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Check Your Diabetes Risk

June 4, 2014

As the incidence of diabetes continues to grow, Marina Litvin, MD, shares what people can do to help prevent or control the disease.

Are You at Risk for Diabetes?

Marina Litvin, MD, is a Washington University endocrinologist at Barnes-Jewish West County Hospital who focuses on treating patients with endocrine disorders including diabetes. She shares what people can do to help prevent or control diabetes.

What is Type 2 diabetes?

Type 2 diabetes is a very common disease, characterized by elevated blood sugars, known as hyperglycemia, resistance to insulin, and the body’s inability to secrete a sufficient amount of insulin to overcome the body’s insulin resistance.

What is the prevalence of diabetes and what concerns are associated with it?

According to 2010 estimates from the Centers for Disease Control and Prevention, about 2 million people in the United States are diagnosed with diabetes each year. Almost 26 million people have the disease and about another seven million people are undiagnosed. Diabetes is the leading cause of non-traumatic lower extremity amputations, new blindness and end-stage kidney disease requiring dialysis. Diabetic patients also suffer from higher rates of heart disease and death from heart disease. Diabetic patients experience more hospitalizations with longer hospital stays, and also show higher rates of depression, especially in the elderly.

Why is controlling hyperglycemia important and what are treatments?

By controlling hyperglycemia in diabetics, we hope to minimize the potential complications of retinopathy (eye problems); neuropathy (damage to the nerves usually occurring in the legs and feet); kidney disease; and stroke and heart attack, which can all be devastating. There are multiple treatment options, such as lifestyle modification with healthy nutrition, which includes a diet limited in carbohydrates, fat and calories; regular exercise, medications that can be taken orally or by injection, and insulin.

What are the risk factors for developing diabetes?

Certain individuals are at higher risk for Type 2 diabetes including patients with elevated blood glucose levels detected on common screening tools, such as impaired fasting glucose (IFG), usually drawn after an overnight fast; impaired glucose tolerance (IGT), an elevated blood glucose measured two hours after consuming a sugary drink; and/or an elevated hemoglobin A1C, a three month average blood sugar extrapolated from the glucose on red blood cells. Other groups at increased risk include those with a family history of diabetes, those who are overweight, those with a sedentary lifestyle, those who have a history of gestational diabetes (diabetes in pregnancy), and certain ethnic groups, including people of Asian, Hispanic, African American and Native American ethnicities.

What can someone at risk for diabetes do to delay its onset?

Lifestyle modifications can help prevent or delay the onset of diabetes. Diet is an important factor in prevention. Increased risk of diabetes is associated with eating red meat, processed meats and consuming sugar-sweetened beverages. A diet rich in fruits, vegetables, nuts, whole grains and olive oil can help reduce the risk of progression.

Lifestyle changes that can also decrease the risk of diabetes include weight loss, adding moderate-intensity exercise based on a physician’s recommendation and smoking cessation. Patients with a prior history of elevated blood sugars, or those with pre-diabetes, should have at least an annual follow-up. Medications may also be effective in decreasing the risk of progression to diabetes in very specific cases.

What can a patient do to manage their diabetes?

Patients should work closely with their diabetes physician specialists, educators and dietitians to help manage their disease, and monitor their blood sugars. Recommended frequency of blood sugar checks varies depending on the severity of diabetes. In mild diabetes treated with diet and/or oral medications, a patient may monitor their blood sugar once a day, at different times of the day. Patients treated with intensive insulin therapy and multiple daily injections will check their blood sugars more frequently. In between physician visits, patients should keep an updated blood sugar log to help fine tune their diabetes regimen. Patients should also be monitored regularly for complications of diabetes with regular eye exams, foot exams, blood pressure and cholesterol monitoring and control.

Why is Barnes-Jewish West County Hospital a good choice?

Many of our patients are already seeing their primary care physician or other specialists at the hospital, so it is helpful to see their doctors all in one place. It is also a convenient location for those who live in the suburban area.

At Barnes-Jewish West County Hospital, we take the health of our community seriously. Patients are our ambassadors and we look forward to partnering with each of you as we bring available diabetes technology and skill to the care of individuals with diabetes.

To schedule an appointment with Dr. Litvin at Barnes-Jewish West County Hospital, call 314.542.WEST (9378).


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