What You Need to Know About Diabetes
Getting screened is easier than ever.Doctors used to rely on a fasting blood glucose test (which meant no eating for at least 8 hours) or a glucose tolerance test (which takes at least two hours and involves gulping down a terrible-tasting sugary drink). Blood sugar levels of 126 mg/dL or higher on either of these tests means you have diabetes.Photo: Anthony-Masterson/Getty Images
But now there's the A1C screening—a blood test that requires no fasting and gives a snapshot of your blood sugar levels over the previous 3 months. Doctors used to give the A1C only to people already diagnosed with diabetes to assess how they were managing the condition, says Richard M. Bergenstal, MD , president of medicine and science for the American Diabetes Association (ADA). However, earlier this year the ADA started recommending it to help with diagnosis because it's so convenient and reliable. In fact, it's better at catching pre-diabetes than a fasting blood test, since it's less affected by short-term changes in diet and exercise.
Newer meds can help patients lose weight.Ironically, some of the drugs used to treat type 2 diabetes cause weight gain, which only perpetuates the problem. But in the past five years several diabetes drugs have hit the market that promote weight loss, or at least prevent weight gain. These medications, including Byetta and Januvia, target hormones that help lower your blood sugar levels when they're too high, and may reduce your appetite. They tend to be most effective when you take them during the early stages of the disease or use them in combo with other diabetes medications.
The artificial pancreas is getting closer to reality.Many type 1 patients wear insulin pumps, which monitor blood sugar and eliminate the need for injections. But you still have to decide how much insulin to inject via the pump, and it's not easy: Some people try to keep their blood sugar from dropping too low (which can cause seizures and even death) by letting their blood sugar run high (which can lead to problems like nerve damage and blindness). The so-called artificial pancreas would change that by continuously monitoring blood sugar levels and automatically injecting the appropriate amount of insulin, says Aaron Kowalski, MD , PhD, research director of the Artificial Pancreas Project for the Juvenile Diabetes Research Foundation. Thanks to recent successful trials, it's now being tested at hospitals across the country. Learn more at artificialpancreasproject. com.
Who Should Get Screened?
Starting at age 45, everyone should get tested for type 2 diabetes. But ask your doctor whether you need to be screened earlier if one or more of these risk factors applies to you:
• A family history of diabetes
• Excess weight/obesity (a BM I of 25 or higher)
• HDL or "good" cholesterol under 35 mg/dL
• High blood pressure (140/90 mmHg or above)
• High triglycerides (over 200 mg/dL)
• Gestational diabetes during pregnancy
• Polycystic ovarian syndrome (PCOS)
Photo: Getty Images
Beyond Types 1 and 2
Until recently, everyone with diabetes was put into one of two categories. You either had type 1, an autoimmune condition in which your body doesn't produce insulin, a hormone that helps you use blood sugar, or you had type 2, the most common form, usually found in adults who tend to be overweight. But as many as 10 percent of people originally diagnosed with type 2 actually have a hybrid form, according to research from the National Institute of Diabetes and Digestive and Kidney Diseases. People with this condition, called type 1.5 or double diabetes, are insulin-resistant like type 2 diabetics (meaning the body can't properly use the insulin it produces), but they also have antibodies that show the body is attacking the pancreas (a sign of type 1), says Jerry Palmer, MD, director of the Diabetes Endocrinology Research Center at the University of Washington in Seattle.Photo: Thinkstock
If you've been diagnosed with type 2 but have an immediate family member with type 1, are thin, or are having trouble controlling your diabetes with oral meds, ask your doctor if you should be tested for type 1.5 (with a blood test). If you have it, your doctor may recommend starting you on insulin.
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