American Diabetes Month is November, and Nov. 14 is World Diabetes Day — a time to promote awareness of diabetes, its symptoms, the different kinds of diabetes, and how the disease affects adults and children.

More than 38 million people of all ages in the U.S. have diabetes, and the condition may be diagnosed at any age. Type 2 diabetes is the most common form, affecting 1 in 10 Americans. It occurs when the body cannot use insulin (the hormone that balances blood sugar levels) correctly, and sugar builds up in the blood. With more children having problems with excess weight, pediatricians are seeing increasing rates of type 1 and type 2 diabetes during childhood, reflecting projections made by the Centers for Disease Control and Prevention that are expected to continue through 2060.

More common in youth (though it can develop at any age), type 1 diabetes is a lifelong autoimmune disease in which the body’s immune system destroys insulin-secreting cells in the pancreas. In both types of diabetes, high blood sugar levels caused by diabetes can damage the eyes, kidneys, nerves and heart, making disease management mandatory for long-term health.

Johns Hopkins Medicine experts say many people are at risk of diabetes and are unaware. Prediabetes, or blood sugar above the normal range, is common, though many people don’t know they have it. Blood sugar levels should be assessed yearly for most adults. For people with prediabetes or elevated type 2 diabetes risk, it is possible to prevent diabetes through lifestyle intervention and medication.

Experts say there is a growing focus on individualized diabetes goals, especially with aging. Diabetes treatment involves balancing the control of blood sugar, blood pressure and cholesterol, while minimizing the risks and burdens associated with medications, including side effects, administration difficulties, financial costs and the psychological toll of managing a lifelong illness. With aging, the risks associated with medications become greater, and often control of blood sugar levels does not need to be as strict. Arriving at the right balance requires open communication among doctors, people with diabetes and their care partners.

Johns Hopkins Medicine experts say diabetes treatment is improving; newer medications and technologies target not just blood sugar but also cardiovascular health, kidney health, liver health and weight loss. For example, continuous glucose monitoring (CGM) can benefit many people with type 1 or type 2 diabetes, especially those who are treated with insulin. CGM allows people with diabetes to view their blood sugar levels in real time, understand their daily blood sugar patterns, and receive alerts to prevent dangerous low or high blood sugar episodes, as well as allowing caregivers of pediatric patients and health care partners to follow blood sugar levels. Additionally, specialized treatments for type 1 diabetes are being developed, including new technologies to deliver insulin into the body and new medicines to preserve the body’s ability to make insulin.

The following Johns Hopkins Medicine and Johns Hopkins Children’s Center experts are available for interviews:

Type 1 Diabetes:

• Aniket Sidhaye, M.D.

Endocrinologist, The Johns Hopkins Hospital

Associate Professor of Clinical Medicine and Pediatrics, Johns Hopkins University School of Medicine

• Tom W. Donner, M.D.

Director, Johns Hopkins Diabetes Center, The Johns Hopkins Hospital

Associate Professor of Medicine, Johns Hopkins University School of Medicine

Type 2 Diabetes:

• Scott Pilla, M.D., M.H.S.

Internal Medicine Physician, Johns Hopkins Health Care & Surgery Center — Green Spring Station

 Assistant Professor of Medicine, Johns Hopkins University School of Medicine

• Eva Tseng, M.D., M.P.H.

Internal Medicine Physician, Johns Hopkins Health Care & Surgery Center — Green Spring Station

Associate Professor of Medicine, Johns Hopkins University School of Medicine

Pediatrics:

• Kristin Arcara, M.D.

Clinical Co-director, Division of Pediatric Endocrinology and Diabetes, Johns Hopkins Children’s Center

Assistant Professor of Pediatrics, Johns Hopkins University School of Medicine

• Sheela Magge, M.D., M.S.C.E.

Director, Division of Pediatric Endocrinology and Diabetes, Johns Hopkins Children’s Center

Professor of Pediatrics, Johns Hopkins University School of Medicine

• Risa Wolf, M.D.

Director, Pediatric Diabetes Program, Johns Hopkins Children’s Center
Associate Professor of Pediatrics, Johns Hopkins University School of Medicine