The odds are high in South Carolina that, at this very moment, one of your friends or family members is living with a serious disease – and doesn't even know it.

At last count, nearly 560,000 people (or 13.5 percent of the Palmetto State's adult population) had been diagnosed with diabetes. Another 34.9 percent of South Carolina's adult population had been diagnosed with pre-diabetes.

But, the actual number is likely much higher, with another 120,000 adult South Carolinians estimated to have the disease and do not yet know it, according to Diabetes Free SC.

"Diabetes is often an asymptomatic disease until it becomes pretty severe; people can go years without knowing they have it," said Anthony Paul Schwab Jr, MD, an internal medicine physician with The Columbia Medical Group. "It doesn't really have a lot of significant symptoms like some other diseases do."

Dr. Schwab sees the impact of this hidden killer every day at his practice.

"It may be something where people just have to urinate a little bit more than normal – or are a little bit more thirsty than normal," Dr. Schwab said. "People will usually chalk that up to the heat, or they'll say, 'I've just been drinking more water, so I'm peeing more.' It can be very subtle."

Diabetes is the seventh-leading cause of death in South Carolina, and it disproportionately impacts Black patients - who are 2.3 times more likely to die from it than whites. One in every ten emergency room visits in our state is diabetes related.

Diabetes can wreak havoc on the body, especially when it is undiagnosed.

"Two different processes are going on most of the time," said Dr. Schwab. "First, your body is usually unable to produce enough of a hormone called insulin, which helps regulate your blood sugar. And then your body doesn't respond to insulin well anymore. That's because you've probably had high sugar levels in your blood for so long that it has almost desensitized to it."

As diabetes slowly worsens, the damage it causes within the body increases.

"Over time, diabetes damages the blood vessels - and you see that come up in the form of heart disease, kidney disease and other serious conditions," Dr. Schwab said. "Diabetes is the leading cause of kidney failure along with contributions from hypertension. It can also cause issues with blood pressure because it damages blood vessels. It puts you at risk for strokes as well as blindness because it also affects your eyes."

While these symptoms are noticeable once they hit, the key to effective treatment is noticing them before they hit - before they can cause irreversible damage or death.

"Diabetes does a lot of damage silently, which is why people need to get screened early," Dr. Schwab added. "The earlier we catch it, the better we can prevent these problems from occurring down the line."

Age and obesity can also factor into someone developing diabetes - and heredity plays a significant role, too.

"If you have a strong family history of it, even if you have a very healthy lifestyle, you're still at an increased risk of developing it later in life," Dr. Schwab warned. "It's a process that happens over time, where your body is just unable to produce enough insulin and then develops that resistance. So that happens at different rates for different people. And that often has to do with genetic predisposition, but it's also pretty heavily tied to lifestyle as well."

For those with diabetes, the combination of newer medications - and healthier choices - can work wonders.

"I've seen people prevent the development of diabetes with lifestyle changes as well," Dr. Schwab said. "Everybody associates diabetes with eating ice cream or candy or sodas or sweet teas. But a lot of times, it involves eating things that you don't think about - like bread, rice, pasta, and very carb-heavy foods that aren't sweet."

Being prescribed the proper medication is also critical to tackling the disease.

"An oral medication, like metformin, is very helpful in treatment," Dr. Schwab said. "It's probably the most common one. It's just a pill you take once or twice a day, and it helps with the insulin resistance part and controls those blood sugars."

While medicines are helpful, Dr. Schwab emphasized that the biggest thing people can do is make those lifestyle changes, including increasing their daily physical activity.

"Being active - even if it's just walking for 20 to 30 minutes a day - starting small helps," he said. "And then making those dietary changes where you don't have to get rid of everything, but you do have to cut back. It's that 'everything-in-moderation' approach. Those are all things that can help prevent diabetes."


Anthony Paul Schwab Jr, MD, The Columbia Medical Group