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Talk Tuesday - Ep. 9: Why Is Early Detection Key In Diabetes

December 2, 2020
Dr.Howard

Stefanie:

Welcome, everyone! Thank you for joining us today. 

My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states. 

It is Talk Tuesday and we are back with our weekly educational series, talking with our experts, exploring some common healthcare concerns that we see, and hopefully answering some questions you may have.

Today our physician expert is Dr. Daniel Kessler, Primary Care Physician, and one of our telemedicine providers. We are talking about a topic affecting one in ten Americans, Diabetes. 

Dr. Kessler, thank you for joining us today.

Stefanie:

Let’s start by talking about Diabetes statistics. According to the American Diabetes Association, in 2018, 10.5% of Americans were estimated to have diabetes and about one-fifth of those were undiagnosed. Those are pretty significant numbers. Should people be concerned about diabetes?

Dr. Daniel Kessler:

Well that depends. We know about risk factors that can increase the likelihood of getting Type II diabetes. The CDC says you’re at risk for developing type 2 diabetes if you:

  1. Have prediabetes
  2. Are overweight
  3. Are 45 years or older
  4. Have a parent, brother, or sister with type 2 diabetes
  5. Are physically active less than 3 times a week
  6. Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds
  7. Are African American, Hispanic/Latino American, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk)

If you have non-alcoholic fatty liver disease you may also be at risk for type 2 diabetes.

So for individuals with risk factors, there should be some concern or at least awareness.

Stefanie:

So let’s talk about early detection. Why is it important? Why is early detection key in diabetes?

Dr. Kessler:

Early detection is key in diabetes because early treatment can prevent or at least slow serious complications. When a problem with blood sugar is found, doctors and patients can take effective steps to prevent irreparable damage to the heart, kidneys, eyes, nerves, blood vessels, and other organs.

An article in the Current Opinion in Endocrinology, Diabetes and Obesity journal recognized that there are many reasons why earlier detection of diabetes could be of benefit to the individual and the healthcare system, because it creates the opportunity to treat the high blood sugar.

Furthermore, undiagnosed diabetes is often associated with potentially-preventable, costly complications. ER visits and hospital stays can be expensive!

The base estimated cost of living with diabetes is around $9,600 per year. This includes prescription medications, diabetic testing supplies, doctors appointments, and routine care. This cost will be higher for uncontrolled or unmanaged diabetics who more care, more medications, more doctors appointments. Early detection can save thousands of dollars. 

Stefanie:

So Dr. Kessler, for our listeners who may not be familiar with diabetes, can you tell us what a diagnosis of diabetes means? What is diabetes?

Dr. Kessler:

Sure, Diabetes is a metabolic disorder in which your body is not able to efficiently turn the food you eat into energy, leaving sugar to build up in the bloodstream. This creates two problems: the cells are not getting the sugar energy they need, and the sugar is accumulating in the blood. High blood sugar, known as hyperglycemia, causes damage to many tissues and organs of the body. This is why diabetes is a serious condition that can be dangerous.

Normally when you eat, your body breaks food down into glucose. As your blood glucose level rises, the pancreas releases insulin. Insulin is a hormone that tells body cells to let the glucose inside. 

In diabetes, either your pancreas does not make insulin correctly, or your body cells do not react to the insulin the way they should. This means that the glucose stays in the blood, which is why diabetics experience high blood sugar, also known as hyperglycemia. Over time, hyperglycemia can damage nerves and blood vessels.

Stefanie:

 I understand. And how do doctors know that the pancreas is not making insulin right or the body cells not reacting to the insulin?

Dr. Kessler:

Well, a blood test can determine if a person has diabetes. There are two tests commonly used.

A glycated hemoglobin test, known as a hemoglobin A1c (HbA1c) test, measures the glycated form of hemoglobin to determine the three month average of blood sugar. This blood test takes about a minute to perform, and results are generally available in two to three days. A normal HbA1c is below 5.7%. Prediabetes is 5.7 to 6.4%. A result of 6.5% or more is classified as diabetic. Another test doctors use to detect diabetes is a fasting blood glucose, or fasting blood sugar (FBS), test. This blood test measures the basal (base) sugar levels of the blood. Testing is usually performed in the morning after the patient has had nothing to eat or drink for eight hours or more. This test may take around ten minutes and results can be immediately available. A normal FBS is 70-100 mg/dl (3.9 - 5.6 mmol/L). An abnormal fasting blood sugar test may be repeated by the doctor or additional tests may be performed for confirmation of the abnormal blood sugar reading.

Stefanie:

And what these tests find, high blood sugar, can it go away? Can diabetes go away, or can early diabetes be cured?

Dr. Kessler:

Diabetes is a chronic condition which means it may not go away. It is possible, however, to reverse some of the effects of diabetes, and to even go into a remission state for those with Type II Diabetes. Remission in diabetes means that your blood sugar levels are within the normal range and you have not required medication to manage your blood sugar for six months or more. 

Lifestyle changes like a healthy diet, daily exercise, and weight management can improve the way your body uses insulin, and can improve the prognosis for someone diagnosed with diabetes.

Stefanie:

Thank you Dr. Kessler, you have definitely helped me to understand diabetes better and how important it is for individuals to know their risk and talk to their physician to prevent problems and even get diagnosed and treated early!I appreciate you joining us for Talk Tuesday and telling us what we need to know about early detection in diabetes. For everyone else joining us as well, this has been Talk Tuesday with MyVirtualPhysician. If you would like to talk with one of our board-certified physicians about diabetic screening or your risk, you can check out our website at www.myvirtualphysician.com. We look forward to talking with you again, and we hope you have a great week.

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