Diabetes is a disorder of metabolism--the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.

After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Diabetes is widely recognized as one of the leading causes of death and disability in the United States. In 2000, it was the sixth leading cause of death. About 65 percent of deaths among those with diabetes are attributed to heart disease and stroke. An estimated 18.2 million people (6.3 percent of the population) in the United States have diabetes, a serious, lifelong condition.

Diabetes is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.

In 2002, diabetes cost the United States $132 billion. Indirect costs, including disability payments, time lost from work, and premature death, totaled $40 billion; direct medical costs for diabetes care, including hospitalizations, medical care, and treatment supplies, totaled $92 billion.

The three main types of diabetes are:
    type 1 diabetes
    type 2 diabetes
    gestational diabetes

Diabetes is not contagious. People cannot "catch" it from each other. However, certain factors can ncrease the risk of developing diabetes.

Type 1 diabetes occurs equally among males and females, but is more common in whites than in nonwhites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most African, American Indian, and Asian populations. However, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are unknown.

Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanic Americans. On average, non-Hispanic African Americans are 1.6 times as likely to have diabetes as non-Hispanic whites of the same age. Hispanic Americans are 1.5 times as likely to have diabetes as non-Hispanic whites of similar age. American Indians have one of the highest rates of diabetes in the world. On average, American Indians and Alaska Natives are 2.2 times as likely to have diabetes as non-Hispanic whites of similar age. Although prevalence data for diabetes among Asian Americans and Pacific Islanders are limited, some groups, such as Native Hawaiians and Japanese and Filipino residents of Hawaii aged 20 or older, are about twice as likely to have diabetes as white residents of Hawaii of similar age.

    you are overweight
    you are 45 years old or older
    you have a parent, brother, or sister with diabetes
    your family background is African American, American Indian, Asian American, Hispanic American/Latino, or Pacific Islander
    you have had gestational diabetes or gave birth to at least one baby weighing more than 9 pounds
    your blood pressure is 140/90 or higher, or you have been told that you have high blood pressure
    your HDL cholesterol is 35 or lower, or your triglyceride level is 250 or higher
    you are fairly inactive, or you exercise fewer than three times a week

The prevalence of diabetes in the United States is likely to increase for several reasons. First, a large segment of the population is aging. Also, Hispanic Americans and other minority groups make up the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and sedentary. According to recent estimates, the prevalence of diabetes in the United States is predicted to reach 8.9 percent of the population by 2025.

Many Americans are at a high risk of developing type 2 diabetes, and being overweight increases that risk. Losing a small amount of weight, by getting 30 minutes of physical activity 5 days a week and eating healthy, will help prevent diabetes. To get started, use this guide for ideas on moving more, eating healthier, and tracking your progress.

    Less on your plate.
    Keep meat, poultry and fish servings to about 3 ounces.
    Make less food look like more by serving your meal on a salad or breakfast plate.
    Try not to snack while cooking or cleaning the kitchen.
    Try to eat sensible meals and snacks at regular times throughout the day.
    Make sure you eat breakfast every day.
    Use broth and cured meats (smoked turkey and turkey bacon) in small amounts. They are high in sodium. Low sodium broths are available in cans and powder.
    Share your desserts.
    When eating out, have a big vegetable salad, then split an entree with a friend or have the other half wrapped to go.
    Stir fry, broil or bake with non-stick spray or low sodium broth and try to cook with less oil and butter.
    Drink a glass of water or other "no-calorie" beverage 10 minutes before your meal to take the edge off your appetite.
    Select the healthier choice at fast food restaurants. Try grilled chicken instead of the cheeseburger. Skip the french fries or replace the fries with a salad.
    Listen to music while you eat instead of watching TV (people tend to eat more while watching TV).
    It takes 20 minutes for your stomach to send a signal to your brain that you're full. Eat slowly.
    Eat a small meal.
    Teaspoons, salad forks, or child-size utensils may help you take smaller bites and eat less.
    You don't have to cut out the foods you love to eat. Just cut down on your portion size and eat it less often.

    Dance it away.
    Show your kids the dances you used to do when you were their age.
    Turn up the music and jam while doing household chores.
    Deliver a message in person to a co-worker instead of e-mailing.
    Take the stairs to your office. Or take the stairs as far as you feel comfortable, and then take the elevator.
    Make a few less phone calls. Catch up with friends during a regularly scheduled walk.
    March in place while you watch TV.
nbsp;   Park as far away as possible from your favorite store at the mall.
    Select an exercise video from the store or library.
    Get off the bus one stop earlier and walk the rest of the way home or to work at least two days a week.

    Snack on a veggie.
    Try getting at least one new fruit or vegetable every time you grocery shop.
    Macaroni and low-fat cheese can be a main dish. Serve it with your favorite vegetable dish and a salad.
    Try eating foods from other countries. Many international dishes feature more vegetables, whole grains and beans and less meat.
    Cook with a variety of spices instead of salt.
    Find a water bottle you really like (church or club event souvenir, favorite sports team, etc.) and drink water from it wherever and whenever you can.
    Always keep a healthy snack with you.
    Choose veggie toppings like spinach, broccoli and peppers for your pizza.
    Try different recipes for baking or broiling meat, chicken, and fish.
    Try to choose foods with little or no added sugar.
    Gradually work your way down from whole milk to 2% milk to 1% milk until you're drinking and cooking with fat free (skim) milk.
    Try keeping a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods high in fat or calories.
    Eat foods made from a variety of whole grains-such as whole wheat bread, brown rice, oats, and whole grain corn-every day. Use whole grain bread for toast and sandwiches; substitute brown rice for white rice for home-cooked meals and when dining out.
    Don't grocery shop on an empty stomach and make a list before you go.
    Read food labels. Choose foods with lower fat, saturated fat, calories, and salt.
    Fruits are colorful and make a welcoming centerpiece for any table. Have a nice chat while sharing a bowl of fruit with family and friends.
    Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a slice of cake. Peel and eat an orange instead of drinking orange juice.

    You can exhale, Gail.
    Don't try to change your entire way of eating and exercising all at once. Try one new activity or food a week.
    Find mellow ways to relax--try deep breathing, take an easy paced walk, or enjoy your favorite easy listening music.
    Give yourself daily "pampering time" and honor this time like any other appointment you make... whether it's spending time reading a book, taking a long bath, or meditating.
    Try not to eat out of boredom or frustration. If you're not hungry, do something else.
    Honor your health as your most precious gift.

There are many more ways to prevent type 2 diabetes with healthy eating and physical activity. Discover your own and share it with your family, friends and neighbors.

Take the first step today. If you're overweight, you may be at high risk for developing type 2 diabetes. Talk to your health care provider today.