More than 16 million Americans have diabetes and half of them don't know it, according to national statistics.

That's a problem because the longer diabetes goes undiagnosed, the greater the chance of serious complications, including blindness, heart attack, stroke, kidney failure and amputations, said Nancy Russell, office manager of the Diabetes Education and Management Center at St. Francis Medical Center.

Often the damage to blood vessels that can cause stroke and eye and heart damage will occur before serious symptoms of diabetes arise, said registered nurse Janet Stewart, a certified diabetes educator at Southeast Missouri Hospital.

There are several types of diabetes, a disease in which the body doesn't produce or properly use insulin, a hormone needed to convert sugar, starches and other food into energy needed for daily life. Type 1 is an autoimmune disease in which the body does not produce any insulin, most often occurring in children and young adults. Gestational diabetes develops in about 5 percent of all pregnancies but disappears when a pregnancy is over.

The most common, and most preventable, form of the disease is Type 2 or adult onset diabetes, a metabolic disorder resulting from the body's inability to make enough, or properly use, insulin.

Accounting for 90 percent to 95 percent of all diabetes cases, Type 2 diabetes is nearing epidemic proportions, due to an increased number of older Americans and a greater prevalence of obesity and a sedentary lifestyle, according to the American Diabetes Association.

Some risk factors can't be changed, such as age (diabetes is more common in people over age 45), having a family history of diabetes and a woman having a baby that weighs more than nine pounds at birth, Russell said. Other risk factors are under a person's control, such as being overweight and leading a sedentary lifestyle.

Maintaining a healthy weight (within 20 percent of ideal weight), eating a balanced diet, eating on a regular schedule (rather than gorging then fasting) and participating regularly in physical activities can help reduce the risk of developing diabetes, Stewart said.

Those same things can help those who have already developed diabetes control the disease, Stewart said.

People newly diagnosed with diabetes who are put on a program to manage the disease usually start feeling better right away, Stewart said.

"Diabetes is a metabolic disease that affects how the body produces energy," Stewart said. "When patients get their metabolism back on track, they have more energy, rest better at night, get their strength back."

The management of diabetes generally involves diet, exercise and, often, medications. However, sometimes proper diet and exercise can control the disease without the need for medication, Stewart said.

There are warning signs that could alert people that they might have diabetes, Russell said. Symptoms include extreme thirst, blurry vision from time to time, frequent urination, unusual tiredness or drowsiness and unexplained weight loss.

People who have such symptoms, especially if they have several of the risk factors for diabetes, should have a screening done right away. Even without symptoms, those who have risk factors should have a screening done yearly, Stewart said.

A screening for diabetes takes only a few minutes. The diabetes center at St. Francis offers free screenings on an appointment basis and at certain events. Southeast charges $5 for the screening, but often offers free screenings in association with some health fairs or events.

The screening involves a finger prick to draw blood then doing a quick analysis of blood sugar. The screening is not a diagnosis, emphasized registered nurse Amy Ward, a diabetes educator at St. Francis. If the screening reveals a high blood sugar reading, the person is referred to a physician for more thorough testing, Ward said.

The prevalence of diabetes is increasing as the average weight of Americans increases and the amount of time spent in physical activity decreases, Stewart said.

"But it is preventable, if people would watch their weight and exercise more," she said.

To contact the Diabetes Education and Management Center at St. Francis Medical Center, call 331-5897 or (800) 457-1720. To contact Southeast Missouri Hospital's Generation Family Resource Center, which has a library of material on diabetes and can put callers in touch with a diabetes educator, call 651-5825.

SYMPTOMS OF DIABETES

*Extreme thirst

*Blurry vision from time to time

*Frequent urination

*Unusual tiredness or drowsiness

*Unexplained wight loss

RISK FACTORS FOR DIABETES

1. Overweight?... Add 5 points

2. Under 65 years of age and get little or no exercise during the day?... Add 5 points

3. Between 45 and 64 years old?... Add 5 points

4. 65 years or older?... Add 9 points

5. Female who had a baby weighing more than 9 pounds at birth?... Add 1 point

6. Brother or sister has diabetes?... Add 1 point

7. A parent has diabetes?... Add 1 point

Total Score:

3-9 points

Low risk for diabetes, but don't just forget about diabetes. You may be at higher risk in the future.

10 or more points

High risk for diabetes. consult your doctor to find out if you're diabetic.