Could You Have Diabetes and Not Know It? Here's How to Know

Here’s the problem with diabetes: Most people don’t start thinking about it until they’re diagnosed. And that’s too late, says Judith Fradkin, MD, diabetes, endocrinology and metabolic diseases director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a division of the National Institutes of Health. “This is a disease that develops over decades,” she says. Most people, Fradkin explains, have prediabetes for a long time before the disease becomes full-blown, and even then it progresses gradually. That leaves a big window in which to stop, slow or even reverse the disease.

Diabetes occurs when the pancreas doesn’t produce enough insulin to remove sugar from the bloodstream (or, in the case of Type 1 diabetes, any insulin at all). Excess blood sugar damages blood vessels and affects circulation, putting you at risk for a host of ailments, from heart attack and stroke to blindness, impotence and nerve damage.

“Poorly controlled diabetes is a recipe for disaster, because when you’ve got high levels of glucose circulating in your body, it really beats you up,” says American Diabetes Association spokesperson David Marrero, director of the Diabetes Translational Research Center at the Indiana University School of Medicine. “But well-controlled diabetes? It’s the leading cause of nothing,” says Marrero, who happens to have Type 1 diabetes himself. “There’s a lot of research to show that if you get good, close control of your glucose you can avoid many of the negative complications of diabetes.”

So, how do you find out your risk and do something about it? Doctors explain what you need to know, plus how to assess if you could have diabetes.

Understand Your Risks

Any “yes” answer increases your odds of developing diabetes.

• Are you over 40?

• Are you overweight?

• Are you sedentary?

• Do you have a family member with diabetes?

• Do you have high blood pressure?

• Did you develop gestational diabetes during a pregnancy?

Do a Lifestyle Check

Moderate changes can reduce your risk of diabetes between 58 and 71 percent, Marrero says.

Related: Best Apps for Diabetes

Your Weight

“We’re not talking about getting back to your prom-dress size. We now know that when people lose just 7 percent of their body weight, or on average 12 to 15 pounds, their
diabetes risk drops by approximately 60 to 70 percent,” Marrero says.

Your Blood Pressure and Cholesterol

Having too-high numbers raises your risk for Type 2 diabetes.

Your Sleep

Recent research uncovered a surprisingly strong connection between sleep loss and diabetes risk. The reason: Messing with your natural sleep-wake cycle disrupts the body’s circadian clock, which regulates metabolism, hormone levels and other important biological processes. This may contribute to obesity and Type 2 diabetes. Get at least seven to nine hours of sleep a night, and adopt the habit of going to sleep and waking up at approximately the same time each day. (Yes, even on weekends!) If you have sleep apnea, get help so you can get the sleep you need.

Related: How to Fix Your Sleep Schedule

Know How Diabetes is Diagnosed

There are three common tests for diabetes. Have you had one of these in the past year? If not, talk to your doctor.

Fasting Plasma Glucose Test

The FPG is the most common blood test for diabetes.

Prediabetes = 100–125 mg/dl

Diabetes = 126 mg/dl or higher

Related: 22 Celebrities with Diabetes

Oral Glucose Tolerance Test

The OGTT tests to see how your body processes sugar.

Prediabetes = 140–199 mg/dl
Diabetes = 200 mg/dl or higher

A1C Test

This blood test measures your average blood sugar over the past three months.

Prediabetes = 5.7–6.4 percent
Diabetes =  6.5 percent or higher

Other Signs You Could Have Diabetes

We spoke with one of the country’s leading diabetes experts, Dr. Judith Fradkin of the National Institutes of Health, about the increasing danger of Americans who don't know that they're at risk for Type 1 or Type 2 diabetes.

Why should people without symptoms be tested?

Type 2 diabetes, the most common form, is generally a silent disease. If you wait until you experience symptoms such as increased thirst or pain and tingling in your feet, you won’t benefit from steps that can prevent complications like retinal changes, which ophthalmologist can pick up on.

Who is at the highest risk?

Type 2 diabetes occurs more often with age, so everyone over 45 should be tested. Younger people should be tested if they have a family history of diabetes or belong to a racial or ethnic group that is at increased risk, including Hispanics, Native Americans and African-Americans. Women who have a history of gestational diabetes are at very high risk. Finally, obesity is a major risk factor.

Why is Type 2 diabetes showing up in so many young children?

Most young people who are getting Type 2 diabetes are extremely overweight. The longer you have diabetes, the greater your risk of complications, so these children are much more likely to develop potentially dangerous side effects.

Is there a link between diabetes and depression?

Depression raises your cortisol levels and makes you more insulin-resistant, so it can increase the risk of diabetes. At the same time, if you have diabetes and are depressed, you’re probably not going to take as good care of yourself. It’s important that people with diabetes be screened for depression and get treatment.

How is diabetes treatment improving?

We are getting much more information that enables doctors to individualize treatment. We’re looking at people’s genetic backgrounds and seeing how they might respond to different drugs. Hopefully, we will be able to have more individualized medicine in the near future, and that will help us all. The increase in Type 2 diabetes, which occurs mostly in adults, is largely due to the rise in obesity. But researchers are also studying the growing prevalence of Type 1 diabetes, which strikes children and young adults.

Here are 8 Things You Didn't Know About Diabetes.

Sources

• Judith Fradkin, MD, diabetes, endocrinology and metabolic diseases director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)