A nonprofit publication of the Kentucky Center for Public Service Journalism

Diabetes: It’s preventable but a leading cause of death; know warning signs, make lifestyle changes


First of a 3-part series

By Maridith Yahl
NKyTribune reporter

Type 2 diabetes was the 7th leading cause of death in the United States in 2017, according to the Center for Disease Control (CDC). Kentucky has the 7th highest rate in the U.S., over 440,000 residents live with the disease, says the Kentucky Cabinet for Health and Family Services (KCHFS) 2019 report. Type 2 diabetes is preventable. Know the warning signs and risk factors. Making lifestyle changes can help prevent this disease from on-setting.

“It is a complicated issue. It’s not just how the body breaks down carbohydrates and uses them for fuel and stores energy, it’s also how our fat cells, in our muscle cells, in our brain and the rest of your body utilizes the glucose,” says Paula Bergen, RN, BSN, CDCES, Diabetes Educator, Consultant for the Northern Kentucky Health Department. There are other hormones besides insulin that come into play too, she says.

From American Diabetes Association

“Basic signs and symptoms [of type 2 diabetes] are: feeling thirsty, feeling tired, skin infections that don’t go away, blurred vision, dry itchy skin, and urinating more often,” says Bergen. Other symptoms can include feeling hungry (even after eating) and tingling, pain, or numbness in hands and feet according to the American Diabetes Association (ADA).

Bergen warns that some people may not have any symptoms.

There are several risk factors for type 2 diabetes. Type 2 diabetes can be hereditary, but that does not mean it will develop. Those 45 years of age and older, African Americans, Hispanic/Latinos, American Indian, Asian American, Pacific Islander, and having a parent and/or sibling with type 2 increases the chance for developing type 2.

However, many risk factors can be controlled. Among these, Northern Kentuckians rank high in each category.

One main risk factor attributed to the high rate of type 2 diabetes is being overweight or obese, says Bergen. The more excess weight, the more cells become resistant to insulin. The KCHFS 2019 report says 68% of Kentuckians are overweight.

Kentucky is the fifth most obese state in the U.S., according to data from the CDC.

Being overweight is defined as having a Body Mass Index (BMI) of 25 or higher. BMI is a measurement of body fat based on height and weight. Northern Kentucky is a little above the state average. 72% of Boone, 66% of Campbell, and 73% of Kenton County residents are considered overweight.

Smoking is directly related to diabetes, says Bergen. The Federal Drug Administration (FDA) says that high levels of nicotine cause insulin to not work as well as normal. The production of insulin increases, leaving the body not knowing how to respond to its effects. The pancreas stops making it, which causes blood sugar levels to become abnormal.

Walking is great exercise. (Creative Commons)

The KCHFS report says, 23% of Kentuckians diagnosed with type 2 diabetes are smokers

Locally, Kenton county has a smoking rate above the state level.

“Tobacco use is the leading cause of preventable death in the United States and around the world. Every year more than 8,000 Kentuckians die of illnesses caused by smoking,” says KCHFS.

Exercising is so important for many reasons, including reducing the risk of type 2 diabetes. Physical inactivity plays a role in its development.

The ADA says exercising makes insulin more sensitive. Cells can then better utilize available insulin to take up glucose, which is needed for energy. To stick with an exercise routine, the ADA recommends picking an enjoyable activity, that fits into a flexible schedule, and is within budget.

Other chronic illnesses influence diabetes. High blood pressure or hypertension and high cholesterol are both intertwined in the development of diabetes.

The American Heart Association (AHA) says that with diabetes, good cholesterol goes down while triglycerides, the bad cholesterol, go up. This increases the risk of heart disease and stroke. Having both high blood pressure and diabetes significantly increases the risks of heart-related problems.

Bergen says diabetes is related to poverty.

“When you look at people with diabetes, people living in poverty have a higher rate,” she says, partly because they cannot afford fresh foods. Instead, more staple grocery items like rice, noodles, and potatoes are purchased. The lack of proper nutrition and the consumption of sugary drinks are risk factors for developing diabetes.

Both Bergen and the ADA say that knowing your risk factors is important. Age, gender, family history, blood pressure, physical activity, race, and BMI give you clues.

To learn more, take the ADA risk assessment quiz. Of course, talk to your doctor about risk factors and potential lifestyle changes. There are blood tests that measure glucose levels, diagnosing pre-diabetic, or type 2 diabetes. Knowing this, allows steps to be taken to prevent or manage diabetes.

“When you look at it, diabetes really is an epidemic,” says Bergen. “If you find that you have pre-diabetes or diabetes, you have the opportunity to make changes and do something about it.”

Next: Pre-diabetic? What to do.


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