The death rate for diabetes has increased since the mid-1980s, and approximately 7 percent of Iowans have the disease. Do you know what you can do to prevent or control the condition?

Diabetes occurs when the body fails to produce or properly use insulin, the hormone that converts sugar, starches, and other food into energy. As a result, high levels of sugar in the blood can cause serious problems, including blindness, kidney failure, heart and brain disease, and nerve damage, which can lead to amputation.

• Type 1 diabetes is a genetic, autoimmune condition and typically requires insulin treatment from the onset, which can be in childhood. About 5 percent of people with diabetes have type 1. Doctors should watch for conditions that can occur along with type 1 diabetes, including pernicious anemia, hypothyroidism, Addison's disease, and polyglandular autoimmune syndrome.
• Type 2 diabetes is associated with obesity and usually occurs gradually. It can generally be controlled and even reversed through diet and exercise. About 95 percent of all people with diabetes have type 2. In addition, women who are pregnant can be at risk of developing gestational diabetes.

Signs and symptoms of diabetes include:

• excessive urination, thirst, or appetite
• fatigue or weight loss
• blurred vision
• numbness or tingling in hands.

It is very important to see your doctor if you are concerned about having diabetes or, if you have the condition, for long-term management.

People with diabetes must control the amount of carbohydrates they eat. Foods high in carbohydrates include many sweets, fruits, milk, and starchy foods such as potatoes and bread. Some vegetables, such as peas and corn, are high in carbohydrates.

For people with type 2 diabetes, weight loss can stave off complications. Exercise also is very important—walking for 45 minutes daily is ideal.

Pre-diabetes usually follows metabolic syndrome, which involves high blood pressure, high triglycerides, and being overweight.

Whether a person has pre-diabetes or diabetes, managing the condition can be challenging. The picnic season will be here soon. Here are some suggestions on how to handle social eating situations:

• Eat something before going to a picnic or party so you aren't tempted to eat everything on the table.
• If the picnic or party is a complete meal and you're comfortable calling your host, ask what's on the menu so you can set your daily meal plan.
• Offer to bring a dish, such as dessert, so you know the carbohydrate content.
• Bring your own carbohydrate-free beverage if you don't want plain water.
• Cut portions in half or even one-quarter of the normal size so you don't overeat in an attempt to appear polite.
• Avoid tasting all the foods available. Pick a few that you really want to try.
• Be selective about foods that are breaded or covered in sauce, as these types of dishes can have many extra carbohydrates and calories.