North Carolina's Silent Diabetes Crisis

For Andrew Tucker, a continuous glucose monitor on his arm has become the center of daily life. The device tracks his blood sugar in real time, a necessity for a man who has managed Type 2 diabetes for nearly twenty years. Tucker was diagnosed at age 35, weighing around 250 pounds while balancing graduate school and long work hours. He now describes his condition as an "everyday, almost every hour" watch of his habits.

Tucker’s case illustrates a widespread gap in awareness. The CDC estimates that 11 million people in the United States live with undiagnosed diabetes. In North Carolina, Novant Health endocrinologist Dr. Adam Spitz notes that roughly one million residents have been diagnosed, but another 250,000 remain undetected. Spitz warns that these individuals can begin to develop serious complications without knowing they are sick.

The state is part of a region often referred to as the "diabetes belt," where rates remain high despite medical advances. Dr. Spitz explains that while new medications like Ozempic and Wegovy have helped many patients, access remains uneven. He points to rural and under-served communities where people often lack both healthcare access and education on healthy lifestyles. This disparity leaves patients vulnerable to conditions such as heart disease, advanced kidney disease, and eye disease.

The risk extends beyond those already diagnosed. An estimated three million people in North Carolina have prediabetes, a precursor condition where the body has not yet fully developed diabetes. Spitz describes this group as standing at a fork in the road. They can either progress to full diabetes or prevent it through sustained changes in diet and exercise. Prevention is difficult because it requires long-term commitment to habits that many people find hard to maintain.

Tucker has adopted specific routines to manage his condition. He bikes regularly and uses technology to stay on track. During a recent doctor’s visit, which he recorded on video, his physician noted improvements in his health metrics. The doctor told him, "Your average sugar is 129, which is also improved from our last time." Tucker credits these changes with helping him stay healthy and avoid the severe outcomes seen in others.

Diabetes remains the seventh leading cause of death in the United States and the primary cause of kidney disease. The American Diabetes Association identifies Type 2 diabetes as the leading cause of amputation. Common signs of the condition include excessive thirst, extreme fatigue, and frequent urination. Medical professionals advise individuals experiencing these symptoms to consult a doctor for further testing.