The Diabetes Spectrum

Because diabetes is the 7th leading cause of death in the United States, we provide resources, education and tools to manage it.


About Diabetes



What happens in the body to cause diabetes and how common is the disease?


Diabetes leads to high blood glucose levels but there are different types of this disease. In this section, you will read about these different types of diabetes and how the treatments may differ.


Some groups of persons with diabetes may have different treatment goals to manage their disease. Explore these specific groups in this section.


Health care providers monitor blood glucose control in several ways. Learn how blood glucose levels are measured and why it is so important.

Living with Diabetes

Learn about diet, exercise, weight loss, and other ways to stay as healthy as possible.



Here you will find information that every person with diabetes should know.


Find out more about obesity and how to reduce your risk.


What foods are best to prevent high glucose? What is carb counting? Is it safe to exercise? How do I lose weight? All of these questions (and more) are answered here.


Some groups of persons with diabetes are managed a bit differently. Here are some ways that these people can manage their diabetes in the safest ways possible


Having frequent low or high blood glucose levels? Find out some common reasons why and what you can do to prevent blood glucose fluctuations.


What situations need urgent attention and treatment? Find out here.

Do you have diabetes?

More than 30 million people in the United States have diabetes, and 1 in 4 of them don’t know they have it.



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The Johns Hopkins Advantage

Our faculty experts developed this program for maximum impact, based on years of research and clinical success.


Diabetes Facts

  • More than 30 million people in the United States have diabetes, and 1 in 4 of them don’t know they have it.
  • More than 84 million US adults—over a third—have prediabetes, and 90% don’t know they have it.
  • Diabetes is the 7th leading cause of death in the United States (and may be underreported).
  • Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes; type 1 diabetes accounts for about 5%.
  • In the last 20 years, the number of adults diagnosed with diabetes has more than tripled as the American population has aged and become more overweight or obese.
  • The good news is that if you have diabetes, DECIDE can help you learn how to make and sustain lifestyle changes to better manage type 2 diabetes.

Diabetes Risk Factors

  • You’re at risk for developing prediabetes or type 2 diabetes if you:
    • Are overweight
    • Are age 45 or older
    • Have a parent, brother, or sister with type 2 diabetes
    • Are physically active less than 3 times a week
    • Have ever had gestational diabetes (diabetes while pregnant) or given birth to a baby weighing more than 9 pounds
  • African Americans, Hispanic/Latino Americans, American Indians/Alaska Natives, Pacific Islanders, and some Asian Americans are at higher risk for prediabetes and type 2 diabetes.
  • American Indians/Alaska Natives are twice as likely as whites to have diabetes.
  • During their lifetime, half of all Hispanic men and women and non-Hispanic black women are predicted to develop diabetes.
  • Type 1 diabetes is thought to be caused by an immune reaction (the body attacks itself by mistake). Known risk factors for type 1 diabetes include:
    • Family history (having a parent, brother, sister with type 1 diabetes)
    • Age (it’s more likely to develop in children, teens, and young adults)
  • In the United States, whites are more likely to develop type 1 diabetes than African Americans and Hispanic/Latino Americans.
  • You’re at risk for developing gestational diabetes (diabetes while pregnant) if you:
    • Had gestational diabetes during a previous pregnancy
    • Have given birth to a baby who weighed more than 9 pounds
    • Are overweight
    • Are more than 25 years old
    • Have a family history of type 2 diabetes
    • Have polycystic ovary syndrome
    • Are African American, Hispanic/Latino American, American Indian/Alaska Native, or Pacific Islander
  • Gestational diabetes usually goes away after your baby is born but increases your risk for type 2 diabetes later in life.
  • Babies born to mothers with gestational diabetes are more likely to have obesity as children or teens, and are more likely to develop type 2 diabetes later in life too.


The goal of DECIDE (Decision-making Education for Choices In Diabetes Everyday) is to help people—ranging in age from 18 to 90 years old—learn how to change their behavior so they can better manage their diabetes.

The DECIDE program teaches problem-solving as a key skill for behavior change and for incorporating self-management activities into their everyday lives.

  • Curriculum engages participants in the step-by-step process of self-management, planning and activation
  • Problem-based training helps participants apply diabetes self-management in their everyday lives
  • Tools and resources support behavioral change
  • Training of health care providers
    to coach and support their patients
  • Lower A1C levels
  • Lower blood pressure
  • Lower cholesterol
  • Improved knowledge of diabetes and cardiovascular disease
  • Increased ability to problem-solve health-related problems
  • Better self-management behaviors (e.g., medication adherence, healthy eating, physical activity, self-monitoring)

Is DECIDE Right for You?

People learn differently and have different ways of accessing information. That’s why DECIDE is available in both in-person and online formats.

DECIDE in-person can be conducted in a group or individual format and in a variety of settings. Consider this version if you:

  • Prefer an in-person educational experience
  • Have lower health literacy, low vision, or other functional limitations
  • Have limited or no access to the internet or computers

DECIDE online digitally delivers the program to patients anywhere, on any device, at any time. Consider this version if you:

  • Need the flexibility to log-in and learn from any location, at any time
  • Seek interactive and engaging digital content
  • Prefer to move through a self-directed program at your own pace
  • Want to revisit modules multiple times

The Johns Hopkins Advantage

Our faculty experts developed this program for maximum impact, based on years of research and clinical success.

DECIDE was developed through years of research and clinical application by Felicia Hill-Briggs, Ph.D., A.B.P.P., a clinical psychologist, behavioral scientist, and professor of medicine at the Johns Hopkins University School of Medicine. She is a nationally recognized expert in diabetes self-management and diabetes population health improvement. Her research has earned scientific awards as well as honors for improving community health and wellness.