understanding diabetes

Kristen Nemoto Jay
June 25, 2024

Diabetes is a chronic disease that occurs when the pancreas doesn’t produce insulin or when the body cannot effectively use the insulin it produces. This results in too much blood sugar in your blood stream, which, over time, may increase your risk of heart disease, stroke, kidney failure, and many other serious complications. We asked HMSA Medical Director David Percy, D.O., who's licensed and board certified in internal medicine, about possible risk factors, signs and symptoms, when to see a doctor, and what foods to avoid to decrease your chances of getting type 2 diabetes.


Know your type
There are three main types of diabetes: type 1, type 2, and gestational diabetes (while pregnant). Type 1 diabetes can start at any age but is most common to develop during childhood or teen years. There is currently no cure and requires daily insulin shots or an insulin pump. Type 2 diabetes is more common in people older than 40 but there has been an increase of cases in children. With diet and exercise, type 2 diabetes may be prevented or delayed, or reversed in prediabetes.

Q&A with Dr. David Percy, D.O.

 When should someone see a doctor about diabetes testing?
According to the American Diabetes Association (ADA), diabetes testing should be considered in adults who are overweight or obese who have one or more of the following risk factors:

  • First-degree relative with diabetes.
  • High-risk race/ethnicity (e.g., African American, Latino, Native American, Asian American, Pacific Islander).
  • History of cardiovascular diseases.
  • Hypertension (≥130/80 mmHg or on therapy for hypertension).
  • HDL cholesterol level <35 mg/dL and/or a triglyceride level >250 mg/dL).
  • History of polycystic ovary syndrome.
  • Physical inactivity.
  • Other clinical conditions associated with insulin resistance (e.g., severe obesity, acanthosis nigricans).

Those with HIV, exposure to high-risk medicines, or a history of pancreatitis should test for diabetes. Patients with prediabetes (A1C ≥ 5.7%) should also be tested yearly, and those with a history of gestational diabetes mellitus should have lifelong testing at least every three years. For all other patients, testing should begin at age 35. If results are normal, testing should be repeated at a minimum of three-year intervals, with consideration of more frequent testing depending on initial results and risk status. Symptoms to also be aware of include those with increased urination, thirst, unexplained weight loss and blurry vision.

What foods or drinks should someone avoid if they have diabetes or prediabetes?
Stay away from refined, highly processed carbohydrate foods and drinks, especially those with added sugar. These include sugary drinks like soda, sweet tea, and juice, and refined grains like white bread, white rice, sugary cereal, and sweets like cake, cookies, and chips. A diet that is high in fruits, nuts, fish, whole grains, vegetables, and olive oil (similar to the Mediterranean diet) is recommended to help maintain blood sugar levels and aid in preventing type 2 diabetes.

What are some resources that folks can refer to, to learn more about diabetes?
For general information about diabetes, go to the ADA website. The ADA also has a website on meal prep information. You can also check out the American Heart Association and the National Diabetes Prevention Program.

If you have questions about diabetes, please talk to your primary care provider.

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