Diabetes Response
Diabetes
Diabetes is a condition that occurs when your blood glucose, commonly referred to as blood sugar, is too high. Glucose serves as the body’s primary source of energy and comes from two main sources: the liver and the food we eat. When we consume food, sugar is absorbed into the bloodstream, where it enters the cells with the assistance of insulin. Additionally, the liver stores glucose in the form of glycogen. When blood glucose levels drop, the liver can break down this stored glycogen to release glucose into the bloodstream. Having diabetes increases the risk of damage to various organs, including the eyes, kidneys, nerves, and heart. It has also been associated with certain types of cancer.
WHY Diabetes?
Diabetes has a disproportionate impact on minority populations in the United States. In 2019, 14.7% of the general adult population had diabetes. However, the rates were higher among specific groups: American Indians/Alaska Natives had a rate of 14.5%, non-Hispanic Blacks had 12.1%, and Hispanics had 11.8%. In contrast, lower rates were observed among non-Hispanic Asians at 9.5% and non-Hispanic Whites at 7.4%.
The prevalence of diagnosed diabetes in the U.S. is expected to rise from 22.3 million (9.1% of the total population) in 2014 to 39.7 million (13%) by 2030, and 60.6 million (17%) by 2060.
In Georgia, the prevalence of diabetes has risen from 9.7% in 2006 to 11.7% in 2018.
Type 2 Diabetes (T2D) ranks as the eighth leading cause of death among adults and costs Georgia approximately $11 billion annually.
Individuals with diabetes face a variety of complications, such as diabetic retinopathy, nephropathy, neuropathy, cardiovascular disease, amputations, and increased risk of premature death.
Pre-diabetes
Pre-diabetes is a condition characterized by elevated blood sugar levels that aren’t high enough for a type 2 diabetes diagnosis, increasing the risk of developing type 2 diabetes and heart disease. Factors such as family history, excess weight, inactivity, age, and certain health conditions contribute to the risk.
Over 133 million Americans have diabetes or prediabetes, with around 96 million (38% of U.S. adults) affected, many of whom are unaware of their status, particularly in minority populations. Georgia CEAL works to educate and empower these communities for improved health support.
Gestational Diabetes
Gestational diabetes occurs during pregnancy and typically resolves after childbirth. Women at average risk are screened in the second trimester (24 to 28 weeks). Risk factors include being overweight, inactive, having prediabetes or a family history of diabetes, belonging to certain racial/ethnic groups, a previous diagnosis of gestational diabetes, or delivering a baby over 9 pounds. Complications for the baby can include excessive birth weight, preterm birth, breathing issues, low blood sugar, and long-term obesity or type 2 diabetes. Mothers may face complications such as high blood pressure, preeclampsia, C-sections, or future diabetes.
Type 1 Diabetes
Type 1 diabetes occurs when the immune system attacks and destroys insulin-producing cells in the pancreas, resulting in little or no insulin production. It is often diagnosed in children and young adults but can develop at any age. The condition may be linked to genetic factors and certain viruses.
Symptoms include frequent thirst and urination, bed-wetting in previously dry children, increased hunger, weight loss, irritability, fatigue, and blurry vision. Risk factors encompass family history, genetics, geography, and age.
Type 1 diabetes can lead to complications affecting the heart, blood vessels, nerves, eyes, and kidneys. Currently, there are no prevention methods, but those diagnosed may explore participation in clinical trials.
Type 2 Diabetes
Type 2 diabetes occurs when the body improperly uses insulin, resulting in abnormal blood glucose levels. It is primarily caused by insulin resistance or insufficient insulin production. Symptoms include increased thirst, urination, hunger, weight loss, fatigue, blurred vision, and slow-healing sores.
Common Risk Factors
How Excess Weight Increases the Risk of Prediabetes
Being overweight, especially with abdominal fat, is a significant risk factor for prediabetes—a condition where blood sugar levels are elevated but not yet high enough to be diagnosed as Type 2 diabetes. If left unaddressed, prediabetes can progress to Type 2 diabetes.
Key Ways Excess Weight Contributes to Prediabetes:
1. Insulin Resistance: Extra fat, particularly in the abdomen, disrupts insulin’s effectiveness, leading to insulin resistance. This causes glucose to build up in the bloodstream rather than being used for energy.
2. Chronic Inflammation: Visceral fat triggers low-grade inflammation that can damage insulin-producing cells and worsen insulin resistance, raising blood sugar levels.
3. Increased Fatty Acids: Higher levels of free fatty acids in the blood can block insulin signaling and impair the pancreas’s ability to produce insulin, increasing the risk of prediabetes.
Why This Matters:
Prediabetes often shows no symptoms but is a crucial opportunity for intervention.
- Losing 5-7% of body weight can significantly improve insulin sensitivity and reverse prediabetes.
- If untreated, prediabetes can lead to serious health issues like Type 2 diabetes, heart disease, and stroke.
How Inactivity Increases the Risk of Prediabetes
A sedentary lifestyle is a major risk factor for prediabetes. Without regular activity, the body struggles to manage blood sugar, leading to insulin resistance. Here are the key ways inactivity contributes to prediabetes and what you can do about it:
1. Reduced Insulin Sensitivity
Inactive muscles lose sensitivity to insulin, requiring the body to produce more insulin to keep blood sugar levels normal, ultimately leading to insulin resistance.
2. Weight Gain
Sedentary behavior often causes weight gain, particularly around the belly, which is linked to insulin resistance. Regular exercise helps manage weight and reduce abdominal fat.
3. Less Glucose Uptake by Muscles
Exercise helps muscles absorb glucose, regulating blood sugar. Inactivity can cause blood sugar levels to rise, increasing the risk of prediabetes.
