National American Diabetes Association Alert Day is observed on the fourth Tuesday of March, every year and falls this year on March 28, 2017.  This day is observed as a one-day “wake-up call” to inform the American public about the seriousness of diabetes and encourage them to undergo the diabetes risk test and learn about their family’s history of diabetes.

What is Diabetes?

For our body to produce energy, most of the food we eat is turned into glucose or sugar.  The pancreas produce a hormone called insulin to help absorb this glucose by the cells.  In a diabetic condition, the body either does not produce enough insulin or can’t use its own insulin as it should.  This leads to an increase in the blood sugar levels in the body. Diabetes is a metabolic disorder wherein the body’s blood glucose levels are higher than the normal range.  The American Diabetes Association recommends a normal fasting plasma glucose level of 70–130 mg/dL (3.9-7.2 mmol/L); and less than 180 mg/dL (10 mmol/L) post meals.

Diagnosed and undiagnosed diabetes in the United States:

People with Diabetes


Diabetes in the US


Undiagnosed Diabetes

What are the types of Diabetes?

  1. Type 1 diabetes, results from the pancreas failure to produce enough insulin.  It is also known as insulin-dependent diabetes mellitus (IDDM) or juvenile onset diabetes and approximately accounts for about 5% of all diagnosed cases of diabetes. Type 1 diabetes can be managed by taking insulin injections.
  2. Type 2 diabetes begins with insulin resistance and is known as non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. This type accounts for about 90-95 % of all diagnosed cases of diabetes. Type 2 diabetes can be treated with medications and with or without insulin injections. In obese patients, weight loss surgery can be helpful as an effective measure to control this type of diabetes.
  3. Gestational diabetes occurs when pregnant women (without previous history of diabetes) develop high sugar levels. If not treated, it can create a problem for the mother and/or the baby.  It develops in 2-10 % of all pregnancies but usually resolves itself after childbirth.
  4. Other types of diabetes, these results from specific genetic alterations, surgery, some types of drugs, undernourishment, infections, and other ailments; and account for about 1-5 % of all diagnosed cases of diabetes.


What are the risk factors for Diabetes?

  1. Age > 35 years
  2. Positive Family History
  3. Presence Of Hypertension
  4. Recent Weight Gain
  5. Sedentary Lifestyle
  6. Gestational Diabetes
  7. Overweight (BMI ≥ 25 kg/m²) & Obesity (BMI ≥ 30 kg/m²)
  8. Enlarged Waist/ Upper Body Adiposity (>90 cm for Men and > 80 cm for Women)

African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.


What are the warning signs of Diabetes?

  1. Unexplained weight loss
  2. Irritability
  3. Frequent tiredness
  4. Frequent urination (polyuria), excessive thirst (polydipsia), and excessive hunger (polyphagia)
  5. Repeated infections in the – urinary tract, genital areas, skin, oral cavity, and delayed wound healing
  6. Dry mouth
  7. Burning, pain, numbness on feet
  8. Itching
  9. Reactive hypoglycemia
  10. Presence of velvety dark patches on the neck, armpit, and groin which is an indicator of insulin resistance
  11. Decreased vision


Which are the screening tests for diabetes?

  • The most common screening test for diabetes is the oral glucose tolerance test (OGTT) [WHO, 1999].  Fasting and a postprandial glucose test helps in identifying impaired fasting glucose (IFG) (fasting glucose >110 – <125 mg/dl), impaired glucose tolerance (IGT) (2 h glucose >140-<200 mg/dl) and presence of diabetes (fasting > 126 and 2 h glucose >200 mg/dl).  If a random blood glucose value is > 150 mg/dl, further confirmation by an OGTT is warranted.
  • Recently, glycosylated hemoglobin (HbA1c) has been suggested as the test for diagnosis of diabetes (>6.5%).  The presence of pre-diabetes is indicated by HbA1c values between 5.7 – 6.4 % [American Diabetes Association, 2011].
  • For undiagnosed Type 2 Diabetes, in women with risk factors, screening is recommended at the first prenatal visit, using standard diagnostic method criteria.  As gestational diabetes remains asymptomatic, screening for the pregnant women (not having previous history of diabetes) is suggested at 24-28 week of gestation [American Diabetes Association, 2011].


Managing Diabetes:

  • Eating healthy: Eat foods containing high amounts of fibre i.e., whole-grain foods, and fruits and vegetables every day.  Avoid eating foods that are high in sugar (sodas, flavored drinks, and sweetened tea/coffee) and high in salt (pickles and processed meats).
  • Remaining physically healthy: Moderate-intensity physical activity (for e.g., walking briskly, mowing the lawn, dancing, swimming, or bicycling) for at least 30 minutes on 5 or more days of the week is recommended.
  • Preventing further complications: Diabetes can affect other parts of the body as well. Cardiovascular problems are the leading cause of death in patients with diabetes.  Adults with diabetes are 2-4 times more likely than non-diabetic individuals to die of heart disease or heart stroke.
  • Stay well in the season of flu: A diabetic individual is three times more likely to catch the flu virus than non-diabetic individuals, which in turn may interfere with the individual’s blood sugar levels.  Thus, as a protective step, get a flu shot or take prescription flu medicine when prescribed by a health care provider.



Awareness regarding the signs and symptoms and intervallic screening would help in preventing new cases of diabetes by providing a break to address the problem at the pre-diabetic stage.  It is evident that by modifying physical activity and diet habits, diabetes can be prevented among pre-diabetic individuals.  Patient empowerment is important in the management of diabetes.  And this can be achieved through patient education and spreading information on management and preventive aspects of diabetes.