The Disease That Nearly 8 Million Americans Don't Know They Have

Ignorance isn’t bliss. About 28 percent of Americans with diabetes aren’t aware they have the disease, finds new research from Emory University and the Centers for Disease Control and Prevention (CDC).  

That number’s even higher for young people: Almost 4 in 10 adults between ages 18 and 44 with the condition are walking around without knowing their blood sugar is high. And it’s not because they’re avoiding their docs. Two-thirds of people in this age group have a usual care provider, and over 40 percent reported seeing their physician two or more times in the past year.

So what’s going on? Some people may believe they’re too young for diabetes, or they may lack insurance coverage for certain tests. Plus, the testing guidelines tend to put the diabetes focus on middle-age and older adults, says study author Mohammed Ali, MBChB. That means younger people can slip through the cracks, especially if they’re seeing their doctor for unrelated issues, like a backache or sprained ankle.

But some health problems that you think have nothing to do with your blood sugar might actually serve as a clue to it. These include issues like repeated skin infections or recurrent urinary tract infections. “In people with diabetes, immune responsiveness is altered somewhat,” says Dr. Ali. “Essentially, you are more prone to having more infections.”

This kind of pattern can signal to your doc that you might benefit from a test. The same thing goes for if you’re overweight with at least one other risk factor: family history, high blood pressure, high cholesterol, low HDL (good cholesterol), low physical activity, or certain minority status. 

You’re probably most familiar with the fasting glucose test, a blood test that measures the amount of sugar in your blood after not eating for 10 to 12 hours. A value of 126 milligrams per deciliter (mg/dL) or higher indicates diabetes.

The catch: This test might miss people whose blood sugar remains fine while fasting, but goes haywire after eating, says Dr. Ali. The hemoglobin A1C test, on the other hand, measures average blood sugar levels over a 3-month period. (A result of 6.5 percent or above signals diabetes). So this might be a more-thorough way to capture your blood sugar status, though both tests are used quite routinely.

And accurate diagnosis is important, because it will allow you to get the treatment you need to keep the disease in check. If your diabetes remains uncontrolled, you’re more likely to experience some of the really serious complications, like damage to your heart, kidneys, eyes, and nerves, says Dr. Ali.

Plus, a test will also show you if you have something called prediabetes, where your blood sugar levels are above the normal range but not quite diabetic. Lifestyle changes can help stave off full-blown diabetes and preserve quality of life, Dr. Ali says. That means shooting for 150 minutes of moderate exercise a week, and losing a modest amount of weight—as little as 5 percent of your body weight.