Why Diabetes is Part of the Wellness Initiative
People with a severe mental illness have a greater risk of developing type 2 diabetes than those without a severe mental illness. The incidence of prediabetes is also higher. They are also more likely to have an unstable economic status, less access to healthy food, housing, and healthcare.
Diabetes is a chronic health condition that affects how your body turns food into energy.
Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream. When your blood sugar goes up, it signals your pancreas to release insulin. Insulin acts like a key to let the blood sugar into your body’s cells for use as energy.
If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it makes as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease.
There isn’t a cure yet for diabetes, but losing weight, eating healthy food, and being active can really help. Taking medicine as needed, getting diabetes self-management education and support, and keeping health care appointments can also reduce the impact of diabetes on your life.
Types of Diabetes
There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant).
Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake) that stops your body from making insulin. Approximately 5-10% of the people who have diabetes have type 1. Symptoms of type 1 diabetes often develop quickly. It’s usually diagnosed in children, teens, and young adults. If you have type 1 diabetes, you’ll need to take insulin every day to survive. Currently, no one knows how to prevent type 1 diabetes.
With type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. About 90-95% of people with diabetes have type 2. It develops over many years and is usually diagnosed in adults (but more and more in children, teens, and young adults). You may not notice any symptoms, so it’s important to get your blood sugar tested if you’re at risk. Type 2 diabetes can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy food, and being active.
Gestational diabetes develops in pregnant women who have never had diabetes. If you have gestational diabetes, your baby could be at higher risk for health problems. Gestational diabetes usually goes away after your baby is born but increases your risk for type 2 diabetes later in life. Your baby is more likely to have obesity as a child or teen, and more likely to develop type 2 diabetes later in life too.
In the United States, 88 million adults—more than 1 in 3—have prediabetes. What’s more, more than 84% of them don’t know they have it. With prediabetes, blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Prediabetes raises your risk for type 2 diabetes, heart disease, and stroke. The good news is if you have prediabetes, a CDC-recognized lifestyle change program can help you take healthy steps to reverse it.
Diabetes Risk Factors
- Type 1
- Type 2
- Gestational
- Prediabetes
Type 1 diabetes is thought to be caused by an immune reaction (the body attacks itself by mistake). Risk factors for type 1 diabetes are not as clear as for prediabetes and type 2 diabetes. Known risk factors include:
- Family history: Having a parent, brother, or sister with type 1 diabetes.
- Age: You can get type 1 diabetes at any age, but it’s more likely to develop when you’re a child, teen, or young adult.
In the United States, whites are more likely to develop type 1 diabetes than African Americans and Hispanic/Latino Americans.
Currently, no one knows how to prevent type 1 diabetes.
You’re at risk for developing type 2 diabetes if you:
- Have prediabetes
- Are overweight
- Are 45 years or older
- Have a parent, brother, or sister with type 2 diabetes
- Are physically active less than 3 times a week
- Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds
- Are African American, Hispanic/Latino American, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk)
If you have non-alcoholic fatty liver disease you may also be at risk for type 2 diabetes.
You can prevent or delay type 2 diabetes with simple, proven lifestyle changes such as losing weight if you’re overweight, eating healthier, and getting regular physical activity.
You’re at risk for developing gestational diabetes (diabetes while pregnant) if you:
- Had gestational diabetes during a previous pregnancy
- Have given birth to a baby who weighed more than 9 pounds
- Are overweight
- Are more than 25 years old
- Have a family history of type 2 diabetes
- Have a hormone disorder called polycystic ovary syndrome (PCOS)
- Are African American, Hispanic/Latino American, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander
Gestational diabetes usually goes away after your baby is born but increases your risk for type 2 diabetes later in life. Your baby is more likely to have obesity as a child or teen, and is more likely to develop type 2 diabetes later in life too.
Before you get pregnant, you may be able to prevent gestational diabetes by losing weight if you’re overweight, eating healthier, and getting regular physical activity.
You’re at risk for developing prediabetes if you:
- Are overweight
- Are 45 years or older
- Have a parent, brother, or sister with type 2 diabetes
- Are physically active less than 3 times a week
- Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds
- Are African American, Hispanic/Latino American, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk)
You can prevent or reverse prediabetes with simple, proven lifestyle changes such as losing weight if you’re overweight, eating healthier, and getting regular physical activity. The CDC-led National Diabetes Prevention Program can help you make healthy changes that have lasting results.
How are We Addressing Diabetes in Oklahoma?
Through the Oklahoma State Department of Health, ODMHSAS is participating in a 5-year CDC grant that supports efforts to address the serious national health problems of diabetes, heart disease, and stroke.
This grant, awarded in September 2018, supports state efforts to:
Prevent or delay development of type 2 diabetes in people at high risk and improve the health of people living with diabetes.
Prevent and manage cardiovascular disease
Eight counties in Oklahoma were selected to participate in this pilot program. They were identified as having a higher than expected risk of developing high blood pressure, high blood cholesterol, diabetes, or prediabetes due to socioeconomic factors such as inadequate access to care, poor quality of care, or low income.
Behavioral Health Centers within these counties are participating in this initiative. Some of the interventions include:
Screening clients for prediabetes and diabetes.
Implementing diabetes self-management education and support (DSMES) programs that are recognized by the American Diabetes Association (ADA) or accredited by the Association of Diabetes Care and Education Specialists (ADCES) within their Behavioral Health Center (BHC).
Referring clients identified with prediabetes to a National Diabetes Prevention Program (National DPP) lifestyle change program.
Enrolling clients with diabetes in the DSMES program available at their BHH location.
Increase medication adherence among clients with high blood pressure and high blood cholesterol.
Increase engagement in self-management among clients with high blood pressure and high blood cholesterol.
Increase participation in evidence-based lifestyle interventions among clients with high blood pressure and high blood cholesterol.
ODMHSAS hopes to extend opportunities for additional Behavioral Health Centers to participate in these programs. If your BHC is interested, please contact: Sharon Buckley, RN, CDCES
The Burden of Diabetes in Oklahoma
Over 370,000 Oklahoma adults reported having been diagnosed with diabetes in 2018.
Type 2 diabetes accounts for 90% to 95% of all diabetes cases.
That’s 1 out of every 8 adults.
In 2018, Oklahoma had the 12th highest diabetes prevalence in the nation.
