The Health Threat Women Ignore

Don't let diabetes sneak up on you. Find out how to stay safe.

Prevent diabetes and avoid?...

A diagnosis of diabetes is a little like a breakup that takes you by surprise: One day, everything seems fine, and then—boom!—he tells you he's fallen in love with someone else. Only when you're looking back can you see all the warning signs.

Diabetes creeps up on you in much the same way. Its symptoms such as thirst, frequent urination and fatigue can be stealthy, appearing so gradually that you don't notice them until your body is already compromised by the disease. (We're talking about type 2 diabetes. Type 1, on the other hand, is genetic and usually comes on suddenly during childhood.) One in 12 American women has diabetes, but a third of them don't know it. That's partly because the illness, which hampers the body's ability to regulate blood sugar properly, is still thought of as an older person's problem and so isn't on young women's radar. "Yet we're seeing more and more women in their 20s and 30s with type 2 diabetes," says Eugene Barrett, M.D., professor of internal medicine at the University of Virginia in Charlottesville. "Before 10 years ago, women younger than 40 rarely developed the illness."

Although blood sugar problems may not sound scary, they are. If not treated, diabetes can damage nearly every system in your body, including the cardiovascular, digestive and central nervous systems. "Untreated or poorly controlled diabetes is a major cause of kidney and heart disease in the United States," says Robert Rizza, M.D., president of the American Diabetes Association in Alexandria, Virginia. The good news: Once you know what you're up against, you can do a lot to protect yourself—both from getting diabetes in the first place and from suffering complications if you do. In other words, you've got a big, bright window of opportunity to control your health future.

As with many chronic conditions, diabetes has no single culprit. Maybe you're a candidate because it's part of your family history. Or you might have gained some weight (being even moderately overweight can increase risk), or perhaps you don't exercise that much, if at all. Or the last time you thought about fiber was circa 1989, when your mom went on her All-Bran kick. Often a few factors come together and slowly start to chip away at your body's ability to absorb blood sugar, or glucose, the energy your cells need to survive.

Here's how your body is supposed to work: You eat, your stomach digests and your intestines transfer all the nutrients, including glucose, to your blood. At that point, your pancreas begins cranking out insulin, the hormone that shuttles glucose into the cells to be used as energy. But in the early stages of diabetes—often called prediabetes—the pancreas either secretes less insulin or the body stops responding to normal levels of the hormone, a condition known as insulin resistance. This means blood sugar levels remain high. "Because the cells don't react, more insulin is produced until they do," Dr. Barrett says. It's this excess supply of sugar that's extremely damaging to the nerves and cardiovascular system. It's so harmful, in fact, that being prediabetic means you're more apt to have a heart attack or stroke than someone with normal levels, Dr. Rizza says. If prediabetes is ignored, sugar levels can soar to dangerously high levels, eventually crossing the threshold for full-blown diabetes, which you'll have for life.

We're seeing more and more women in their 20s and 30s with type 2 diabetes.

Far more people—more than 40 million over age 40—have prediabetes than the disease itself, and they're probably even less likely to know they have it. "The numbers are staggering," Dr. Rizza says. That's because prediabetes and insulin resistance rarely have any symptoms you can detect. "Some people may notice a slight increase in thirst or the need to urinate," Dr. Barrett says. "But the symptoms are insidious. You may find yourself getting up at night to use the bathroom more often, but by the time you start doing it nightly, it seems more like a habit than a symptom."

Fortunately, if you know you have it, prediabetes can often be reversed, or at least reined in, so you're less prone to become diabetic. Simple lifestyle changes can cut diabetes risk by more than half, according to findings from the Diabetes Prevention Trial, a study of 3,234 people sponsored in part by the National Institutes of Health in Bethesda, Maryland. The researchers discovered that losing as little as 5 to 10 percent of your body weight (assuming you're overweight) and walking for 30 minutes, five days a week, can do the job. Both exercise and weight loss reduce the amount of insulin the body needs. Even giving up those fast food runs could make a difference. A study at the University of Minnesota in Minneapolis found that people who ate fast food more than twice a week had twice the increase in insulin resistance as people who indulged less frequently.

As complex as diabetes is, the first step to preventing it is a breeze: Get yourself screened. Your doctor will probably give you a fasting-glucose test, which measures blood sugar levels after an eight-hour fast, or a glucose-tolerance test, which checks how the body responds to being flooded with sugar.

Routine screening begins around age 45, but you may want to ask for it sooner if you have any of the major risk factors, including being overweight, a family history of diabetes or infrequent periods, a sign of polycystic ovary syndrome. You can also take the quiz on the previous page to find out if you should get tested sooner. No matter what your risk, it's a smart idea to ditch your french fry runs and go for a plain old run instead. The payoff will be well worth the grease withdrawal: the long, healthy, happy life you deserve.