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Ask a Doc: Diabetes Awareness

Healthy eating

Why should I worry about diabetes?

Diabetes is a serious disease that affects how your body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up our muscles and tissues and it’s also our brain’s main source of fuel. Insulin is made by the pancreas and transports glucose into our cells to use as an energy source.

If you do not have enough insulin, the glucose just floats around in your blood and your cells do not get the energy they need. The glucose spills into your urine as well. Over time, uncontrolled high blood sugar levels can damage blood vessels leading to injury of organs like your eyes, kidneys, heart and brain. In severe diabetes, the blood vessel damage decreases blood flow to your legs and feet and can lead to amputation due to poor flow and infections.

People with diabetes are at least twice as likely to have heart problems and strokes. Obesity is a national epidemic and often leads to insulin resistance and diabetes. Risk of diabetes is 93 times greater in obese people with BMI (Body Mass Index) above 35. The continuing rise in obesity in the US is driving a rise in diabetes as well.

What are the types of diabetes?

Type 2 accounts for 90 percent of diabetes and is caused by insulin deficiency and resistance. Many of these patients’ diabetes may be controlled with oral medications. Type 1 is caused by autoimmune destruction of the pancreatic beta cells, leading to absolute insulin deficiency and therefore, insulin injections are needed to control their disease. Type 1 diabetes symptoms tend to develop more rapidly and can be life-threatening if unrecognized and untreated. There are other types of diabetes like gestational diabetes that can cause similar symptoms.

Prediabetes is when blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes or need medications. Some people develop prediabetes as they age but never progress to needing medications. Prediabetes caused by insulin resistance and obesity can be treated with lifestyle changes to diet and physical activity and weight loss. You can have a huge impact in delaying – or even preventing – type 2 diabetes, but you may need to make major changes in your habits to lose weight. 

How can I tell if I’m at risk for diabetes or am prediabetic?

Look up your BMI to see if your body weight puts you at increased risk of diabetes. Obesity is the biggest risk factor you can control, but age, race, and family history also play a role. The chart below shows how similar the risks can be. That’s why it’s important to discuss your risks with your physician.

Diabetes Risk Chart

The American Diabetes Association has a good online risk tool. You answer a series of questions about yourself (or for a loved one), and your risk is calculated and explained. This risk assessment is not a replacement for talking to your doctor. And here’s a link to a reputable BMI calculator.

What are the symptoms of diabetes?

More than 34 million people in the U.S. have diabetes, and millions more are prediabetic and don’t even know it. A hemoglobin (Hgb) A1C blood test is usually done as part of an annual physical to look for prediabetes or diabetes. The A1C tells us the average glucose levels over the last 2-3 months. It is also used to monitor how well your diabetes treatment is working over the course of time. Your primary care doctor can order this for you and will help you understand the numbers and recommend a treatment plan. A finger stick glucose test gives a quick look but goes up and down quite a bit depending on what and when you ate; but it can be used to help type 1 diabetics manage the amount of insulin they need.

Below are the most common symptoms of diabetes.

Diabetes Symptoms Chart

What are some ways to manage diabetes?

Here are six things that can make a big difference in preventing and managing diabetes. These are also just plain good things all of us can do to be healthy.

  1. Exercise regularly, planning for 150 minutes a week
  2. Eat healthy
  3. Reduce stress
  4. Quit smoking
  5. Cut back on alcohol
  6. Take note of how you’re feeling – and be sure to follow up with your physician

Do you have a question for us? If so, please send questions to the Clinic at or to the Boca Beacon and we will answer them monthly.

About the Author

Dr. James joined the Clinic in March 2018 and serves as Medical Director of the Clinic. A graduate of Des Moines University College of Osteopathic Medicine, he completed his residency at Metropolitan Hospital in Grand Rapids, Michigan. He is board certified in emergency medicine and has been awarded fellowship status by the American College of […]

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