Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

There are 23.6 million children and adults in the United States, or 7.8% of the population, who have diabetes. While an estimated 17.9 million have been diagnosed with diabetes, unfortunately, 5.7 million people (or nearly one quarter) are unaware that they have the disease.

High Diabetes Rates for Minorities

Identifying disparities is a first step toward understanding what causes them and what can be done to reduce them.
• Different studies found that African Americans are from 1.4 to 2.2 times more likely to have diabetes than white persons.
• Hispanic Americans have a higher prevalence of diabetes than non-Hispanic people, with the highest rates for type 2 diabetes among Puerto Ricans and Hispanic people living in the Southwest and the lowest rate among Cubans.
• The prevalence of diabetes among American Indians is 2.8 times the overall rate.
• Major groups within the Asian and Pacific Islander communities (Japanese Americans, Chinese Americans, Filipino Americans, and Korean Americans) all had higher prevalences than those of whites.

In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.

With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

Major Types of Diabetes

Type 1 diabetes
Results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.

Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.
Gestational diabetes
Immediately after pregnancy, 5% to 10% of women with gestational diabetes are found to have diabetes, usually, type 2.

Pre-diabetes
Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes.

Symptoms
• Tingling or burning in your toes, feet, legs, fingers, hands, or arms
• A "pins and needles" feeling
• Pain or cramping
• Numbness or loss of sensation
• Insensitivity to heat and cold
• Extreme sensitivity to even the lightest touch
• Muscle weakness in your hands or feet
• Loss of coordination or balance that makes it harder to walk
• Chronic constipation or diarrhea
• Frequent indigestion, nausea, or vomiting
• Problems with urination
• Problems with sex or orgasm
• Faintness or dizziness when you stand up
• Trouble seeing well enough to drive at night
• Changes in sweating, either much more or less than usual.

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