Did you know that more than 30 million people in the United States are now living with diabetes? That’s almost 1 in 10 of us — 9.4 percent of the U.S. population, to be exact. And millions more are at risk of diabetes.

Type 1 diabetes — sometimes called juvenile diabetes — accounts for just 5 percent of all diagnosed cases of the disease. That means the overwhelming majority of diabetes sufferers in America are Type 2.

For those who aren’t familiar with diabetes, the difference between Type 1 and Type 2 — in a nutshell — is that people with Type 1 diabetes don’t produce insulin, while people with Type 2 diabetes don’t respond to insulin as well as they should. Type 1 usually develops in children and young adults — for reasons medical researchers don’t fully understand — while Type 2 usually develops in older people. But there are varying shades of gray when it comes to diabetes, and the differences between the two subsets are becoming increasingly blurred. For example, some Type 2 diabetics will develop characteristics of Type 1 diabetes as their disease progresses and their damaged pancreas stops producing insulin. Older adults can occasionally develop Type 1 diabetes, and medical professionals are alarmed at how much earlier in life Type 2 diabetes is occurring.

The biggest differences in Type 1 and Type 2 diabetes are in the way symptoms manifest and the causes behind the disease. Type 1 diabetes, as it is currently understood by researchers, is largely unpreventable; it’s caused when the immune system attacks the body’s own cells and is believed to be due to a combination of genetic and environmental factors, such as exposure to viruses. Symptoms usually develop abruptly. Type 2 diabetes also has a genetic component and may be partially due to environmental factors, but several lifestyle factors are also known to contribute to developing the disease — such as obesity and inactivity. Symptoms typically develop slowly, over a period of years, and the disease may go unnoticed until complications develop.

In either case, Type 1 and Type 2 diabetes causes chronically high levels of blood glucose, which much be managed carefully to avoid complications.

Risks

The primary risk factor for Type 1 diabetes is a family history of the disease. If you have a parent or sibling with Type 1 diabetes, your risk for developing the disease increases. If both parents have Type 1 diabetes, the risk is even higher.

There are multiple risk factors for Type 2 diabetes. Traditionally, the disease has been thought of as one that impacts the middle-aged and elderly. But it’s occurring at younger and younger ages, and there are more than 5,000 children — under the age of 18 — in the U.S. who are diagnosed with Type 2 diabetes annually.

Still, age is a primary risk factor. If you’re age 45 or older, your risk for Type 2 diabetes goes up. Other risk factors include being overweight, a family history of diabetes, having high blood pressure, a low level of HDL or “good” cholesterol or a high level of triglycerides, being physically inactive, or having a history of heart disease or stroke. Race can also be a risk factor; African-Americans and Hispanics, for example, are more likely to develop Type 2 diabetes than caucasians.

Symptoms

Symptoms of diabetes include frequent urination, feeling very thirsty, feeling hungry even though you’re eating, fatigue, blurry vision, cuts or bruises that are slow to heal and unexplained weight loss. The weight loss primarily happens in people with Type 1 diabetes, though it can also be a symptom of uncontrolled Type 2 diabetes. Additionally, people with Type 2 diabetes may experience tingling, pain or numbness in their hands or feet.

A Costly Disease

In 2012, the estimated cost of diabetes in the U.S. was $245 billion — a cost that has increased since that time. The average medical expenditures for people with diagnosed diabetes are about $13,700 per year — about 2.3 times higher than people without diabetes.

That’s the toll to society. The toll to individuals who have been diagnosed with diabetes can be even greater. Uncontrolled, it is a deadly disease. In 2015, it was listed as the seventh leading cause of death in the United States.

Diabetes is also a leading cause of disability. Over time, chronic levels of high blood glucose can damage the body’s blood vessels and lead to problems with many different organs. Among the complications: kidney failure, heart disease, and blindness. Diabetes is also the leading cause of amputations among adults.

A Plan of Action

The good news is that long-term complications of diabetes — such as damage to the eyes or kidneys, or the diabetic neuropathy that leads to problems with the feet and legs — doesn’t happen overnight. Those issues take years to develop, which gives diabetics time to work with their doctor to develop a lifestyle management plan that is right for them.

Particularly in Type 1 diabetics but also in people with Type 2 diabetes, medication is the first step to control. Type 1 diabetics must inject insulin to replace the insulin their body is no longer producing. Medication for Type 2 diabetics usually begins as oral drugs aimed at combatting the body’s resistance to insulin. But many Type 2 diabetics eventually require insulin injections, as well.

For all diabetics, a healthy lifestyle is vital to controlling the disease. A proper diet — one that is low in calories, saturated fat, trans fat, sugar and salt, and one that is high in fiber — is the first place to start. Many diabetics develop a meal plan to help them keep their food intake in check. Physical activity is also important. Taking 10-minute walks three times a day is a good start, and exercise can be increased over time. Diabetics should also stop smoking.

Mental health is also important. Stress can cause blood glucose levels to increase, and depression is common among Type 2 diabetics. Take action to lower your stress — even something as simple as listening to music or going for a walk in the forest can help — and don’t be afraid to ask for help if you need it.

Finally, medical professionals recommend that people who have diabetes or are at risk for developing the disease see their doctor every six months for check-ups. Take prescribed medications regularly, check your feet regularly for cuts or blisters, and brush and floss daily.

This article is the November installment of Focus On: Health, presented by Brennan’s Foot & Ankle Care, Roark’s Pharmacy and Danny’s Drugs on the second week of each month as part of the Independent Herald’s Focus On series. A print version of this article can be found on Page A3 of the November 14, 2019 edition of the Independent Herald.