November is Diabetes Awareness month and I encourage each of us to Be Aware. Diabetes is daunting, complex and at times quite a scary illness. The majority of us know someone who is affected by diabetes and the resulting complications. As a result, we tend to be like an ostrich and just bury our heads in the sand.

For some of you, you may need to Be Aware of your risk of diabetes, either type 1 or type 2 diabetes. Prediabetes is a condition where blood sugars are abnormal but not quite yet to the degree of diabetes. This generally can be defined as an A1c of 5.8 to 6.4% or a fasting blood sugar between 100 and 124 mg/dl. It is estimated that 1 out of 3 Americans has prediabetes and the majority of them dont know it. You can take a formal risk test online at DoIHavePrediabetes.org. You should also Be Aware that there are non-medication treatments to help prevent diabetes which includes working up to 30 min of physical activity 5 days a week, watching your portion sizes, and your resulting weight. Fortunately in Montana, Be Aware that we have multiple CDC certified Diabetes Prevention Programs throughout the state. This includes the collaborative program between St Vincent Healthcare and the YMCA if you want formal coaching in this area. The next program session starts in January, so dont delay.

You should also Be Aware that there has been a new body of research that is helping us identify early stages of type 1 diabetes. This comes from decades of research through coordinated research centers and scientists studying the autoimmunity of type 1 diabetes and ultimately trying to find a way to prevent the onset of type 1 diabetes in those at risk. In a landmark paper published this summer teplizumab, a CD3 monoclonal antibody, was the first medication ever to show a delay in the onset of type 1 diabetes in a high risk population. You can read more about this important research at trialnet.org. Be Aware, that despite these advances, the NIH funding for this research as been dramatically reduced this year and subsequent years.

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Be Aware if you already have diabetes, whether its type 1 or type 2, that you have the ability and resources to take control. Be Aware of others in your life that can help you if you are willing to ask for help. You have a team of diabetes professionals available to you including your diabetes educator, dietician, or pharmacist to help provide tools to improve your glucose control and reduce your risk of long term complications. Maybe for you its engaging with a counselor or life coach to help you overcome your habit of comfort or stress eating. Have you considered asking a friend or your spouse to help you stay committed to the activity goals that you have set for yourself?

Finally, Be Aware that the field of diabetes is advancing with new technologies at speeds never seen before. Some of these include advancements in continuous glucose monitors, automated insulin delivery through insulin pumps, bluetooth connected insulin pens and meters, as well as new medications. Figuring out the best options for you requires you to engage with your treatment team

As we move from November into the holiday season, lets all Be Aware about diabetes and its impact on us, our friends and family, and our healthcare system at large. Be Aware that you have what it takes to make the difficult choices to impact this disease, from prevention to treatment.

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Justen Rudolph, MD, is the Director of the St. Vincent Diabetes & Endocrine Center

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This month, join the fight against diabetes | Health and Fitness - Billings Gazette