One in 10 Americans has diabetes – so if you don’t have it yourself, chances are you know someone who does.

The more you know about a chronic condition like diabetes, the easier it is to prevent it from developing and live a heathy life, said Shane Joy, PA, a primary care provider with Hartford HealthCare Medical Group.

Here are five surprising facts about diabetes, according to Joy, that everyone should know.

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Millions of Americans are undiagnosed.

The American Diabetes Association reports 37.3 million Americans have diabetes but 8.5 million of them are undiagnosed.

“Most patients with pre-diabetes are asymptomatic and unaware of their situation,” Joy says. “That’s why screenings at your annual primary care visit are so important. If your glucose levels are never checked, you may never know they’re elevated.”

Type 2 diabetes can be prevented.

While more than 1 in 3 Americans have pre-diabetes the progression to diabetes can be avoided.

The best treatment for stopping the progression is lifestyle changes. Weight loss, daily aerobic exercise and changing to a low-carb diet are often sufficient in diabetes prevention alone,” Joy says.

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The cause isn’t just too much sugar.

Although a long-term diet loaded with sugar can lead to diabetes, it is not the lone culprit. Type 2 diabetes happens when insulin in the body becomes resistant to the breakdown of sugar.

“Lifestyle and genetics play a huge role. That’s why our number one treatment involves exercise and weight loss, not just dietary adjustments,” Joy says.

Sweets aren’t off the table.

Low-carb doesn’t mean no-carb. People with diabetes can still enjoy sweets.

“As important as it is to avoid simple sugars and sweets, it’s okay to have a cheat meal now and then,” Joy adds. “If you’re putting in the effort to lose weight, exercise daily and eat a low-carb diet with whole grains, a single sweet or baked good will not harm you.”

Complications can arise, however, when regular sweets fill your menu.

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Stress can increase blood sugar levels.

In addition to lifestyle and genetics, stress is a known risk factor for type 2 diabetes.

“When stressed, our bodies release the hormone cortisol, widely known as the ‘stress hormone.’ It causes blood sugars to elevate to deal with whatever is stressing you out,” Joy notes. The more stress, the longer blood sugar levels will stay elevated, ultimately leading to insulin resistance and type 2 diabetes.

When in doubt, talk to your doctor.

Everyone has the power to manage diabetes and live a full, healthy life. Don’t let diabetes or its complications take you by surprise. If you have any concerns, talk to your healthcare provider.