Type 2 diabetes and pre-diabetes (previously called “borderline diabetes”) are occurring in ever increasing numbers in the general population and more specifically in Native Americans.  Both conditions occur when the blood glucose (sugar level) is elevated. Both can cause significant damage such as blindness, kidney failure, amputations, heart attacks and strokes.  These conditions are very treatable if found early, so it’s very important that everyone who has diabetes know it and get proper treatment.
    •    Sometimes the high blood sugars will cause symptoms:
    •    blurred vision
    •    frequent urination (especially at night)
    •    increased thirst/hunger
    •    irritability
    •    fatigue
    •    slow healing cuts or infections
You should certainly be checked for diabetes if these symptoms are present. However many people with diabetes or pre-diabetes have no symptoms at all and can go for months or years before the diagnosis is made. Because of this, it’s also important to be screened if you have certain factors that are known to cause  increased risk.

These risk factors include:
Age 45 or older
Overweight (Body mass index 25 or higher)
Known diabetes in family members (a parent, child, brother or sister).
Certain ethnic backgrounds such as Native American, African American, Hispanic
Previous history of gestational diabetes (high blood sugar during pregnancy) or history of having large babies
High blood pressure
High triglycerides (one of the fats in blood)
Having polycystic ovary syndrome (PCOS).

There are three different ways to be screened for diabetes or pre-diabetes. Each test has its advantages and disadvantages depending on individual circumstances:

1. Fasting blood glucose.  Here a blood sample is drawn after you’ve gone without food overnight.
2. Oral glucose tolerance test (OGTT).  This test includes drinking a certain amount of sugar water (also after going without food overnight).  A blood test is drawn 2 hours later.
3. Hemoglobin A1c.  This test has been around for many years and is traditionally used to determine whether known diabetics are controlling their blood sugar.  It has only recently been found to be useful as a way to diagnose diabetes.  The test involves only a single blood level and can be done at any time and under any conditions.

Sometimes a friend or family member will check a finger-stick blood sugar and find it to be too high. In these cases, it’s always important to have one of the above tests to confirm the diagnosis.

If the test indicates diabetes, you should meet with your medical provider to begin appropriate changes in diet, activity and maybe start medications to control the high readings.  This will greatly lower the chances of developing complications (damage). If the test shows pre-diabetes, you can actually lower your risk of becoming diabetic in the future with these measures.

Finding the condition early is important and proper screening is the key.
The Diabetes Wellness Center can answer questions or provide further information.
Also the American Diabetes Association website at http://www.diabetes.org/ has useful information on this subject.