Diabetes is a disease in which the ability of the body to use energy from food is impaired. Food is converted to glucose for use by the body. The pancreas produces insulin that helps the body use glucose. When the pancreas doesn’t produce enough insulin or the body cannot use insulin sufficiently, too much glucose is circulated in the blood. This is diabetes and if left untreated can lead to very serious consequences. There are three main types of diabetes: Type 1 diabetes, often called “juvenile” diabetes because it begins at an early age, requires the person to take insulin to regulate use of glucose in order to stay alive. Type 2 diabetes occurs when the body does not produce enough insulin or cannot utilize insulin properly. This type is controlled with diet, exercise and often medication. Some adults with Type 2 diabetes also need insulin. In the past, only adults developed this type of diabetes; however now children and youth are experiencing the disease. Gestational diabetes is a temporary form of glucose intolerance that is diagnosed in some women during pregnancy.

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Diabetes can affect many parts of the body and can lead to serious complications such as blindness, kidney damage, loss of teeth, heart attack, stroke and lower-limb amputation. Individuals with diabetes can reduce the occurrence of these and other diabetes complications by controlling their levels for blood glucose, blood pressure and blood lipids. Complications may also be controlled by routinely receiving preventive care practices such as regular physical, dental and eye examinations and receiving flu and pneumonia vaccinations. Individuals with diabetes should check their own blood sugar level as recommended by their doctor and also have a special blood sugar check called an A1C test two to four times a year. Increasing physical activity and maintaining a balanced eating pattern can help minimize the severity of the disease and prevent the development of diabetes.

Before individuals develop Type 2 diabetes, they almost always have “pre-diabetes”—blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. Some heart and circulatory system damage may already be occurring during pre-diabetes.

Increasing diabetes awareness, knowledge and skills can result in improved self-management among those with the disease and prevent others from having the disease. Additionally, it is important to create social and environmental support for those with diabetes through strategies such as creating buddy systems for emotional support and providing safe environments in which individuals can be physically active.

Included in the Intervention MICA diabetes topic are considerations for implementing interventions with different populations and in different settings. Evidence-based strategies and interventions are described in detail. Action steps, tools and resources for planning and implementing a diabetes intervention are provided. Additionally, related Intervention MICA topics include:

• Physical Activity
• Nutrition
• Tobacco

Several resources are available that provide more information about prevention and management of diabetes. For educational materials and campaigns, and information about provider training, self-management, integrated approaches to care, access to services and resources, and other risk factors associated with diabetes, go to one of the following websites:

• Department of Health and Senior Services
  http://health.mo.gov/living/healthcondiseases/chronic/diabetes/
• Centers for Disease Control and Prevention
  http://www.cdc.gov/diabetes/
• American Diabetes Association
  http://www.diabetes.org/
• National Diabetes Education Program
  http://www.ndep.nih.gov/
• Diabetes MICA Tools and Resources