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n Canada, more than two million people have diabetes, and many of them don't yet know it. Knowing whether or not you have diabetes is important. It will help you to take control of the levels of glucose in your blood right now and to largely prevent the long-term damage that can arise from these high glucose levels - complications like blindness, heart disease, kidney problems or nerve damage.

Complications of diabetes can be prevented, but to do so, you need to know you have diabetes.

Diabetes healthcare specialists say that, by the time they are diagnosed with type 2 diabetes, many people have already had diabetes for an average of about seven years. During that time, high levels of glucose in their blood may have caused a lot of damage, despite the fact that they might have experienced no symptoms. In fact, many patients who are diagnosed with type 2 diabetes initially visit their doctor not for symptoms related to the diabetes itself, but because they have already begun to have problems caused by these secondary complications, e.g.blindness (retinopathy), kidney problems (nephropathy), nerve damage (neuropathy) or heart disease.

			Signs and Symptoms of Diabetes
			You should see your doctor about being tested for diabetes right away if you experience any of the signs and symptoms of diabetes (or early signs of its complications): unusual thirst frequent urination weight change extreme fatigue or lack of energy blurred vision frequent or recurring infections cuts and bruises that are slow to heal tingling or numbness in hands or feet trouble getting and maintaining an erection

That's why it is vital to be tested to know for sure if you have diabetes. In fact, the Canadian Diabetes Association 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada recommend that everyone over age 40 should be tested at least every three years. Screening should begin earlier and occur more often if you have any of the following risk factors:

• you have a parent, brother or sister with diabetes
• you are a member of a high-risk group, including those of Aboriginal, Hispanic, Asian, South Asian or African descent
• you have any of the health complications associated with diabetes, including heart disease, kidney disease, eye disease, problems with impotence, or nerve damage
• you gave birth to a baby that weighed more than 4 kg (9 lb)
• you have been told that you have impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), tests that indicate early or "prediabetes"
• you have high blood pressure
• you have high cholesterol or other fats in your blood
• you are overweight, especially if you carry that weight around your middle
• you have been diagnosed with any of these conditions: polycystic ovary syndrome, acanthosis nigricans (darkened patches of skin), or schizophrenia

If you get tested and you do have diabetes, we now know that it's possible to delay or prevent altogether the development of complications that stem from high blood glucose. A landmark study in the early 1990s, the Diabetes Control and Complications Trial (DCCT), proved that people with type 1 diabetes who had very good blood glucose control could prevent or delay the complications of diabetes. This was very exciting news as it supported the theory that a comprehensive approach to the management of diabetes was the best way to prevent complications.

The DCCT had initially set out to explore whether eye disease could be prevented with good glucose sugar control, but it also ended up showing that a number of the other complications arising from damage by high glucose levels to the small blood vessels could also be delayed or prevented. These problems included not only eye disease, but also kidney disease and nerve damage.

While the DCCT did not study heart disease, the study results appeared to show that good blood glucose control has a similar effect on the prevention of large vessel complications, such as heart attack and stroke. So, this study led the way to showing the importance of good blood glucose control for the delay or prevention of complications.

Research continued, however, into the important relationship between diabetes and heart disease. Autumn 2005, further results from the DCCT study will be published, which will clearly show the benefit of good blood glucose control to prevent heart disease For the person with type 1 diabetes, intensive management of blood glucose levels will be even more important, as it is becoming more and more clear that a life without diabetes complications is indeed possible with good blood glucose control.

Although the DCCT studies only studied people with type 1 diabetes, we know that people with type 2 diabetes can experience the same complications of diabetes. So, the key messages from the DCCT regarding good blood glucose control can be employed for all people with diabetes—whether type 1 or type 2.

So, the good news is that the complications of diabetes can be prevented or delayed by taking control of your own care. If diabetes complications are the first indication that you have diabetes, though, you will start your fight at a disadvantage. If you don't yet have diabetes, it can be prevented, so get tested if you are at risk. If you do have diabetes, there are many things you can do to help yourself stay healthy, now and in the future.