There is the tendency among people to believe that only type 1 (insulin-requiring) is the severe form of the disease. Not only is this untrue, it can lead to non-compliant care amongst people with type 2 diabetes the result of which can lead to a variety of complications including heart and kidney disease, nerve problems and blindness.

Diagnosis = Diabetes When…
…2 Fasting Blood Glucose Tests Exceed 125 mg/dl

Diabetes is diagnosed when at least 2 fasting blood tests indicate a blood sugar in excess of 125 mg/dl. Everyone over the age of 40 should be tested at least annually and those at risk for diabetes, more often.

Diabetes Delineations

Type 1 diabetes is usually diagnosed in children and young adults, but can be diagnosed at any age. This was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin. Insulin is necessary for the body to be able to use sugar. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells. The cause of type 1 diabetes is unknown, but may relate to a genetic defect that causes the body to destroy it's own cells in the pancreas. Symptoms include rapid unintentional weight loss, excessive thirst and urination, nausea, vomiting, and a generalized ill feeling. People who develop type 1 diabetes become ill rapidly and require insulin shots immediately to regain health. Testing the blood sugar begins the process of diagnosing type 1 diabetes. In a non-diabetic blood sugar normally runs between 70-100 mg/dl but someone with type 1 diabetes can run from 200 to over 600 mg/dl when first diagnosed.

In type 2 diabetes, the blood sugar may be sporadically elevated without overt symptoms for many years. It was once estimated that a person with newly diagnosed type 2 diabetes was likely to have had the disease for the prior 8-10 years. The other grim statistic is that people with newly diagnosed type 2 diabetes have a 50/50 chance of already having some form of heart disease. That's because the increased concentrations of sugar in the blood leads to blood vessel deterioration as well as nerve damage. It is therefore ill advised to not take type 2 diabetes seriously. The complications are just as severe as in type 1.
The cause of type 2 diabetes is not known, but there is a stronger genetic link than in type 1 and inactivity, obesity and diet also contribute to your risk. Symptoms of type 2 diabetes include excessive thirst and urination, mild weight loss and fatigue, but present themselves in a subtle manner.

Before people develop type 2 diabetes, they almost always have "pre-diabetes" -- blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. At least 20.1 million people in the United States (21.1% of the population), ages 40 to 74, have pre-diabetes. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes. Two fasting blood tests with a glucose result in the 100-125 range is an indication of pre-diabetes.

There's Never Been a Better Time to Have Diabetes
The good news is that research has proven that you can do things to delay or prevent diabetes from occurring. There are also exciting ways of treating diabetes including new medications, insulin delivery products and testing supplies that are more convenient and accurate than ever.

A recent study of people without diabetes showed that participants randomly assigned to intensive lifestyle intervention reduced their risk of getting type 2 diabetes by 58 percent. These individuals achieved a 5% weight loss (10 pounds for a 200 pound person) and exercised for thirty minutes daily.

Checking blood sugar, which is the fastest means of determining control for someone who has been diagnosed with diabetes is much easier now. New devices permit checking from sites other than the fingertips, which requires less blood and can be less painful.

Myths About Diabetes

The following are some common myths about diabetes:
1. Type 1 diabetes is more serious and severe than type 2. This was previously mentioned, but bears repeating. 90% of people who have diabetes have type 2. The risk of a heart attack is 2 times that of someone without diabetes.

2. If you need insulin, you have type 1 diabetes. While it is true that people with type 1 require insulin to manage their health, the need for insulin in type 2 diabetes does not indicate failure or severity of diabetes. The need for insulin simply reflects that oral medications are not effective enough to achieve desired control.

3. People with diabetes cannot have sugar or sweets. While eating excessive sweets is not a desirable habit, adjusting medication or insulin can control blood sugar allowing any foods to be included in the diet with proper planning and balanced eating.

4. People with diabetes should eat "sugar-free" sweets. I have heard many people with diabetes proclaim that they never eat anything with sugar! Unfortunately food labels are misleading and most sugar-free foods are loaded with carbohydrates such as flour, fruit juice and milk that turn to sugar in the body. This does not mean that carbohydrate foods should be drastically curtailed, just that they should be balanced and controlled.

5. A fasting blood sugar every morning that is 110 mg/dl, must mean I am OK. It is helpful to check your sugar at various times of the day so that you can see the effect of foods, exercise and even stress on your control. It is important to know your A1c number, which is a blood test that should be drawn quarterly. The A1c reflects the degree of control of your blood sugars over the prior three months. Typically, this number should be under 7%.

Written by Kathy Stone, MBA, RD, CDE, a Registered Dietitian and Certified Diabetes Educator.