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Published on August 13, 2015

Have you been tested for diabetes?Have you been tested for diabetes?

You’re getting older. Your vision and hearing might not be what they once were. You complain about circulation in your legs. You get tired more easily. Bruises may not heal as quickly.

But before you blame all of these aches and pains on yet another birthday, consider that these symptoms also may be indicators of diabetes.

Debbie Allietta, a registered nurse for the Visiting Nurse Association of Cape Cod, meets many Cape Codders in their 50s and 60s who waited too long before discovering that they have pre-diabetes or have developed Type 2 diabetes.

“It’s easy to rationalize that these conditions are part of the aging process and then not think about them further,” says Allietta, a diabetes educator for the last decade. “Even I did not go to the doctor to be tested for diabetes until I was in my 50s,” she said.

“And my dad has diabetes. Shame on me.”

Should you be tested for diabetes? Debbie Allietta, a registered nurse for the Visiting Nurse Association of Cape Cod, says everyone should get tested by age 45 and beyond, even if you appear to be otherwise healthy.


Age is a leading risk factor for Type 2 diabetes, along with family history, being overweight and out of shape, suffering high stress, high blood pressure and cholesterol, Allietta explained.

The American Diabetes Association recommends that even if you appear otherwise healthy, you should get tested by age 45.

Screening should be repeated at least every three years if the results are normal, or every year for those people who are at increased risk for future diabetes.

The specter of Type 2 diabetes and pre-diabetes is particularly acute on Cape Cod, where the average age is among the oldest not only in Massachusetts, but in the country. One out of every Cape Codders is 65 or older, and that’s about double the national average, according to the U.S. Department of Health and Human Services.

On the Cape, more than 10,000 fulltime residents suffer from diabetes. Many more are pre-diabetic. The actual incidence of diabetes on the Cape probably is much higher, given the huge second-home population here.

About 70 percent of second homeowners live within two hours of the Cape and spend significant time here not only in the summer, but year round.

The disease lowers life expectancy by up to 15 years and increases the risk of heart disease by two to four times. It’s the leading cause of kidney failure, lower limb amputations and adult-onset blindness.

The death rate on Cape Cod from diabetes and its complications is about 13 people per thousand, according to the federal Centers for Disease Control and Prevention.  Of these, men are significantly more at risk: slightly more than 16 deaths per 1,000, compared with under 10 women per thousand.

In 1958, less than 1 percent of the U.S. population had the disease. Today, that number exceeds 7 percent. Moreover, it is estimated about 8 million people are not aware they have the disease because early onset symptoms are subtle or misunderstood.

“Across the United States, there are 29 million people with diabetes, and every six to eight months, the statistic goes up,” said Allieta. “Genetics loads the gun, but lifestyle factors pull the trigger. Being overweight, even by as few as 10 pounds, being sedentary and eating unhealthy foods all increase the risk of developing Type 2 diabetes.”