization so that you can connect with someone in your situation, it's important to find support.
Eat more Plants
Higher intakes of vegetables, whole grains, legumes, and nuts have been associated with a substantially lower risk of insulin resistance and type 2 diabetes and improved glycemic control in either normal or insulin-resistant individuals.
A meta-analysis published in the Journal of Diabetes Investigation concluded that a higher intake of fruit, especially berries, and green leafy vegetables, yellow vegetables, cruciferous vegetables, or fiber from these sources is associated with a lower risk of type 2 diabetes.
A study published in 2020 in the British Medical Journal found that increasing vegetable intake by about half a cup per day can reduce the risk of type 2 diabetes by 25%. Other studies have shown a reduced rate of inflammation in people with type 1 diabetes who eat high-fiber diets (more than 30 grams daily).
Plant-based foods such as fruits, vegetables, nuts, whole grains, and seeds are rich sources of fiber.
Fiber can help reduce cholesterol, promote feelings of fullness, and prevent blood sugar excursions (highs and lows). If you don't eat many plants, aim to start slowly, one meal at a time.
Most adults should consume about 1.5 to 2 cups of fruit per day and 2 to 3 cups of vegetables per day, yet the Centers for Disease Control and Prevention (CDC) states that only 1 in 10 adults are eating enough.
Keep in mind, the number of servings will vary based on your age and activity level. Kids need to consume less than adults, for example.
Some tips for getting in more plants include:
- Add ½ to 1 cup serving of berries (strawberries, blueberries, blackberries, raspberries) to your oatmeal, toast, yogurt, or smoothie in the morning.
- Add 1 cup raw or ½ cup cooked vegetables such as broccoli, spinach, kale, squash, zucchini, or cauliflower to your salad, soup, or whole-grain wrap for lunch.
- Snack on an apple, pear, or citrus fruit with a tablespoon of nut butter or a handful of unsalted nuts. Or cut up some fresh crudité—raw carrots, peppers, celery, or broccoli—and pair it with a tablespoon or two of hummus or guacamole.
- Make one night a week meatless. Serve up some grain bowls using 1 cup of whole-grain such as quinoa, barley, bulgur, farro, or brown rice. Add your favorite vegetables, herbs, and seasonings.
- Swap your dessert with fresh fruit, such as 1 cup of melon or frozen berries.
Take Work Breaks
Many people began to work from home when the COVID-19 pandemic hit in 2020. You may find that eliminating your commute means you are spending more time sitting down and working. While your employer probably isn't complaining, too much sitting is not good for your health.
In fact, researchers have found that sedentary behavior (no matter what length of time) is particularly harmful to those people who do not participate in physical activity.
Experimental studies that mimicked sedentary behavior in a laboratory setting have also provided evidence of greater postprandial (after meal) glucose and insulin levels during bouts of prolonged sitting (i.e., seven hours) compared with individuals taking frequent standing or walking breaks.
As hard as it may be, aim to block out 30 minutes once a day for exercise, walking, or other physical activities. If it's just impossible to do this every day, try to do it a few times a week. Or you can aim to simply get out of your chair every 30 minutes to an hour to stretch and march in place. The key is to refrain from sitting for extended periods of time.
Find a Type of Exercise You Love
Exercise is a huge part of blood sugar management as well as overall health in people with diabetes and prediabetes. Most people have heard this already, but that doesn't always mean they are incorporating more exercise into their lives.
Oftentimes, the reluctance is time-related or due to the sheer fact that they haven't found something that they enjoy.
Now to make things more complicated, many gyms are functioning at reduced capacity, requiring those who show up to wear masks, and understandably some people may not be comfortable doing that. Now you really need to get creative, but perhaps this can help you engage in activities that you truly enjoy.
Sustainable healthy habits like exercise occur when you enjoy what you are doing. This month, encourage yourself to do something you truly love. Or even better, do something you love with someone you love.
Schedule exercise into your day as you would any other meeting. Consider going for a walk with a friend or pet before or after work, sign up for a virtual race in your community, or an on-demand exercise streaming service that offers fun classes like kickboxing.
If weather permits, go for or a family hike or bike ride, jump on the trampoline (if you have one), set up an obstacle course, play a game of tag, or turn on your favorite music and dance until you sweat.
Go to Sleep an Hour Earlier
There is epidemiologic evidence that shows an association between shorter sleep and the prevalence or incidence of diabetes mellitus and/or obesity. In fact, researchers have found higher rates of type 2 diabetes in individuals who get less than six hours of sleep.
National sleep guidelines advise that healthy adults need between seven and nine hours of sleep per night. People over 65 should also get seven to eight hours per night. Babies, young children, and teens need even more sleep to enable their growth and development.
It may seem impossible to get this much sleep, especially if you have to log on to work after getting your family to rest or if you work nights. But, don't be discouraged. This information is not meant to overwhelm or add another thing to your already explosive to-do list, rather to remind you or make you aware of how important sleep is.
Even if you can add one more hour to your nightly regimen, or 30 minutes at night and 30 minutes in the morning, you will reap the benefits. Set a goal for yourself to try to go to bed around the same time every night.
If you wake up in the morning feeling as if you need a ton of coffee to wake up or that you can go back to sleep in the next hour or so, odds are you are not getting enough sleep.
Make Mental Health a Priority
Life can be hard and stressful for anyone; adding diabetes to the mix and day-to-day life can be extremely overwhelming at times. According to the CDC, untreated mental health issues can make diabetes worse, and problems with diabetes can make mental health issues worse.
But fortunately if one gets better, the other tends to get better, too. It is estimated that people with diabetes are two to three times more likely to have depression than people without diabetes and that only 25% to 50% of people with diabetes who have depression get diagnosed and treated.
If you aren't feeling depressed, but are instead feeling burnt out from your own diabetes or taking care of a loved one, understand that it's OK to feel this way and that you need support. Getting support is important.
Consider calling your insurance (if applicable) to find out your options for a mental health professional, reach out to your healthcare team for advice, or reach out to a diabetes organization for support. Teaming up with someone else who knows what you are going through can make a world of difference.
Diabetes affects people of all ages, professions, races, and ethnicities. It is important to take the time to acknowledge diabetes and all of the factors that can influence the disease. During Diabetes Awareness Month, take the challenge of investing in small, simple changes that can heavily impact the health and well-being of yourself or your loved one. Regardless of what type of diabetes you have and what your journey with it has looked like, it is never too late to make some changes!
Sources:
https://www.niddk.nih.gov/health-information/community-health-outreach/national-diabetes-month
https://www.diabetes.org/risk-test
https://www.diabetes.org/diabetes-risk/tools-know-your-risk
https://www.diabetes.org/diabetes/complications
https://www.diabetes.org/diabetes/complications/dka-ketoacidosis-ketones
https://www.niddk.nih.gov/health-information/community-health-outreach/national-diabetes-month
https://www.verywellhealth.com/observe-national-diabetes-awareness-month-5083359#citation-2
https://www.verywellhealth.com/recommended-blood-glucose-levels-for-diabetes-1087681