Doctor addresses key questions surrounding diabetes
Diabetes Awareness Month feature: Part 2 of 3
When a person initially is diagnosed with diabetes, a swarm of questions run through the head.
What is it? What will I have to do now? How did I get it?
Dr. Cheri Ogwo, chief medical officer with SugarPros, a telemedicine practice offering endocrinologist-led care for diabetes and weight management, answered some of those questions and more.
“Diabetes is a chronic condition where the body has trouble regulating blood sugar (glucose) levels,” she said. “Glucose is our body’s main source of energy, and insulin is a hormone made by the pancreas that helps move glucose from the bloodstream into the cells where it’s used for fuel. “When there isn’t enough insulin, or the body can’t use it properly (causing resistance), glucose builds up in the blood instead of being used for energy,” Ogwo said. “Over time, this can cause damage to the heart, kidneys, eyes, nerves and blood vessels.”
People can have one of two different types of diabetes.
Type 1 diabetes is an autoimmune disease, she said, explaining, “The body’s immune system mistakenly attacks the insulin-producing cells in the pancreas, so the pancreas no longer produces insulin.
“People with Type 1 must take insulin daily to survive,” Ogwo said. “It often begins in childhood or young adulthood, but it can also appear at any age.”
She said Type 1 is caused by the autoimmune destruction of beta cells, possibly triggered by genetic and some environmental factors like viral infections.
“Type 2 diabetes happens when the body still makes insulin, but the cells don’t respond to it properly,” Ogwo said. “This is a condition called insulin resistance.
“Over time, the pancreas can’t keep up with the body’s increased demand for insulin,” she said. “This is the most common form of diabetes, usually linked to genetics, excess weight, poor diet and inactivity.
“A combination of genetics, obesity — especially belly fat — sedentary lifestyle and aging leads to insulin resistance,” Ogwo added.
The warning signs of diabetes are:
• Increased thirst and frequent urination;
• Unexplained weight loss, which is more common in Type 1;
• Fatigue or weakness;
• Blurred vision;
• Slow-healing wounds;
• Tingling or numbness in hands and feet; and/or
• Frequent infections, such as yeast, urinary, skin.
When asked what people can do to prevent diabetes, she answered there currently is no way to prevent Type 1 but prevention is possible with Type 2.
“Maintaining a healthy weight, eating balanced meals rich in fiber and low in processed sugars, exercising regularly, managing stress, reducing weight and getting good sleep can all lower risk,” Ogwo added.
Additionally, she said the following lifestyle changes can help manage Type 2 diabetes:
• Eat balanced meals, which include protein, healthy fats and high-fiber unprocessed carbs.
• Limit sugary drinks and processed foods.
• Move your body, aim for at least 150 minutes of activity weekly.
• Manage stress and prioritize sleep.
• Don’t skip medical check-ins or labs.
• Check your blood sugar regularly.
For people diagnosed with the disease, Ogwo said uncontrolled diabetes can damage nearly every organ system. They have a higher risk of heart attacks and strokes.
Also, it is the leading cause of kidney failure, as diabetic kidney disease can lead to kidney failure and ultimately dialysis.
Left uncontrolled, she said diabetics can develop diabetic retinopathy, which can cause blindness, and they can develop numbness, or neuropathy, pain and poor circulation, which can lead to amputations and even death.
“The good news is that most of these are preventable with good control and consistent care,” Ogwo said.
When can patients expect to go on medication or insulin?
“Many people with Type 2 start with lifestyle changes,” she said. However, “ if blood sugars, or A1C, stay high, oral or injectable medications are added.
“Insulin is used when the pancreas can’t produce enough on its own either by itself or in combination with oral medications,” Ogwo added.
She explained AIC is “a blood test that measures your average blood sugar level over three months.
“A normal A1C is below 5.7 percent; pre-diabetes is 5.7 to 6.4 percent; and diabetes is 6.5 percent or higher,” Ogwo said. “Most people with diabetes aim to keep it under 7 percent, but goals can vary based on age and other factors.”
Ogwo explained there are several classes of medications:
• Metformin, which reduces liver sugar production;
• GLP-1 agonists (Ozempic, Mounjaro), which help with blood sugar, weight and heart protection;
• SGLT2 inhibitors (Jardiance, Farxiga), which help the kidneys flush out excess glucose;
• DPP-4 inhibitors, which improve insulin release; and
• Sulfonylureas – stimulate the pancreas to make more insulin.
If a person fails to take their medications, she warned, “Blood sugars rise, leading to fatigue, thirst, weight loss and eventually serious complications, like kidney failure, heart disease, nerve damage and vision loss.”
