January 2020 Issue
There is a surefire formula for Americans that is resulting in the rise of the dangerous disease of diabetes: Decreased exercise plus increased weight equals more and more diabetes diagnoses. There is good news and bad news when it comes to diabetes. Let’s talk bad new first: Diabetes is one of the most destructive diseases one can face. It breaks the body down, affecting vision, kidneys, nerves, gastric function, and blood circulation. It also severely increases the risks for heart disease and stroke. In other words, it negatively affects almost every body function. So whats the good news? Diabetes is controllable, and there is a lot of help out there to get you going on the right track. Speaking of tracks, one of the best ways to combat diabetes is by taking a daily brisk walk. In other words, by changing your lifestyle, you can change your trajectory of illness due to diabetes. Read on to learn more about this disease from our leading experts.
Nikki A. Keisler, MD - Beaufort Memorial Hospital
At what age should I get checked for diabetes and what are the symptoms?
Most patients who have been seeing a doctor on a regular basis get annual blood work that checks blood sugar and screens for diabetes. Patients should have yearly screening fasting blood work starting around the age of 18. The United States Preventative Services Task Force (USPSTF) recommends screening all overweight/obese adults age 40 to 70 for diabetes, as being overweight increases the risk of insulin resistance and the development of Type II diabetes.
There are different types of diabetes. Type I diabetes usually occurs in childhood, and these patients do not produce insulin. Symptoms include increased thirst, weight loss and increased urination. Type II diabetes is mostly an adult onset disease. The symptoms are the same, increased thirst and urination being the most common, along with unexplained weight loss.
Nikki A. Keisler, MD, is a board-certified family medicine specialist. A graduate of the University of South Carolina School of Medicine, Dr. Keisler sees patients at Beaufort Memorial May River Primary Care in Bluffton.
Kerri Dodson, Certified Nutrition Therapist —NuBodia
If I’m overweight, how many pounds do I have to
lose to see my sugar levels change?
Type II Diabetes can be a chronic condition that affects the way the body processes glucose. Because of this, fat storage likely occurs. If you are overweight and have Type II Diabetes, you will lower your blood sugar and improve your health, along with feeling better, if you lose some weight. The amount of weight loss that is beneficial will vary according to person. Factors would include how long they have had Type II Diabetes, how much weight they have to lose and if there are any other health issues. Therefore, putting a number on weight loss is difficult. However, losing even 5 to 10 percent of your body weight will have benefits when it comes to Type II Diabetes. Research shows that the more weight you lose, the more likely you are to reverse your Type II Diabetes.
Prevention is key. Maintaining a healthy body weight, exercising and eating whole foods is essential to health. Consider consulting a nutrition therapist who is experienced in helping people who struggle with high A1c and Type II Diabetes. Nutrition therapists will teach lifestyle management and proper nutrition in order to put a personal plan in place to help reverse chronic illness.
Kerri Dodson is a Certified Nutrition Therapist and Master Certified Health and Wellness Coach for NuBodia, LLC. Kerri specializes in Nutritional Counseling and nutritional protocols to help her clients overcome chronic diseases such as high cholesterol, high A1c, Type II Diabetes and all autoimmune diseases. Call today: 843-816-3733.
Atul M. Gupta, M.D. - FastFit Body Sculpting
How does belly fat affect your risk for Type 2 diabetes? And how does losing belly fat help?
Belly fat is a dangerous predictor of many diseases, including diabetes. We have a very unhealthy type of fat called “visceral fat” that lives behind the ribcage and lines all of our organs. According to the Mayo Clinic and Harvard Medical School, visceral fat has been shown to cause diabetes, high blood pressure, high cholesterol, fatty liver and inflammation throughout the body. The more visceral fat we have, the more likely we are to develop these conditions, which then causes heart disease and cancer. When we have visceral fat, our body is unable to properly absorb nutrients. This can lead to higher sugar levels in our blood, and that changes how our organs function. We become resistant to our body’s own insulin produced by our pancreas. When this happens, our sugars get higher and higher, and it begins to affect the other organs in our body. The key is to reduce that dangerous belly fat—the visceral fat. Unfortunately, dieting does not reduce visceral fat. Fat has to be metabolized, meaning it has to be burned. While proper nutrition is very important, it will not burn visceral fat. Exercise also is limited in its ability to burn visceral fat. To most effectively reduce visceral fat, we need to use a combination of healthy nutrition, walking and staying active regularly, and LED light technology that targets visceral fat to allow our bodies to naturally burn the fat more efficiently. By reducing that dangerous belly fat, we can reduce our blood sugars, and allow our body to function better. This improves our health and how we feel everyday.
Dr. Gupta is residency trained in both Surgery and Emergency Medicine, with subspecialty certifications in Advanced Wound Care, Hyperbaric Medicine, and Physical Medicine. He is the President of Hilton Head Concierge Physicians, a wellness based Concierge practice and the Medical Director of FastFit Body Sculpting.
David Burke, RPh - Burke’s Main Street Pharmacy
What are the advantages of the new pen injectables for insulin?
Insulin pens continue to grow in popularity, and many people with diabetes nowadays use a pen to administer insulin. The pens allow more simple, accurate and convenient delivery than using the older vial and syringe method. Not every person with diabetes will need to take insulin. However those who do sometimes find that sticking to an insulin schedule can be demanding, disruptive and exhausting. Many patients prefer insulin pens as a way to make taking insulin less intrusive and inconvenient. There are both disposable and reusable insulin pens. Just remember, the needle has to be changed EVERY time insulin is injected. There are now even “smart” pens available that can calculate appropriate doses of insulin and provide a report on insulin usage for the user to download.
