Written by Jeff Dai, PharmD Candidate; Tanya H. Khamis, PharmD Candidate; David Q. Pham, PharmD, BCPS, CDE Jeff Dai and Tanya Khamis are from Western University of Health Sciences, College of Pharmacy in Pomona, California. Dr. David Pham is an Associate Professor of Pharmacy Practice at Western University of Health Sciences as well as a Diabetes Pharmacist at the Mary and Dick Allen Diabetes Center.
Diabetes is a chronic disease in which glucose in the blood is consistently elevated. Recent data reports that 29.1 million people in the U.S. currently have diabetes, of which 8.1 million are undiagnosed.1 Statistically it is estimated that there will be a 165% increase in newly diagnosed patients with diabetes from 2000 to 2050.2 By being aware of the risk factors of the disease it may be possible to prevent or delay the onset of diabetes.
There are three major classifications of diabetes: type 1, type 2, and gestational diabetes (GDM). Type 1 diabetes occurs due to a lack of insulin caused by an autoimmune process that destroys insulin producing cells in the pancreas. Unfortunately, there is not much that can be done to prevent this type of diabetes.
Type 2 diabetes can be prevented. Type 2 diabetes occurs when the insulin that is being made by the pancreas is resistant or less effective. There are two categories of risk factors; those that are modifiable and those that are not. Non-modifiable risk factors for type 2 diabetes include: first degree relative with diabetes and high risk ethnicities such as Native Americans, African Americans, Pacific Islanders, Hispanics, and Asians. Modifiable risk factors include a high BMI (body mass index), cigarette smoking, high blood pressure, and high cholesterol levels.
Achieving a healthy body weight through exercise and diet has been shown to lower type 2 diabetes risks by up to 58% in high risk populations.3 A healthy body weight is considered to be a BMI of 18.5 – 24.9 kg/m2. Moderate weight loss through weekly exercise and engaging in dietary strategies revolving around reducing both caloric intake and consumption of dietary fat can reduce the risk of developing diabetes. Physical activity has been shown to increase insulin sensitivity and the American Diabetes Association recommends 30 minutes of exercise 5 times a week.3
GDM is defined as glucose intolerance during the course of pregnancy. Factors that put mothers at risk for GDM include: older than 25 years of age, overweight (BMI > 25 kg/m2), previous GDM, previous newborn over 9 lbs., diabetes in first-degree relatives, stillbirth in previous pregnancy, and lastly high risk ethnicities similar to type 2 diabetes. As with type 2 diabetes, reducing the risk of GDM may be achieved through exercise, diet, and early detection.
Screening for diabetes, specifically with a routine blood test, is suggested at least every 3 years in patients with any of the risk factors listed above. Early detection can help delay the complications of diabetes. A fasting blood glucose reading above 100 mg/dl should be discussed with your clinician. While diabetes is generally considered a silent disease, signs of high blood glucose such as increased thirst, hunger, or urination should trigger people to get their sugar tested and/or see their primary care provider.
Prevention is possible with type 2 diabetes. Early detection is key to delaying any complications. In addition, engaging in a healthy lifestyle through diet and exercise has been shown to reduce the risk of developing the disease.
References
- Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services; 2014.
- Boyle, James P., et al. “Projection of Diabetes Burden Through 2050.” Diabetes Care 24:1936–1940, 2001.
- American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care. 2014;37(suppl 1):S14-S80