4. Increased Fat Build-Up
Lack of activity leads to fat accumulation in organs, worsening insulin resistance. Regular exercise helps burn this fat and improve insulin sensitivity.
5. Poor Blood Sugar Control
Physical activity regulates blood sugar, while inactivity can lead to spikes after meals, putting strain on insulin response.
6. Worsening of Other Health Conditions
Inactivity raises the risk of high blood pressure, cholesterol, and obesity, all part of metabolic syndrome. This increases the likelihood of developing Type 2 diabetes.
The Good News: Physical Activity Can Reverse Prediabetes
Active individuals have a 30–50% lower risk of developing Type 2 diabetes. Moderate exercise, like brisk walking for 30 minutes a day, can lower blood sugar and improve insulin sensitivity.
How Aging Increases the Risk of Prediabetes
As we age, the risk of prediabetes rises, characterized by elevated blood sugar levels that aren’t yet high enough for a diabetes diagnosis. Here are the key factors linking aging to prediabetes:
1. Decline in Insulin Sensitivity
Aging leads to insulin resistance, where cells become less responsive to insulin, causing higher blood sugar levels.
2. Slowed Pancreatic Function
The pancreas produces less insulin with age. Reduced insulin output makes it harder to control blood sugar levels.
3. Body Composition Changes
Muscle mass typically decreases while fat, especially around the abdomen, increases, leading to higher blood sugar levels and more insulin resistance.
4. Slower Metabolism
A slower metabolism can lead to weight gain, particularly around the middle, which is a significant risk for prediabetes.
5. Reduced Physical Activity
Inactivity, common in older age, decreases insulin sensitivity and contributes to weight gain, further raising blood sugar levels.
6. Increased Risk of Other Conditions
Aging increases the risk of high blood pressure and cholesterol, contributing to metabolic syndrome, which raises prediabetes risk.
What Can Help?
To reduce the risk of prediabetes while aging, consider the following:
- Stay Active: Aim for 150 minutes of moderate exercise weekly and include strength training.
- Eat Well: Focus on whole foods, limit sugars and processed foods to stabilize blood sugar.
- Maintain a Healthy Weight: Losing just 5-7% of body weight can improve insulin sensitivity.
- Get Regular Check-Ups: Regular blood sugar testing aids early detection and intervention.
How Family History Increases the Risk of Pre-diabetes
Family history plays a significant role in increasing your risk of prediabetes, especially if Type 2 diabetes runs in your family. While you can’t change your genes, understanding your risk empowers you to take preventive measures early. Prediabetes often signals potential progression to diabetes, but it can be reversed with timely action.
1. Genetic Predisposition
A family history of Type 2 diabetes in close relatives considerably raises your risk, as genetics can influence insulin production and function.
2. Inherited Insulin Resistance
Some people inherit a tendency toward insulin resistance, leading to elevated blood sugar levels over time, often without noticeable symptoms.
3. Shared Family Lifestyles
Families tend to share dietary and activity habits, with unhealthy eating and sedentary lifestyles increasing the risk of prediabetes, especially with a genetic predisposition.
4. Increased Risk Regardless of Health
Even individuals with healthy lifestyles may face higher risks if they have a family history of diabetes. However, maintaining healthy habits can delay or prevent the onset of Type 2 diabetes.
Increased Risk Factors
Having one parent with Type 2 diabetes raises your risk by 2-3 times while having both parents can increase it up to 6 times.
Ethnicity and Genetic Risk
Certain ethnic groups, including African American, Hispanic/Latino, Native American, Asian American, and Pacific Islander populations, face even greater risks, making early screening crucial.
Genetic Insights
Researchers have identified various genes associated with diabetes risk affecting insulin production, sugar processing, and fat storage.
Early Detection
Proactive measures are essential since prediabetes often shows no symptoms. To mitigate your risk:
- Monitor your blood sugar regularly.
- Get screened earlier, especially if diabetes runs in your family.
- Watch for signs like increased thirst, fatigue, and frequent urination.
Symptoms
Increased Thirst
Frequent Urination
Fatigue or Low Energy
Blurred Vision
Increased Hunger
Slow Healing of Cuts
and Wounds
Dark Patches of Skin
Tingling or Numbness
in Hands or Feet
Frequent Infections
But Here’s the Truth: Many People with Prediabetes Have No Symptoms at All
Most people with prediabetes won’t notice these signs—until they develop Type 2 diabetes. That’s why it’s important to:
✅ Get regular blood sugar screenings (especially if you’re 45+ or have risk factors like family history or excess weight)
✅ Pay attention to any subtle changes in your body
✅ Take action before symptoms appear
INTERVENTION AND RESEARCH PROGRAMS
Georgia CEAL RESTORES proposes a Community-Based Participatory Research (CBPR) approach designed to prevent chronic disease development, address mental health, and advance Social Determinants of Health (SDOH) policy and support in our communities. To address the problem of Type 2 Diabetes (T2D) in these communities, we propose a pilot study in four counties Bibb, Houston, DeKalb and Fulton.
The goals of this initiative are to:
1) Reduce type 2 diabetes (T2D) risk among parents and children (i.e., individual and interpersonal levels).
2) Support mental health in communities through Mental Health First Aid training for adults (MHFA-Y) (i.e., interpersonal and organizational/community levels).
3) Positively advance community-level SDOH determinants of diabetes prevention and other health issues through policy and support training, capacity building, and mobilization.
Families from the four counties will be recruited to curriculum based sessions that will include the following six components: 1) strategies for monitoring food intake and reducing calories; 2) identifying and controlling both personal and social cues for unhealthy eating behaviors; 3) the role of stress in unhealthy eating and relapse prevention; 4) strategies for monitoring and improving physical activity and sedentary behaviors; 5) strategies to improve family support and cohesion; and 6) MHFA-Y for parents.