While insulin pens might be a little more expensive than traditional vial and syringe, they are more convenient, less painful, easily storable and transportable. Be sure to closely follow the instructions on the packaging and store insulin in a cool dry place once open. Insulin alone can help manage diabetes, but maintaining a balanced diet and exercise routine along side any prescribed medications is an effective route to controlling blood sugar.
David Burke, RPh is a registered pharmacist and partner of Burke’s Main Street Pharmacy, Chairman of the HH Hospital Board of Governors and a member of the Cardinal Health National Advisory Board. Burke’s Pharmacy prides itself on being large enough to serve you and small enough to know you. Located at 1101 Main Street, HiHI; 843-681-2622.
Anthony P. Williamson, MD, PhD - Hilton Head Regional Healthcare
I experience nerve pain from my type 2 diabetes,
is there a way to alleviate the pain?
Picture yourself walking on soft sand at the beach, holding a hot cup of coffee, or curling up in a cashmere blanket. The ability to touch is perhaps the one sense that really keeps you connected to your surroundings. But imagine what it would be like if you had trouble feeling heat or cold in your hands, or your feet become so sensitive that it hurts for things to touch you. Diabetic neuropathy causes nerve damage that can lead to pain, tingling, numbness, or loss of feeling in the hands, arms, feet and legs. Nerve problems also may extend to the digestive tract, heart and sex organs. More than half of those with diabetes will develop some form of neuropathy. Neuropathy is more likely among those who have had diabetes at least 25 years.
Symptoms of nerve damage include:
• Numbness, tingling or pain in the hands, legs or feet.
• Urinary problems.
• Problems with sexual function.
• Constipation or diarrhea.
• Dizziness after standing or sitting up.
• Nausea or vomiting.
There are four main categories of neuropathy. Peripheral neuropathy, the most common form of the condition, affects the ability to sense temperature, texture or pain in the toes, feet, legs, hands and arms. Autonomic neuropathy affects nerves that control involuntary body functions, such as digestion, vision, urination, respiratory function and perspiration. Proximal neuropathy may cause pain in the thighs, hips or buttocks, typically on one side of the body. Focal neuropathy causes sudden weakness in specific nerves, such as double vision, paralysis on one side of the face, or pain in the front of a thigh.
Diabetic neuropathy may be diagnosed based on symptoms and a physical exam. Treatment for the condition focuses on relieving discomfort and preventing further nerve damage. Diabetics should bring blood sugar levels within the normal range and eat a variety of foods that are low in fat and sugar. Regular exercise can help strengthen and tone muscles affected by nerve damage.
People with diabetic neuropathy need to keep their feet healthy because nerves in the feet are the ones most susceptible to nerve damage. More than 86,000 lower-limb amputations are performed every year on people with diabetes. Doctors estimate that approximately half of these surgeries caused by poor circulation and neuropathy could have been avoided with proper foot care.
You can take care of your feet by:
• Cleaning your feet daily and checking for cuts, blisters,
redness, swelling or other problems.
• Applying a moisturizer to keep feet smooth.
• Choosing the right shoes and breaking them in slowly to prevent irritation.
• Cutting nails to the shape of your toes.
• Inspecting the inside of shoes for gravel or a torn lining that could hurt your feet.
• Never walking barefoot and avoiding nylon or stretch socks,
and socks with an elastic band or inside seam.
Anthony P. Williamson, MD, PHD, Board Certified Neurologist, is a graduate of the University of Arkansas Medical Center and completed his internship and residency at the University of Utah in Salt Lake City. He possesses extensive experience in the primary treatment and secondary prevention of acute strokes. Dr. Williamson is accepting new patients and accepts most insurance plans. Medical Associates of the Lowcountry Neurology, 843-836-3667; 75 Baylor Drive, Suite 155, Bluffton, SC
Dr. Gigante - James F. Gigante, M.D. Internal Medicine
Can diabetes be cured?
Can you control diabetes without meds?
The formal answer to whether or not Type II (adult onset) diabetes can be cured is that it instead can go into remission. Type II diabetes has both a genetic and an environmental component that reflects nutrition and exercise. For those predisposed to diabetes, the problem involves resistance at the cellular level (mostly our muscles) to insulin’s effects. Insulin normally knocks at the cells doors—receptors—and tells the cells to “open up and let sugar in.” For those predisposed, as they gain weight, the insulin receptor mechanism slows and glucose in the blood rises. This genetic component COMBINED with poor diet, weight gain and lack of exercise, opens the door to diabetes. Exercise is crucial because it makes muscles grow and demand more sugar, increasing the sensitivity of the cells to insulin. Fix the weight gain, avoid simple carbohydrates and exercise EVERY day, and with time, these type of patients can control their blood sugar and often go into remission, their blood sugar testing normal For the patients who we have helped lose significant amounts of weight over a year or two, they often stay in remission. For others, they can have a perfect weight, yet still have a fasting blood sugar over 126, where diabetes is defined, but be very healthy otherwise. It all depends. A Type I diabetic is a totally different story. This often begins early in life, and there is very little insulin production at all. There is no remission, but the hope is that both forms will one day be cured.
James F. Gigante, MD is a Board Certified doctor of Internal Medicine and a fellow with the American College of Physicians. He has been practicing medicine for 25 years, the last 17 here in the Lowcountry. 843-681-2222; 35 Bill Fries Drive, Bldg H, HHI.