FAIRMONT - The Minnesota Department of Health estimates 80,000 adults in the state could have diabetes and not know it.
"I've seen [statistics say] up to 1.4 million may have pre-diabetes and not know it," Robin Arndorfer, a nurse and certified diabetes educator with Mayo Clinic Health System-Fairmont.
The percentage of adults in Minnesota living with diabetes has nearly doubled between 1994 and 2010, and these numbers probably underrepresent the true number of people living with the condition, according to the Department of Health.
About 290,000 adults in Minnesota, or 7.3 percent, say they have been told by their health care team that they have diabetes.
Several things factor into the rising case of diabetes, Arndorfer said. People are living longer; they are not as active; and they are carrying extra weight. Ethnicity also plays a role; anyone who is not white is at greater risk.
"Society is changing," Arndorfer said.
Even a generation or two ago, people were more active, doing more physical labor, and they ate differently.
"It was the basics: meat, vegetables; smaller portions," she said. "Today, we're eating more on the go; more processed foods. We're consuming more carbs and fat."
Carbs are a problem, Arndorfer explained, because the pancreas makes insulin. Insulin production needs to keep up with the carbs we eat.
"If the pancreas isn't making enough insulin, if we take in too many carbs, we make our pancreas overwork," Arndorfer said.
Just like the rest of our bodies, our pancreas doesn't work as well as it ages.
"If our body isn't making good-quality insulin, our bodies store it as fat," Arndorfer said.
Watching what you eat is one of the simplest ways to help your health.
"Try to get back to good old basic eating," she said.
Fast food burgers used to be much smaller, Arndorfer pointed out, and fries only came in one size: small.
"We think we need three times that," Arndorfer said.
She offered some tips to stay on track. Use a smaller plate so you're not tempted to load it up. Have one set snack and choose something healthy, such as fruit, vegetables, nuts, mozzarella sticks or yogurt.
"Cut down on fats, calories and carbs; limit fast food," she said.
Calories can hide in foods: Arndorfer said one can of regular soda has 10 teaspoons of sugar. She said to limit diet sodas because of the artificial sweeteners. Water is a better choice for a drink because it hydrates you.
Exercise is also important.
"Exercising 150 minutes a week can make a world of difference," Arndorfer said. "It can help you lose weight and make the insulin you are making work better."
Everyone should know where they are on the diabetes risk scale.
"A risk assessment test is a good first step," Arndorfer said. "If you're rating high on that, you'll want to get tested."
There are two types of diabetes, Arndorfer said. Type 1 has a sudden onset, whereas Type 2 progresses over time.
"Certain medications can put you in a state of Type 2 diabetes," she warned.
Since Type 2 diabetes comes on slowly, the first step is pre-diabetes.
"With pre-diabetes, you don't feel any different in the early stages," Arndorfer said.
Those with pre-diabetes could experience blurry vision and excessive thirst, the need to urinate more often, be more tired, and be at an increased risk of infection.
Risk factors for developing diabetes include a family history, getting older and carrying extra weight, she said. High blood pressure, high cholesterol, smoking and excessive alcohol consumption also can contribute. Women who had gestational diabetes or large babies are also at risk.
People with risk factors should be tested for diabetes at least once a year, Arndorfer said.
Fasting glucose, or blood sugar, is calculated on a scale. Normal is between 70-100, pre-diabetes is between 100-125; and diabetes is 126 and above.
The consequences of uncontrolled diabetes are staggering.
People are at a greater risk of stroke and heart attack; they can develop retinopathy in their eyes; the kidneys can be damaged, and so can the feet.
"Neuropathy, circulation issues, sores that don't heal," Arndorfer said of possible foot issues.
Amputations are also a consequence.
Despite the sobering status of society when it comes to diabetes, Arndorfer says the future looks brighter.
Schools are implementing nutrition programs to keep childhood obesity in check. Workplaces and insurance companies are promoting exercise in stay-well programs. Minnesota is promoting the "I Can Prevent Diabetes" program and many communities are picking up on it.
"The earlier they take control, the more you push the complications away in your lifetime," Arndorfer said. "People do want to do the right thing, but they need the tools to understand how to prevent these situations. Getting control right away is paramount."