Nearly 11 million Americans live with diabetes they don't know they have

The CDC estimates nearly 11 million people in the United States have diabetes without knowing it, out of roughly 40 million living with the disease nationwide. Diabetes ranks as the seventh leading cause of death in the country and the top cause of kidney disease.

Andrew Tucker, who lives with Type 2 diabetes, was diagnosed about 15 years ago when he was 35 and weighed around 250 pounds. He was in graduate school then, working long hours, and eating what he now calls a diet full of junk food. He followed medical advice, changed his eating habits, and started exercising, dropping more than 30 pounds. The diabetes stayed. "Yes, for me, it is truly an everyday, almost every hour watching what I do," Tucker said. "What I learned, it was also hereditary. My father had it, grandfather had diabetes."

Dr. Adam Spitz, an endocrinologist at Novant Health, said North Carolina sits inside a region often called the diabetes belt, where rates run higher. He said the state has about a million people with diabetes and another 250,000 with undiagnosed cases. "And that is very scary because they can start to develop all the complications without even knowing it," Spitz said. Those complications include coronary artery disease, heart attacks, advanced kidney disease, eye disease, nerve damage, and amputations. The American Diabetes Association identifies Type 2 diabetes as the leading cause of amputation in the United States.

Spitz said GLP-1 drugs such as Ozempic and Wegovy have helped many patients, but access remains uneven. "We've got more people, especially in rural or under-served communities who don't have access to health care," Spitz said. "And don't have good education on healthy lifestyle." He added that an estimated 3 million people in North Carolina have prediabetes. "They are at a fork in the road where they can either go on to get diabetes, or they can prevent it," Spitz said.

Doctors point to excessive thirst, extreme fatigue, and frequent urination as common signs of undiagnosed diabetes, and advise consulting a doctor for testing. Tucker bikes, stays active, and uses a continuous glucose monitor that shows his blood sugar in real time. In a video he recorded of a recent doctor's visit, his physician told him his numbers are improving. "Your average sugar is 129, which is also improved from our last time," the doctor said.