What is Diabetes Mellitus?

Diabetes mellitus is a group of diseases characterized by a consistently elevated blood sugar level.

The most common types of diabetes are known as Type 1 and Type 2:  

• Type 1 diabetes is an autoimmune disease that has to do with the body’s inability to produce insulin, the hormone responsible for controlling blood sugars.
• Type 2 diabetes, which accounts for up to 95 percent of cases, can be genetically passed or acquired and involves the body’s resistance to insulin.

How common is diabetes?

According to the Centers for Disease Control and Prevention (CDC) estimates, a staggering one in nine people – more than ten percent of the United States population – has diabetes. One in five people with diabetes do not know they have it.

At the same time, an additional three in ten people have what is known as prediabetes – a condition in which blood sugar is high, but not high enough to be diagnosed with type 2 diabetes.  It’s also important to note that diabetes was the eighth leading cause of death in the country in 2023.
 
According to the CDC’s National Diabetes Statistics Report for 2024: 

• there are an estimated 29.7 million people—or nearly nine percent of the U.S. population—living with diagnosed diabetes
• only about five percent of people with diabetes were estimated to have type 1 diabetes; the rest are type 2

What was interesting in the study from a preventive medicine perspective is that an estimated 38 percent of U.S. adults age 18 years or older (97 million people) had prediabetes in 2021, based on their fasting glucose or A1C level. We try to screen people early on for prediabetes, a potentially reversible condition through preventive medicine.

What causes diabetes?

There are many contributing factors to type 2 diabetes.

Diabetes occurs when the body becomes resistant to insulin and/or when insulin production is compromised.  Genetics plays a part as do other factors, such as obesity and dietary habits.

Think about it this way: when people gain weight and have more cells in their bodies, they will need more insulin to reach these cells and get glucose into them instead of leaving it circulating in the bloodstream.

Are there risk factors that contribute to diabetes?

There are many risk factors associated with an increased risk of diabetes. These are some of the most common ones:

• Family history:  If a parent or a sibling has diabetes, you are at a higher risk of developing diabetes.
• Ethnicity: If you are African American, Hispanic, Indian American or Asian American, you might be at a higher risk.
• Obesity/fat distribution in the body: More fatty tissue means more cells are likely to be insulin resistant.
• Alcohol consumption. Heavy alcohol consumption has been associated with increased risk for diabetes.
• Exercise: The less active you are, the more likely you will have elevated blood sugars as your body uses less blood glucose, while weight gain from lack of exercise can also lead to insulin resistance.
• Smoking: Tobacco use is associated with increased blood sugar levels and insulin resistance. Smokers are much more likely to develop diabetes than nonsmokers. People with diabetes who smoke have a more difficult time controlling their blood sugar levels and are at a higher risk for serious health problems like heart or kidney disease.
• High blood pressure or high lipids in the blood: Having elevated blood pressure and elevated cholesterol levels has been linked to an increased risk of diabetes type 2.

How is diabetes treated?

Treatment for type 2 diabetes depends on a patient’s baseline A1c levels and risk factor modification. That means things like a healthier diet, losing weight, quitting smoking and cutting back on alcohol consumption can all impact your condition. Because of that, we usually start by recommending these lifestyle changes, but sometimes it is necessary to start directly with medication, usually oral.

Type 1 diabetes and some advanced cases of type 2 diabetes are treated with injectable insulin.

The dangers of diabetes

Diabetes is a very serious condition, especially if not properly managed.  It is a leading cause of death worldwide and can have significant complications that affect all organs. It is associated with an increased risk of heart attacks, strokes and kidney disease.

It can affect:

• the nerves, increasing your risk to develop a condition known as neuropathy
• the skin, as uncontrolled diabetes can cause decreased circulation which can lead to poor wound healing
• the eyes, increasing your risk for retinopathy, cataract and glaucoma
• blood vessels, increasing your risk for developing peripheral vascular disease

If left untreated, diabetes can cause metabolic disturbances like diabetic ketoacidosis, a serious condition that requires a intensive care hospital admission. In addition, severe long-term consequences can lead to limb amputation, blindness, cerebrovascular disease, renal impairment and cardiovascular disease.

Managing diabetes

Nutrition and physical activity are key to managing diabetes. In fact, lifestyle changes are some of the best ways to do so. It is also important to regularly monitor your blood sugar levels and continue to see your doctor as recommended.

Type 1 diabetes is a lifelong condition. However, for people with prediabetes, and some cases of type 2 diabetes, the condition may be reversed or well-controlled with risk factor modification and adoption of a healthier lifestyle.

If you haven’t been diagnosed yet, adopting healthy habits like eating a balanced diet, exercising regularly, and avoiding smoking or vaping are the best actions you can take for both your short-term and long-term health. 

If you have additional questions or concerns about your risk for developing diabetes, speak with your primary care provider.