South Carolina has one of the highest rates of diabetes in the nation, with 1 in 7 adult South Carolinians diagnosed with the condition. It’s important to know the warning signs of diabetes so you can intervene early. Angie Cain, PA-C, with Lexington Internists Northeast, is here to answer your questions about diabetes.

Q. What is diabetes?

There are two main types of diabetes: type 1 and type 2. Both types of diabetes are chronic diseases that affect the way your body regulates blood sugar, or glucose.

People with type 1 diabetes don’t produce insulin. This condition often appears suddenly in childhood or adolescence and cannot be prevented.

People with type 2 diabetes don’t respond to insulin as they should and, later in the disease, often don’t make enough insulin. Type 2 diabetes is much more common that type 1 diabetes and makes up more than 95 percent of all cases.

Q. What are the symptoms of diabetes?

A. The most common symptoms include increased thirst, frequent urination, fatigue, blurry vision and numbness or tingling in the hands or feet. If you’re experiencing these symptoms, you should see your health care provider, who may order a blood test called a hemoglobin A1c to determine your average blood sugar level over the past three months.

Q. Can you be borderline diabetic?

A. Yes, you can be borderline or pre-diabetic.

• Normal:  A1c less than <5.7
• Pre-diabetic: A1c between 5.7 – 6.4
• Diabetic: A1c of 6.5 or greater

It is much better to diagnose someone in the pre-diabetic stage because it is easier to treat at that stage. It is also possible to prevent the condition from progressing into diabetes and causing damage to the body.

Q. If you’re diagnosed with pre-diabetes or diabetes, what can you do to manage it?

You can help control both conditions through diet and exercise. It’s important to follow a low-carbohydrate diet and exercise regularly. Even weight loss of as little as five pounds can help lower your blood sugar.

If you are diagnosed with type 2 diabetes, you may be prescribed oral medications in addition to managing your diet and increasing your physical activity. If these combined measures lower your A1c level to 6.0 or below, you may be able to discontinue oral medications. However, if your A1c rises to 10.0 or greater, you will likely need to begin taking insulin.

If you are diagnosed with type 1 diabetes, you will begin taking insulin right away.

Q. What are the risks of uncontrolled diabetes?

Diabetes can cause damage to many parts of the body, including the eyes, kidneys, nerves and blood vessels. This can lead to loss of vision, kidney disease, heart diseases, stroke, pain or loss of feeling of the arms and legs, poor circulation and even amputations. The longer diabetes remains uncontrolled, the greater the risk of damage.

Q. Why are people with diabetes more at risk for complications from COVID-19?

In general, people with diabetes are more likely to have more severe symptoms and complications when infected with any virus, including COVID-19. Studies have shown that uncontrolled blood sugar impair the body's normal immune response.

Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19 or other viral infections because having more than one health condition makes it harder your body to fight infection.

Q. What do you wish more people knew about diabetes?

Some people assume that all diabetics need insulin, which is not the case. Many people can control with diabetes with diet, exercise and oral medications.

It is important to see your health care provider regularly to manage your diabetes so you can prevent other health conditions from developing.


Angie Cain, PA-C, Lexington Internists Northeast