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December 9, 2020 - Updated July 20, 2022

November is American Diabetes Month and World Diabetes Day is November 14th

According to the Centers for Disease Control and Prevention (Diabetes Quick Facts | Basics | Diabetes | CDC, 2021):

  • The seventh leading cause of death in the United States is diabetes.
  • Over 96 million Americans have prediabetes and over 37 million American have diabetes.
  • Over eight in 10 people with prediabetes don’t know they even have it.
  • One in five people with diabetes don’t even know they have it.
  • An estimated 5-10% of diabetics are diagnosed as type 1 and around 90-95% of diabetics are diagnosed with type 2 diabetes.
  • The number of adults diagnosed with diabetes cases over the past 20 years has more than doubled.
  • $327 billion is spent annually on diabetes for medical costs and lost work and wages.

Each year, November is recognized as American Diabetes Month and World Diabetes Day is recognized on November 14th. Both events promote awareness about diabetes and its effects on a person’s health. Community outreach events such as screenings, social media events, health fairs, and educational opportunities are performed to encourage the community to learn more about the importance of prevention, early detection, and treatment of prediabetes and diabetes.

Diabetes involves one of two circumstances: either the body does not make insulin or the cells stop responding to the insulin being made by the body and therefore can’t use the insulin as effectively as it should. This results in a rise in the blood glucose. If not resolved, the uncontrolled high levels of blood glucose can lead to long term, serious health complications.

The hallmark symptoms of diabetes are polyuria (often with nocturia), polydipsia, and polyphagia. These symptoms can develop quickly (as seen with type 1 diabetics) or develop more subtly (as seen with type 2 diabetes). Other symptoms of diabetes that may occur include unexplained weight loss, fatigue, blurry vision, sores that are slow to heal, increased infections, and dry skin. Type 1 diabetics may also present with symptoms of nausea, vomiting, or stomach pain in addition to the classic symptoms.

Prediabetes

  • It is estimated that over one in every three people in the United States has prediabetes.
  • With prediabetes, an individual’s blood sugar level is higher than what is considered normal but it is not elevated enough for a diagnosis of type 2 diabetes.
  • The person with prediabetes may not experience any symptoms until the condition develops into type 2 diabetes.

Type 1 Diabetes

  • Type 1 diabetes occurs when the body does not make insulin.
  • This may be due to an autoimmune response that causes the body to stop making insulin.
  • The onset of symptoms usually develops quickly with type 1 diabetes.

Type 2 Diabetes

  • With type 2 diabetes , insulin resistance develops as the fat, liver, and muscle cells stop responding to the insulin being made by the body.
  • Glucose is unable to be stored as energy in these cells and therefore  blood glucose begins to rise in the body and cause symptoms.

Gestational Diabetes

  • Gestational diabetes develops in pregnant women who have not been diagnosed with diabetes prior to pregnancy.
  • It resolves once the baby is born, though the mother is still at a higher risk for developing type 2 diabetes in the future.

Screening and Diagnosis
The three diagnostic tests for screening and diagnosing for diabetes are the fasting blood glucose test, the oral glucose tolerance test, and the hemoglobin A1c test.

 

Fasting Blood Glucose

Glucose Tolerance Test

Hemoglobin A1c

Normal

 Less than 100 mg/dL Less than 140 mg/dL Less than 5.7 %

Prediabetic

 100-125 mg/dL 140-199 mg/dL 5.7-6.4%

Diabetic

 126 mg/dL or above 200 mg/dL or above 6.5% or above

Prevention
With regular screening and follow-up care, prediabetes and diabetes can be manageable and may be preventable. There are several steps you can take to promote the health of your Medicare beneficiaries

  • Encourage your patients to schedule annual wellness visits and health screenings.
  • Educate your patients on healthy habits such as exercising, eating a well-balanced diet including foods that are low in salt, fat, and cholesterol, lowering stress levels, controlling weight (or losing weight if needed), and getting enough sleep.
  • If your patient is diabetic, educate them on self-monitoring blood glucose (SMBG) and encourage them to monitor their levels. Educate your patients on how and when to report any abnormal readings and what treatment to do if they have an abnormal reading.
  • Monitor your patients’ blood glucose levels. Manage and treat accordingly. Educate your patients about the relationship between blood glucose levels and complications of diabetes.
  • Monitor your patients’ cholesterol levels. Manage and treat accordingly. Educate your patients about the relationship between elevated cholesterol levels and diabetes.
  • If your patients are currently on antidiabetic medications, review the importance of regularly taking medications. Address any questions they may have regarding the medications prescribed.
  • Medicare covers many diabetic services for your Medicare beneficiaries including diabetic screening, Diabetes Self-Management Training (DSMT), Medical Nutrition Therapy (MNT), and Medicare Diabetes Prevention Program (MDPP) for prediabetics. Discuss this Medicare covered benefits with your patients and encourage them to enroll if they qualify.
  • Discuss Medicare covered preventive services with beneficiaries and providing recommendations and/or referrals for these preventive services when appropriate.

To learn more about Medicare-covered services, visit CMS Preventive ServicesExternal Website:

For More Information:
CMS.gov and Medicare.gov resources

Diabetes resources

References

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