11 Million Americans with Undiagnosed Diabetes Face Silent Risk of Organ Failure
New estimates show a large portion of the U.S. population manages a chronic condition without knowing it, with the South experiencing the highest rates.
By Dominic Foster ·
Approximately 11 million people in the United States are living with diabetes without knowing it, according to the Centers for Disease Control and Prevention. These individuals are at risk for severe health complications, including heart attacks, kidney failure, and amputations, often before they receive a diagnosis. The condition currently affects an estimated 40 million Americans, making it the seventh leading cause of death in the country and the primary cause of kidney disease.
The burden falls disproportionately on the Southern United States. North Carolina is part of a region often referred to as the diabetes belt, where incidence rates are higher than the national average. Dr. Adam Spitz, an endocrinologist at Novant Health, stated that about one million people in North Carolina have been diagnosed with diabetes. He noted that another 250,000 residents have the condition but have not yet been identified by medical professionals.
Spitz explained that the undiagnosed population is particularly vulnerable because the disease can progress quietly. Patients can develop advanced kidney disease, eye disease, and heart conditions while remaining unaware of their status. The American Diabetes Association identifies Type 2 diabetes as the leading cause of amputation in the United States. While medical advancements have introduced new treatment options, Spitz said that access to care remains a barrier, especially for residents in rural or underserved communities.
For patients who have been diagnosed, managing the disease is a constant physical and mental effort. Andrew Tucker, who was diagnosed with Type 2 diabetes at age 35, has lived with the condition for nearly two decades. At the time of his diagnosis, Tucker weighed about 250 pounds and was balancing graduate school with a demanding work schedule. He described his daily routine as a continuous battle involving close monitoring of his food intake and physical activity.
Tucker adopted lifestyle changes following his diagnosis, including dietary adjustments and regular exercise. He lost more than 30 pounds, but the diabetes persisted. He attributed the condition partly to genetics, noting that both his father and grandfather had the disease. Today, Tucker uses technology to help manage his health, including a continuous glucose monitor that tracks his blood sugar levels in real time. He recently recorded a doctor's visit where his physician confirmed that his average blood sugar level had improved to 129.
The risk extends beyond those already diagnosed. Spitz estimated that three million people in North Carolina have prediabetes. This condition represents a critical decision point where individuals can either progress to full diabetes or take steps to prevent it. Doctors say that preventing the progression often requires sustained changes to diet and exercise habits, which many patients find difficult to maintain over the long term.
New medications, including GLP-1 drugs such as Ozempic and Wegovy, have shown benefits for some patients. However, Spitz emphasized that medication alone does not solve the issue of limited healthcare access and health education in certain communities. The most common symptoms of undiagnosed diabetes include excessive thirst, extreme fatigue, and frequent urination. Medical professionals advise individuals experiencing these signs to consult a doctor for further testing.
The prevalence of the disease continues to rise despite decades of public health education and treatment breakthroughs. The combination of genetic factors, lifestyle habits, and limited access to care creates a complex challenge for the healthcare system. For many in the diabetes belt, the focus remains on early detection and consistent management to avoid the long term physical toll of the disease.
