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Understanding diabetes and the importance of early screening

Published: March 14, 2023 |8 minute read

Written by: Ashley Lauretta

Colorful illustration of a mature man in a doctor’s office with speech bubbles indicating that they’re discussing diabetes causes and treatments like diet and weight.

About 37.3 million Americans — or roughly 1 in 9 — are living with diabetes, and 23 percent of them are undiagnosed, according to a 2019 estimate. Here’s how to find out if you could be at risk.

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Diabetes, especially when uncontrolled, can result in nerve damage, heart disease, chronic kidney disease, and vision and hearing loss, among other complications. The same 2019 study indicates that 1 in 3 U.S. adults have prediabetes, its precursor; for those ages 65 and older, it’s nearly 1 in 2. Of the 96 million adults considered prediabetic, more than 80 percent are estimated to be unaware of their condition.

“People with prediabetes and type 2 diabetes can remain asymptomatic for years, and in some cases, they develop complications before they get diagnosed and treated effectively,” says Kathleen Dungan, MD, MPH, associate professor of medicine in the Division of Endocrinology, Diabetes and Metabolism at Ohio State University. If you’re not sure where you stand, you can get your answer with a simple blood test under the supervision of a trusted health care provider.

Left: Illustration of type 1 and type 2 diabetes as opposing sides of a balance scale, where type 1 contains fruit and vegetables while type two contains medicine. Right: Illustration of a cut section showing the organs of the body.

What is diabetes?

Diabetes is a chronic disease that affects how your body turns food into energy. Insulin, a hormone made by your pancreas, helps cells to use sugar from your bloodstream. When you have diabetes, your body’s cells don’t respond to insulin properly or your pancreas can’t make enough. Instead of being used as energy by your cells, sugar lingers in the bloodstream and, over time, this can cause serious health problems.

What’s the difference between type 1 and type 2 diabetes?

Type 1 diabetes

About 5 to 10 percent of people with diabetes have type 1, and they are usually diagnosed as children, teens or young adults. In type 1 diabetes, the pancreas loses the ability to make enough insulin.

Type 2 diabetes

About 90 to 95 percent of people who have diabetes have Type 2. The onset of type 2 diabetes can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy food and being active.

Gestational diabetes

Gestational diabetes can occur during pregnancy in those who have never had diabetes. Having gestational diabetes increases the risk of developing type 2 diabetes later in life.

How to help lower your chances of developing type 2 diabetes

If you do receive a test result indicating you may have prediabetes or type 2 diabetes, don’t despair. Studies have shown that prediabetes is reversible with lifestyle changes, and type 2 diabetes itself can sometimes be controlled with lifestyle changes, with or without medication.

“Changes in diet and exercise that promote weight loss can make an impact on the risk of developing type 2 diabetes,” says Dr. Dungan. “And you don’t even really need to lose a ton of weight. If you are overweight, just a 5 to 7 percent weight loss was demonstrated in clinical trials to reduce the risk.” Your weight loss program should be conducted under the supervision of a trusted health care provider.”

If your doctor says you have prediabetes, consider it an alert that your body may be on the way to type 2 diabetes. “Think of it as a warning sign,” says Edward Chao, DO, a clinical professor of medicine at the University of California, San Diego. “The good news is that with lifestyle changes, there are a lot of folks who never develop full-blown diabetes.”

Currently, we don’t know how to prevent type 1 diabetes, but there are steps you can take to lower your risk of developing type 2 diabetes. Losing a small amount of weight if you’re overweight and getting regular physical activity can aid in type 2 diabetes prevention.

The U.S. Department of Health and Human Services recommends at least 150 minutes per week of moderate-intensity aerobic activity — think cycling, aqua aerobics, power walking or dancing — as well as two to three days of strength training. Check with your health care provider before embarking on a new exercise regimen.

What is the importance of diabetes screening?

Prediabetes is typically asymptomatic, and patients with type 2 diabetes often do not experience many symptoms in the early stages; that’s why it’s important to get tested regularly — especially if you are considered “high risk.” Dr. Chao explains that diabetes risk factors are connected to age, weight, ethnic background, family history and more. (Bear in mind that you can still develop diabetes even if you are at a healthy weight.) One screening approach: You can find an online prediabetes questionnaire from the Centers for Disease Control and Prevention to help you understand what this means for you.

