context: The rates of diabetes have dramatically increased in all states. Twenty-six million children and adults in the United States -- 8% of the population -- have diabetes. The risk for type 2 diabetes typically increases with age. In the absence of risks, testing should begin after age 45. One of the biggest jumps in type 2 diabetes was among men. The risk factors for type 2 diabetes include: being overweight or obese a sedentary lifestyle a diet high in sugar and refined carbohydrates and low in fiber and whole grains a history of type 2 diabetes in your immediate family (mother, father, sister, or brother) African- Americans, Hispanics, American Indians, Native Alaskans, Asian Americans, and Pacific Islanders also have an increased risk. Having diabetes, in turn, increases the danger of heart disease, as well as a range of problems associated with impaired circulation, such as eye disease and nerve damage. Diabetes is a disease that occurs when the body can't control blood glucose levels properly. Normally, the digestive tract breaks down food into glucose, a form of sugar. After being absorbed, it is released into the blood. The hormone insulin, produced by the pancreas, stimulates cells to absorb glucose from the bloodstream and use it for energy. Type 1 diabetes, which typically shows up in childhood, is caused when the immune system mistakenly attacks insulin-producing cells in the pancreas. Type 2 diabetes occurs when tissues in the body gradually become resistant to the effect of insulin. The pancreas responds by churning out more of the hormone. But eventually it can't keep up, and blood sugar levels begin to climb. That's bad for many reasons. High glucose levels damage nerve and blood vessels, leading to heart disease, stroke, blindness, kidney disease, and gum infections. Advanced type 2 diabetes can result in blindness and the need to amputate limbs that no longer get adequate circulation. One of the main causes of the type 2 diabetes epidemic, researchers believe, is the rise in obesity . Over time, excess weight makes cells in the muscles, liver, and fat tissue less responsive to insulin -- a condition called insulin resistance. Another driver of type 2 diabetes, also linked to the others, is inactivity. Lack of activity increases the risk of obesity, of course. But a sedentary lifestyle may contribute directly to type 2 diabetes risk, as well. Studies show that overweight or obese people who become active improve their blood sugar control, even if they don't lose weight. An estimated 7 million people in the U. S. have this serious disease and don't know it. An estimated 79 million people have prediabetes, meaning they have elevated blood sugars not yet high enough to be diagnosed with the disease. However, with prediabetes you are at risk for diabetes in the future. It's easy for doctors to check for diabetes using a simple blood test that measures blood sugar levels or a test called a hemoglobin A1c. Unfortunately, many people aren't tested because they either don't have symptoms or the symptoms are so mild that they don't notice them. Talk to your doctor about being tested, especially if you're experiencing any of the following symptoms: increased thirst increased hunger fatigue frequent urination, especially at night unexplained weight loss blurred vision sores that don't heal Plenty. Studies show that 90% of cases of type 2 diabetes could be prevented -- or significantly delayed -- simply through a healthier diet and plenty of physical activity. The big proof of that came in a study of 3,234 people who were overweight and had elevated blood glucose levels, putting them in the crosshairs of diabetes risk. Those who followed a lifestyle change program of exercise and diet geared to losingexcessweight -- in this case, an average of 15 pounds -- lowered their risk of diabetes by 58%. Those in the 60-and-older set cut their risk by 71%. And these were people who already had a high risk of diabetes. Keep your weight in the normal range and stay active, experts say, and you stand an excellent chance of never getting diabetes. A diabetes diagnosis isn't the end of the world. In some cases, lifestyle changes can keep the disease entirely under control. Still, many people with diabetes need to take oral medications that lower blood sugar levels. When these aren't enough to do the job, insulin (which is inhaled and/or injected) may be necessary, sometimes in combination with oral drugs. Several new drugs that work in combination with insulin to improve blood sugar management have been approved by the FDA. While treatment has improved, however, controlling diabetes remains a challenge, which is why experts emphasize prevention. Experts say that a healthy diet designed to prevent type 2 diabetes should emphasizewhole grains, fruits and vegetables, and small amounts of sugar and refined carbohydrates. Studies suggest that alcohol may actually protect against diabetes. Combining data from 15 studies, researchers writing in the journal Diabetes Carefound that moderate alcohol consumption reduced the risk of type 2 diabetes by almost 30%. Excessive drinking, however,increased the risk. Here, as always, the word is moderation. For men, that would be a glass or two of wine or beer with a meal.