Diabetes is a disease in which blood glucose levels are above normal.
Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugar to build up in your blood. Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States. People who think they might have diabetes must visit a physician for diagnosis.
More than 55,000 Vermonters have diagnosed diabetes. The rates for diabetes in Vermont have been steady for the past several years, but one out of four Vermonters do not yet know that they have diabetes. As overweight Vermont children reach adulthood, diabetes rates are expected to increase substantially. Even more Vermonters do not know that they have prediabetes – 15% to 30% of them will develop Type 2 diabetes within five years. Additional data is available on the diabetes surveillance page.
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Type 1 diabetes, previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, may account for about 5% of all diagnosed cases of diabetes.
Type 2 diabetes, previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, may account for about 90% to 95% of all diagnosed cases of diabetes.
Gestational diabetes is a type of diabetes that only pregnant women get. If not treated, it can cause problems for mothers and babies. Gestational diabetes develops in 2% to 10% of all pregnancies but usually disappears when a pregnancy is over.
Other specific types of diabetes resulting from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses may account for 1% to 5% of all diagnosed cases of diabetes.
- older age
- family history of diabetes
- prior history of gestational diabetes
- impaired glucose tolerance
- physical inactivity
- race/ethnicity (African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes). Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in developing this type of diabetes.
People who think they might have diabetes must visit a physician for diagnosis. They might have some or none of the following symptoms:
- Frequent urination
- Excessive thirst
- Unexplained weight loss
- Extreme hunger
- Sudden vision changes
- Tingling or numbness in hands or feet
- Feeling very tired much of the time
- Very dry skin
- Sores that are slow to heal
- More infections than usual.
Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called Type 1 diabetes.
Healthy eating, physical activity, and insulin injections are the basic therapies for Type 1 diabetes. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.
Healthy eating, physical activity, and blood glucose testing are also the basic therapies for Type 2 diabetes. In addition, many people with Type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.
People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high.
People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. In addition, people with diabetes may see endocrinologists, who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.
Additional information is available from the Centers for Disease Control and Prevention (CDC).
Poorly controlled diabetes is measured by a laboratory blood test known as the A1C (previously called the hemoglobin A1C). A1C is a measure of average blood glucose during the preceding 3-month period of time. It is easiest to think about an A1C as a “batting average”.
A normal A1C for people without diabetes is approximately 5%; for someone with diabetes the goal for good control is 7% or less, except in a population that is aged or experiences frequent low blood sugars (for which the goal may be 8%). Poorly controlled diabetes is indicated by an A1C greater than 9%.
This performance measure is currently one that primary care practices, Accountable Care Organizations, and other health system policy and regulatory agencies measure to assess the quality of diabetes care. Clinical-Community Strategies to Improve Adult Type 2 Diabetes Control addresses clinical approaches, innovative patient-centered care, and community linkages for self-management programs available in Vermont.
Diabetes is one of the four diseases (along with lung disease, cancer and cardiovascular disease) that results in more than 50% of the deaths in Vermont. Diabetes prevention and management is part of a statewide initiative to raise awareness and reduce the damages caused by tobacco, poor nutrition, and physical inactivity that lead to these four diseases and the resulting overwhelming population burden and costs: 3-4-50.
Prediabetes affects 1 out of 3 adults in the United States. In 2014, 27,000 Vermont adults had diagnosed prediabetes, but an additional 243,000 may have prediabetes and not know it. Vermont is fortunate to have a free, evidence-based program to reverse prediabetes, available statewide. Helping Yourself to Health – Preventing Type 2 Diabetes is a guide for professionals to refer your patients with prediabetes to an evidence-based Diabetes Prevention Program. View and download the guide in the Tools & Print Resources for You and Your Patients section below.
Free web-based diabetes software for tracking blood sugars and medications.
My Fitness Pal
Free software for tracking diet and exercise.
Self-Management Programs Available Free to Vermonters
Diabetes prevention and management workshops are available throughout the state with no fees to attend. To learn more about workshops offered in your health service area: Free Diabetes Prevention and Management Workshops
Preventing Type 2 Diabetes Guide - A guide to refer your patients with prediabetes to evidence-based Diabetes Prevention Programs. The full guide also includes the following individual patient handouts or training materials for health care staff:
- Participant Eligibility Checklist - patients can self-assess risk for developing diabetes and determine eligibility for YMCA's Diabetes Prevention Program
- So You Have Prediabetes. Now What? - describes the YMCA's Diabetes Prevention Program features and shows the website to find a local program
- Talking Points for Phone Outreach - sample scripts for health care staff to use when referring patients to the YMCA's Diabetes Prevention Program
- Point of Care Prediabetes - suggests method to assess an individual patient for referral to the YMCA's Diabetes Prevention Program
- Retropsective Prediabetes Identification - suggests electronic health records query to identify patients eligible for YMCA's Diabetes Prevention Program
- Provider FAX Referral Form - for individual patient referrals via FAX
Learning to Live Well With Diabetes - A detailed resource to help people learn how to meet blood sugar goals and how to prevent health problems. Quantity orders are available from AIDC.
Dietary Approaches to Stop Hypertension - This eating plan for controlling blood pressure is also a good basic weight control eating plan for type 2 diabetes or prediabetes. Quantity orders are available from AIDC.
Guide for Diabetes Care - This single page guide helps patients and clinicians "get on the same page". It provides a summary of recommendations for treatment at medical provider office visits, a review of lab reports, and self-management responsibilities.
To order copies: AIDC is a storage and fulfillment center where some Health Department print resources described below are available for free distribution to our partners. You can request multiple copies of these two resources: Learning to Live Well with Diabetes and Dietary Approaches to Stop Hypertension. There are three ways to order materials:
- Phone – (844) 207-0971 (toll free)
- Fax – (802) 864-7626
- Email – firstname.lastname@example.org
Vermont Diabetes Prevention and Control
Phone: 866-331-5622 (toll free) or 802-863-7330
Diabetes Program Administrator
Vermont Department of Health
108 Cherry Street, PO Box 70
Burlington, VT 05402