The grip of diabetes on Americans is getting tighter, the way clothes fit more snugly when you gain weight.

A federal study released last week shows the rate of new diabetes cases nearly doubled in the past 10 years, with the vast majority of them diagnosed as Type 2, the form linked to obesity.

Pennsylvania's latest rate was close to the national average, with 8.6 cases per 1,000 people in 2005-07, up from 4.7 from a decade earlier. The worst rate was in West Virginia, where about 13 in 1,000 adults were diagnosed with the disease in that period, more than double the rate of a decade earlier.

The fact that the nation is losing its battle against weight gain and losing the fight for physical fitness is not new. The Centers for Disease Control and Prevention, which led the study, estimates that 25.6 percent of adults are obese and one-third of children are obese or overweight, and research has shown that many adults and children fail to get enough exercise.

Diabetes affects 24 million Americans, 800,000 of them in Pennsylvania. According to the American Diabetes Association, direct medical costs and productivity losses stemming from the disease totaled $174 billion nationally in 2007.

Yet this is one health-care crisis that everyday citizens can do something about.

First, take note of who is at risk. According to the state Health Department, risk indicators besides being overweight or inactive include being over 45, having a parent or sibling with the disease and high blood pressure. Risks are higher for women who had a baby weighing more than 9 pounds at birth or having gestational diabetes during pregnancy. High-risk ethnic groups are African Americans, Hispanics, Latinos, American Indians, Asian Americans and Pacific Islanders.

Second, be aware that warning symptoms associated with Type 1 diabetes -- excessive thirst and urination, lost weight, blurry vision and slow-healing sores -- don't show up until Type 2 is very advanced. The only sure way to detect the disease is through blood tests that detect high glucose levels.

For those who already have diabetes, it's vital to try to manage the disease by maintaining a healthy weight, getting sufficient exercise and following a doctor's advice on monitoring glucose and the use of medication. For those not afflicted, the prescription of limiting weight and increasing exercise can help prevent diabetes from taking hold.

Americans interested in good health (and shouldn't that be all of us?) cannot afford to ignore the damage inflicted by diabetes and the common-sense ways we can combat it.