November is Diabetes Awareness Month and doctors throughout Europe Regional Medical Command are encouraging Servicemembers, Families and Civilians to be aware of how health choices can lead to this debilitating illness.

According to the Centers for Disease Control (CDC) and Prevention, Diabetes is the seventh leading cause of death in the United States and a major cause of heart disease and stroke. Diabetes increases the risk of developing dementia (Alzheimers) and the risk of gum (periodontal) disease. Diabetes is also the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness among adults in the United States.

According the American Diabetes Association, there are an estimated 25.8 million adults and children with diabetes in the United States. Of those, it is estimated that as many as seven million have diabetes but remain undiagnosed.

What is diabetes?
Diabetes means that your blood glucose, also called blood sugar, is too high. Glucose comes from the food you eat and is needed to fuel our bodies. Glucose is also stored in our liver and muscles. Your blood always has some glucose in it because your body needs glucose for energy. But having too much glucose in your blood is not healthy.

An organ called the pancreas makes insulin. Insulin helps glucose get from your blood into your cells. Cells take the glucose and turn it into energy.

If you have diabetes, the pancreas makes little or no insulin or your cells cannot use insulin very well (insulin resistance). Glucose builds up in your blood and cannot get into your cells. If your blood glucose stays too high, it can damage many parts of the body such as the heart, eyes, kidneys, and nerves.

The information below outlines the different types of diabetes, the risk factors for each and how people can lower the risk of developing diabetes.


Type 1 diabetes
• Produce very little or no insulin.
• Usually develops in children or young adults.
• Need injections of insulin every day to control the levels of glucose in their blood. If people with type 1 diabetes do not have access to insulin, they will die.

Type 2 diabetes accounts for at least 90% of all cases of diabetes.
• The pancreas still makes some insulin but cells cannot use it very well.
• Can occur at any age.
• Often, but not always, associated with overweight or obesity
• Initially manage their condition with exercise and diet. However, over time most people will also need oral medicines and or insulin.

Gestational diabetes (GDM)
• Is a form of diabetes consisting of high blood glucose levels during pregnancy.
• Develops in one in 25 pregnancies worldwide and is associated with complications to both mother and baby.
• Usually disappears after pregnancy but women with GDM and their children are at an increased risk of developing type 2 diabetes later in life. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery.

Prediabetes or Impaired Glucose Tolerance (IGT)
• Is a category of higher than normal blood glucose, but below the threshold for diagnosing diabetes


Type 1 diabetes risk factors are still being researched. However, having a family member with type 1 diabetes slightly increases the risk of developing the disease. Environmental factors and exposure to some viral infections have also been linked to the risk of developing type 1 diabetes.

Type 2 diabetes risk factors are:
• Family history of diabetes
• Overweight
• Unhealthy diet
• Not exercising or not exercising enough
• Increasing age
• High blood pressure
• Ethnicity (Hispanic American, African American, Native American, Asian American, Pacific Islander)
• Prediabetes or Impaired Glucose Tolerance (IGT)
• History of gestational diabetes
• Depression

How to lower your Risk of developing Diabetes

Physical activity
• 30-60 minutes of exercise a day can lower your risk of developing Type 2 Diabetes by 40%.
• Has the greatest impact for losing and maintaining weight
• Reduces blood pressure, reduces resting heart rate
• Increases insulin sensitivity
• Decreases body fat
• Lowers stress levels and Improves psychological well-being.

Balanced and nutritious diet
According to the Dietary Guidelines for Americans 2010, a healthy eating plan:
• Emphasizes fresh fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products
• Includes lean meats, poultry, fish, beans, eggs, and nuts
• Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars

Lose Weight if you are overweight
• To lower your risk of developing Type 2 Diabetes and reduce high blood pressure.

Quit Smoking
• Smoking increases abdominal fat and insulin resistance which leads to Type 2 Diabetes.

Get Help for Depression
• Talk to your primary care provider to check for possible physical cause and treatment
• Talk with a mental health specialist for counseling and treatment

Get Enough Sleep
• Too little (9h) sleep may be associated with a higher risk of developing type 2 diabetes.
• Not enough sleep may impair the balance of hormones regulating food intake and energy balance.
• Long sleep durations may be a sign of sleep-disordered breathing or depression and should be treated appropriately.

If you are worried about your risk for Diabetes, make an appointment to see your doctor either through TRICARE Online, Army Secure Messaging (Relay Health) or by calling your clinic.