Q&A: Preventing and Managing Diabetes

More than 38 million Americans are living with diabetes, with 8.5 million of these individuals believed to be undiagnosed. In addition, 38 percent of the United States adult population is estimated to have prediabetes, a serious condition that increases the risk of developing type 2 diabetes, heart disease, and stroke.

November is observed as American Diabetes Month, a time when communities and health experts across the country seek to bring attention to diabetes. In recognition of this year’s theme, Take Charge of Tomorrow: Preventing Diabetes Health Problems, obesity medicine expert Eleanor Yusupov, D.O., assistant professor of clinical specialties at the College of Osteopathic Medicine (NYITCOM), shares insight on early symptoms, warns against disease implications, and dispels common diabetes misconceptions.

What early symptoms might someone with diabetes experience? 
In the early stages, someone may not experience any symptoms, or they can be mild. Because of the lack of symptoms, diabetes diagnosis may be delayed or even missed for many years.

Excessive thirst and hunger, frequent urination, blurred vision, and feeling tired are symptoms that can be experienced by individuals with both type 1 and type 2 diabetes. Individuals with type 1 diabetes are usually children or adolescents, while those diagnosed with type 2 diabetes are typically middle-aged and older adults. In addition, individuals with type 1 diabetes may experience sudden significant weight loss, but type 2 diabetes is usually associated with weight gain or obesity.

What are the complications of high blood sugar levels?
There are many complications that can develop over time, such as heart disease, stroke, kidney problems, decreased vision, nerve damage, and many others. Due to the nerve damage that occurs over time, people with diabetes can develop foot ulcers. Individuals with diabetes are also at higher risk for complications from many infections, including COVID-19.

If left untreated, very high blood sugar can be extremely dangerous and cause severe complications, even coma and death. The risk of diabetes complications can be lowered by taking medications to control blood sugar, eating healthier foods, becoming more physically active, and stopping smoking.

What constitutes prediabetes?
If someone has prediabetes, it means they have a higher risk of developing diabetes in the future. It is diagnosed based on blood tests and may also be described as “borderline diabetes.” While it can be confusing for patients to be told that they have prediabetes, it’s a great time for them to make lifestyle changes to prevent diabetes, such as cutting down on soda and sugary foods, becoming more physically active, and stopping smoking.

What are some common diabetes myths?
There are many myths surrounding diabetes. The thinking that “no one in my family has diabetes, so I won’t get it” is a myth because there are a lot of different risk factors that play a role in developing diabetes. It’s true that having a close family member with diabetes puts someone at higher risk for the disease, but other important risk factors include being overweight, older age, and lifestyle choices. Ethnicity and race are other important risk factors, as diabetes is more common among Hispanic, African American, American Indian, and Alaska Native adults.

The thinking that diabetes medicine can be stopped once the blood sugar is under control is also a myth. Eating healthier foods, like vegetables, beans, and lentils, as well as eggs, fish, and whole grains, being physically active, and losing excess weight can improve diabetes control and decrease the number of necessary medications. In most cases, medications, like metformin and others, will still be necessary to prevent diabetes from worsening and leading to complications.

This interview has been edited.