Nearly 11 million people in the U.S. could be living with undiagnosed diabetes

CHARLOTTE, N.C. (InvestigateTV) - Diabetes is the seventh leading cause of death in the United States, the No. 1 cause of kidney disease, and an estimated 40 million people are living with it nationwide.

Despite decades of prevention education and major breakthroughs in treatment, doctors say diabetes continues to hit the South especially hard — including North Carolina.

It can create serious long-term complications, including coronary artery disease, heart attacks, never damage, and amputations.

But many people who have the disease may not know it. The CDC estimates around 11 million live with undiagnosed diabetes.

“Every day, almost every hour” battle

Andrew Tucker has lived with Type 2 diabetes for nearly two decades. He’s made major lifestyle changes but said managing the disease is still a daily fight.

Tucker was diagnosed about 15 years ago, when he was 35.

“Yes, for me, it is truly an everyday, almost every hour watching what I do,” Tucker said.

Type 2 diabetes develops when the body doesn’t make enough insulin or doesn’t use insulin properly. Doctors say obesity is a major risk factor.

Tucker said at the time of his diagnosis, he weighed about 250 pounds, while juggling graduate school and long hours — along with what he now calls a diet full of junk food.

He said he followed medical advice, changed how he ate, and started exercising. He lost more than 30 pounds — but the diabetes remained.

“What I learned, it was also hereditary,” Tucker said. “My father had it, grandfather had diabetes.”

And even with better habits, the grind can be exhausting.

The “diabetes belt”

Novant Health endocrinologist Dr. Adam Spitz said North Carolina is part of what’s often called the “diabetes belt,” a region where rates tend to be higher.

Spitz said diagnoses have continued to climb, even as medications improve.

“We’ve got about a million people in NC with diabetes,” Spitz said. “But we have another quarter million people who have undiagnosed diabetes. And that is very scary because they can start to develop all the complications without even knowing it.”

Those complications can include heart disease, advanced kidney disease, and eye disease. The American Diabetes Association said Type 2 diabetes is the leading cause of amputation in the United States.

Spitz said newer medications — including GLP-1 drugs such as Ozempic and Wegovy — have helped many patients, but other challenges remain.

“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.”

Millions more have prediabetes

Spitz said the stakes are even bigger because 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 say prevention often requires major, sustained changes — improving diet and adding regular exercise — and many people struggle to keep those changes long-term.

Tucker said he’s committed to those changes. He bikes, stays active, and uses technology to help manage his condition, including a continuous glucose monitor that shows his blood sugar in real time.

He even recorded a recent doctor’s visit in which he was told his numbers are improving.

“Your average sugar is 129, which is also improved from our last time,” the doctor said in Tucker’s video.

For Tucker, the motivation is simple: stay healthy long enough to enjoy life — and avoid the worst outcomes he’s seen in others.

What to look for

The most common signs associated with undiagnosed diabetes include excessive thirst, extreme fatigue, and frequent urination.

You should consult your doctor for further testing.