(Editor’s note: This is the first of five articles contributed by nurse Nancy Johnsen recognizing November as American Diabetes Month.)


November is American Diabetes Month.  Diabetes affects more than 1.8 million New York State residents.  Of this, 760,000 have no idea that they have diabetes.  According to the NYS Health Foundation, the total cost for New Yorkers with diabetes was 12.9 billion in 2006.  For someone with diabetes, the health care costs are five times that of someone without diabetes.  Quite a price!

(Editor’s note: This is the first of five articles contributed by nurse Nancy Johnsen recognizing November as American Diabetes Month.)


November is American Diabetes Month.  Diabetes affects more than 1.8 million New York State residents.  Of this, 760,000 have no idea that they have diabetes.  According to the NYS Health Foundation, the total cost for New Yorkers with diabetes was 12.9 billion in 2006.  For someone with diabetes, the health care costs are five times that of someone without diabetes.  Quite a price!


Diabetes is a disorder of metabolism that leads to a higher than normal blood sugar.  The condition is both chronic and progressive.  When we eat, our body breaks down food into glucose. Glucose is our main source of energy and the only source of energy for our brains.  Glucose passes into our blood stream where it is available to our cells for energy.  Insulin must be present for the glucose to move into the cell.  About 1% of the pancreas is responsible for producing insulin from Beta Cells and the secretion of insulin should happen automatically when we eat.  Depending on how this process is interrupted or challenged, we have different types of diabetes.  Type 1 diabetes affects 5 percent to 10 percent of the diabetic population and those with this type have no insulin production left in the pancreas.  The remaining 90 percent to 95 percent have type 2 diabetes where either insufficient insulin is produced by the beta cells or the body’s cells have become resistant to the insulin and don’t use the insulin efficiently or both.  Make a note, type 2 diabetes is on the rise in our youth.  Gestational diabetes affects women during pregnancy. According to the American Diabetes Association (ADA), about one in every 15 pregnant women will be diagnosed with this type of diabetes and of this number, about 40 percent will go on to develop type 2 diabetes.  


There are a number of risk factors for diabetes, some we can control and some we cannot. Risk factors we cannot control include:




Our age – The older we get, the more our risk increases;

Our family history – Having a parent or sibling who has or had the disease will increase our risk; and

Our ethnic background – Being African American, Native American, Hispanic, Asian American or a Pacific Islander will increase our risk.

For women, if you had gestational diabetes or a baby weighing nine pounds or more, your risk is increased.


What about the risk factors we can control?




Our weight – Weighing more than we should increases our risk.

Our inactivity – Lack of regular exercise and  the predominance of the more sedentary lifestyle increases our risk

The classic signs of diabetes are increased thirst, increased urination and increased eating with no weight gain.  With some types of diabetes, these signs are not present due to the insidious onset of the condition.  


Where do you start? Knowledge is the first step starting with your blood sugar. If you are not diabetic but have some of the above risk factors, do you know what your fasting blood sugar is? If you are a diabetic, do you know what your HbA1c test is? (to be explained in future articles). Armed with the answers to these questions you are now ready for the next step which is prevention and self-management. Both include a healthy lifestyle of maintaining a healthy weight, exercising and eating a well balanced diet. If you have symptoms, don’t ignore them. Be alert and make an appointment with your physician.  Get educated about the condition and take charge. In coming weeks I will look at the specifics of some of the types of diabetes, new advances in treatment options and management tools.


(Nancy M. Johnsen RN, CDE is a Certified Diabetes Educator and Community Health Education Coordinator and Coordinator of the Diabetes Education Program at Noyes Memorial Hospital.)