News: CDC Says 21 Million Adults Have Type 2 Diabetes

An additional 1.3 million adults have type 1.

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By Patrick Sullivan

More than 30 million Americans have either type 1 or type 2 diabetes as of 2015, says the Centers for Disease Control and Prevention (CDC). That’s about five times the number of people who had diabetes in 1980. Additionally, more than one in three Americans have prediabetes—higher-than-normal blood sugar—which puts them at risk for developing type 2 diabetes within five years.

In March 2018, the CDC released a report breaking down those figures even further. An estimated 21 million adults are thought to have type 2 diabetes—about 8.6 percent of the US population over age 18. Approximately 1.3 million adults have type 1 diabetes, a comparatively small 0.55 percent of the adult population.

Diabetes is a serious condition that can potentially lead to heart trouble, kidney damage, blindness, loss of extremities or limbs and other disabling conditions. But with exercise, a healthy diet and the right medication, you can control your diabetes.

What's more, there's a growing consensus that weight loss could reverse type 2 diabetes for many—and it's increasingly backed by research. For example, one 2017 study published in British journal The Lancet looked at about 300 people diagnosed with type 2 diabetes in the previous six years. Half were placed on a low-calorie liquid diet for up to five months, followed by therapy and a gradual reintroduction of foods. After a year, they had lost an average of 22 pounds—and a whopping 46 percent had gone into remission. Only 4 percent of the control group, who used their usual diabetes treatment regimens, had similar success.

With that in mind, here’s what you need to know about diabetes, from diagnosis to treatment.

Type 1 or type 2?

2 / 9 Type 1 or type 2?

Sugar, or glucose, is what cells use for energy. It’s absorbed into the bloodstream as the digestive system breaks down nutrients in the food we eat. The pancreas makes a hormone called insulin, which carries your blood sugar to muscle, fat and liver cells. People develop diabetes when there’s not enough insulin to carry glucose from the blood to the cells, or when the cells become resistant to insulin.

In those with type 1 diabetes, the immune system destroys the insulin-producing cells in the pancreas, so either they don't produce enough insulin or they don't produce insulin at all. Type 2 diabetes occurs when the pancreas doesn’t make enough insulin, and generally develops during middle age.

Type 2 diabetes progression

3 / 9 Type 2 diabetes progression

About 95 percent of diabetics have type 2 diabetes. Type 2 diabetes starts with insulin resistance, or when your muscle, fat and liver cells can’t use insulin to bring in glucose as efficiently as they once could. Sugar starts to build up in the bloodstream as the pancreas tries to keep up by making more insulin.

As long as the pancreas can meet the demand for more insulin, you’ll have normal blood sugar levels. If it can’t keep up, glucose builds in the bloodstream, a condition called hyperglycemia. That’s prediabetes, and if it goes unchecked, it can eventually become type 2 diabetes.

Risk factors

4 / 9 Risk factors

Risk factors for type 2 diabetes include:

  • Being over age 45
  • Being of Native American, African American, Asian American, Latino/Hispanic American or Pacific Island descent
  • Having a body mass index (BMI) of 25 or more, unless you’re Asian American (23 or more) or of Pacific Island descent (26 or more)
  • A family history of diabetes
  • High blood pressure
  • High cholesterol
  • Low physical activity

5 / 9 Symptoms

Diabetes goes undiagnosed in more than one-quarter of people who have it because symptoms can be mild and easy to miss. Common symptoms include frequent urination, abnormal hunger or thirst, extreme fatigue, slow-to-heal cuts and bruises, blurry vision and tingling, pain or numbness in the hands or feet.

Diagnosis and testing

6 / 9 Diagnosis and testing

Diabetes is diagnosed with a blood test. The most commonly used tests are the A1C test, the fasting plasma glucose test and the oral glucose tolerance test.

Once you’ve been diagnosed with diabetes, it’s important to monitor your blood sugar with a handheld meter. Typical targets are an A1C reading of below 7 percent, a pre-meal blood sugar level of between 80 and 130 milligrams per deciliter (mg/dl) or post-meal at less than 180 mg/dl.


7 / 9 Complications

Heart disease is a common complication among people with diabetes. The CDC found that 71 percent of adults with diabetes also have high blood pressure, and 65 percent have high cholesterol. People with diabetes die from cardiovascular problems more often, and they’re hospitalized for heart attack and stroke more often, in part because high blood sugar levels damage blood vessels.

When small blood vessels are damaged, especially in the eyes and kidneys, blindness and kidney failure may result. Nerve damage is another complication that can lead to loss of sensation and severe wounds in the feet. In extreme cases, amputation may be necessary.


8 / 9 Medication

Type 2 diabetes was thought to be irreversible, though recent studies have shown weight loss to be effective for some.

The condition can be managed with medication. Most type 2 diabetes treatment programs start with a drug called metformin, which improves the body’s ability to use insulin.

If the blood sugar is still high after a few months, insulin injections or drugs like sulfonylureas—which increase your body’s insulin production—or thiazolidinediones, which increase insulin sensitivity, may be added to your treatment regimen.

Prevention and management tips

9 / 9 Prevention and management tips

Keeping weight down is one of the most important things people can do for their diabetes. Eating a healthy diet high in fiber, exercising, tracking carbohydrates and consuming sugar and alcohol in moderation may help control blood sugar levels.

Exercise not only helps maintain a healthy weight, but it can help control your blood glucose, too. When you’re active, your cells can use insulin more effectively. Your muscles also pull glucose out of the blood to use for energy during physical activity. The CDC recommends getting at least 150 minutes of moderate exercise per week.

This content was updated April 10, 2018.

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