Staying on top of your annual physicals and the requisite blood work will help you and your health care provider identify if you have prediabetes. Identifying whether you have prediabetes early on can help encourage you to make necessary lifestyle changes to help reverse the condition before it develops into diabetes.

What are common diabetes symptoms?

It’s also important to be aware of diabetes symptoms in case they do appear. Common signs of diabetes include:

  • Blurry vision
  • Fatigue
  • Frequent urination
  • Increased thirst and/or hunger
  • Numb or tingling hands or feet
  • Severely dry skin
  • Sores that are slow to heal
  • Unexplained weight loss

How to test for diabetes

To test for diabetes, your doctor will likely order one or both of the following screenings if you’re at risk or show signs or symptoms of diabetes. A fasting glucose test or fasting blood sugar test are two different names for the same diabetes test that measures your blood sugar (or glucose levels) after an overnight fast (not eating). You may also complete an oral glucose tolerance test, where your blood sugar is measured before and after consuming a sugary liquid. Lastly, the hemoglobin A1C test measures your average blood sugar levels over the past two to three months. If you’re not sure whether your physician is taking these measurements during regular checkups, don’t be afraid to ask. Because the A1C test doesn’t require an eight-hour fast, Dr. Chao says that the results remove an element of human error: “Sometimes, patients don’t remember if they’ve fasted or not.”

For fasting glucose, a reading of less than 100 milligrams per deciliter (mg/dL) (the glucose found in a set amount of blood) is considered normal; 100 to 125 mg/dL indicates prediabetes; and any reading above 126 mg/dL indicates diabetes.

The numbers are slightly different for a glucose tolerance test. A blood sugar level of 140 mg/dL or below is normal, 140 to 199 mg/dL indicates prediabetes and 200 mg/dL or above indicates diabetes.

For an A1C test, a normal result is a level below 5.7 percent, prediabetic is 5.7 to 6.4 percent and diabetic is 6.5 percent or higher.

Any of these tests can be used to diagnose diabetes, but your doctor may use more than one type or repeat the same test before confirming a formal diagnosis.

People with diabetes, prediabetes or a high-risk of developing the disease should monitor their A1C or blood glucose with regular testing. Talk to your doctor about the best plan of action. They may recommend laboratory testing and at-home tests, as well. Self-administered tests — such as the CVS Health At Home A1C Test Kit— give you results within five minutes. For an in-person screening, talk to your health care provider or visit a MinuteClinic® location that offers A1C testing.*

Glucometers and lancets

Those with a diabetes diagnosis will want to work closely with their health care providers, including their pharmacist, and, if possible, a diabetes educator and nutritionist. “It’s certainly possible to live well with diabetes,” says Dr. Chao. Your plan for diabetes care may include at-home testing, as well.

People can test with a blood glucose monitor like the OneTouch Ultra2 diabetes blood glucose monitor, CVS Health Advanced Bluetooth Blood Glucose Meter or CVS Health Premium True Metrix glucometer.

This will give you a snapshot of your glucose level at the moment of testing, which may be useful for seeing how certain meals affect your level. People with diabetes should take A1C tests for what Dr. Chao calls “the 10,000-foot view” in their doctor’s office at least twice a year. You may also test at home between visits if you wish.

If you have already been diagnosed with diabetes and are testing your blood sugar levels, you can find glucometer test strips and lancets on CVS.com® as well:

Test strips

Lancing devices and lancets

In conclusion, don’t be afraid to learn your blood sugar status to help prevent serious complications down the road. Says Dr. Chao: “I believe increasing awareness and decreasing stigma is so important — so this disease doesn’t sneak up on you.”

This content is for informational purposes only and is not medical advice. Consult with your health care provider before taking any vitamins or supplements, and prior to beginning or changing any health care practices.

  • *FOR A1C TESTING: Patients must be 18 years and older. Services vary by state. Restrictions apply. Get details here.