Although diabetes mellitus ranks only as No. 6 among the top 10 causes of mortality in the United States, it is a primary risk factor for many other diseases. And as this silent killer claims new victims, it costs our economy $175 billion a year.

The American Diabetes Association estimates that nearly 81 million people in the United States are affected by either diabetes or prediabetes. That’s nearly one out of every four, and the numbers are only getting worse.

Diabetes is a metabolic disorder resulting in hyperglycemia or high blood sugar (glucose), first described by a physician in ancient Egypt around 1552 B.C. It occurs as a result of insulin deficiency, insulin resistance, decreased insulin secretion, increased glucose production or a combination of the above.

Depending on the cause and age at onset, there are several types. Type 1, Type 2, Maturity Onset Diabetes of the Young (MODY) and pregnancy-related or gestational diabetes are the most common.

The complications are as important as the disease itself. They include strokes, heart attacks, blindness, kidney failure, diminished nerve sensation or neuropathy, increased risk of infections, sexual dysfunction and peripheral vascular diseases. The list of potential complications is extensive.

The most important preventable risk factors for diabetes are being overweight and lacking adequate regular exercise. Some of the non-modifiable risk factors include a family history of diabetes.

There are several ways your doctor or medical provider can diagnose diabetes. The most convenient way is to check blood glucose levels.

Diabetes is determined by two fasting glucose levels of greater than or equal to 126 milligrams per deciliter on two separate occasions, or a random blood glucose greater than or equal to 200 milligrams per deciliter accompanied by symptoms of diabetes, such as increased urination, increased thirst, increased hunger with unintentional weight loss and blurred vision.

Many initially will not have any symptoms. Most patients recently diagnosed with diabetes have likely had it for years, even decades, before being diagnosed, which is why prevention is so important.

Based on the factors contributing to diabetes and its complications, individual treatment regimens vary.

Prediabetes and prevention

Recently, researchers have discovered that the development of diabetic complications begins even before a diagnosis of diabetes. It was because of this information that the new term “prediabetes” was coined.

A prediabetic can become a diabetic in a few years. This transition could be delayed or even prevented with some important early steps. Currently there are no clear guidelines on how to treat prediabetes. The hope is that this will change as recommendations by various endocrine societies are revealed.

For now, the general consensus on prevention includes maintaining a normal body weight, eating a well-balanced diet low in saturated fats and processed foods, getting plenty of regular exercise, and getting regular screenings if you are at risk of developing diabetes. There is ongoing discussion regarding the initiation of diabetic medications during the prediabetic phase.

As always, please consult your healthcare provider before initiating any change to your diet or lifestyle, as this may affect your medical condition and treatment plan. Some patients may require additional testing — for example, stress testing — before they make certain lifestyle changes such as exercise. Find out what’s right for you.

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