By Kathy Cunningham

As many as 552 million people – or about 1 in 10 adults worldwide – could have diabetes by 2030, according to a report by the International Diabetes Federation. Experts said as many as 183 million people were unaware that they have diabetes, and the highest proportion of cases is among those ages 40 to 59.

November is the month to raise our awareness of diabetes, so we can know if we are at risk for developing type 2 diabetes. With the statistics of 183 million unaware, do you know if you are at risk?

There are three basic steps to reduce your risk of developing type 2 diabetes. One, know your risk factors; two, raise your awareness of the warning signs; and three, get tested to know your numbers. These simple steps can determine if you have pre-diabetes or diabetes.

Pre-diabetes is a condition where greater than normal glucose levels are found in the blood, and without healthy lifestyle changes can develop into type 2 diabetes. Pre-diabetes often has few or no symptoms, which is why 100 million people in the US are affected and may not even know it.

Type 2 Diabetes occurs when either the body does not produce enough insulin, or the cells ignore it. Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can lead to diabetes complications.

To take action, follow these steps:

Step one: Am I at risk?

To find out Click here: This 10 questionnaire will help to determine your risk for developing type 2 diabetes and help you move toward next steps for a healthier you.

Step Two: Do I have any symptoms?

Although most people with pre-diabetes have no symptoms at all, they may experience unusual thirst, a frequent need to urinate, blurred vision, or extreme fatigue. Frequent urination is caused by the kidney’s attempt to lower the elevated blood glucose levels by excreting the excess in the urine. This increased flow of urine results in significant loss of body fluid and signals thirst to the brain to get you to drink more water. Fatigue is another very common symptom that is associated with the body’s inability to properly utilize the glucose for fuel, which the body needs for everything to work correctly. The lack of efficient energy production causes fatigue.

Another sign of pre-diabetes and diabetes, most commonly among people of African descent, is Acanthuses Nigricans which is a skin disorder that results in velvety, light-brown-to-black markings that occur in areas including the neck, armpits, groin, and under the breasts. Most people with Acanthosis Nigricans have an insulin level that is higher than normal.

Being overweight, inactive, and consuming an unhealthy diet of foods and sugary drinks containing refined starches and sugars can raise insulin levels.

If you have a risk assessment score that indicates increased risk or have any of the symptoms, take step number three and contact your primary care physician.

Step three: Get tested to know your number for pre-diabetes and diabetes risk.

Your doctor will test urine and blood for glucose levels and A1C. Normal glucose levels are less than 100mg/dl, pre-diabetes levels are 100-125mg/dl, and diabetes is levels greater than 126.

Another common blood test is A1C. The A1C test result reflects your average blood sugar level for the past two to three months, so it can be a measure to gauge how well your managing if diagnosed with diabetes. Normal non-diabetic A1C levels are between 4-5.5 percent, pre-diabetes levels are between 6-6.5 percent and greater than 6.5 percent indicates diabetes.

By being informed about your risk factors, symptoms, and blood levels, you can speak with your provider about healthy foods and beverages, and a physical activity schedule that will fit your lifestyle. Taking control of your lifestyle habits to support even a 5 percent or more weight loss can make a big difference in the possibilities of preventing or slowing down the progression of diabetes. For more information, visit the American Diabetes Association.

Kathy Cunningham is a registered dietitian at the Boston Public Health Commission.