Noblesville endocrinologist talks diabetes management
Nancy knew she needed to lose weight and make other healthy lifestyle changes if she was going to get her dangerously high blood glucose levels under control. At age 53, her type 2 diabetes had all but robbed her of a normal life, draining her of energy and putting her at an increased risk of coronary heart disease.
As medical director of Riverview Hospital Diabetes Center, I see patients like Nancy, who requested I withhold her last name for privacy’s sake, all the time. Within two months, she lowered her blood glucose level from 300 to 130 — a number within the American Diabetes Association’s recommended range. This dramatic reduction enabled her to lead a more active life and improve her overall health. However, few are so motivated to tackle their diabetes head-on.
To better understand diabetes, it’s important to know a little more about the disease. There are two main types. Type 1 occurs when the immune system attaches to insulin-producing beta cells in the pancreas and disables them. This form of diabetes often occurs in younger people and requires insulin to manage. In contrast, type 2 diabetes is caused by insulin resistance that results from the body’s inability to either produce enough insulin or properly respond to insulin. In this most common form of diabetes, factors such as weight, exercise, activity levels, diet, age and genetics can all play a role in development of the disease. Failure to properly manage diabetes can damage blood vessels and nerves, causing complications like heart disease, kidney disease, blindness, and even death.
I know firsthand that maintaining a normal blood sugar level requires each of us to learn — or in some cases, relearn — how to eat right. Today, Nancy records her daily calorie intake and chooses more low-fat and low-carbohydrate options, attending classes through Health & Nutrition Technology, a weight management program for which I serve as medical director. Nancy exercises an hour or more each day, often walking, riding a stationary bike or lifting light weights. Her efforts paid off, as she’s lost more than 30 pounds.
In addition, Nancy dutifully follows an insulin regimen to make up for her body’s own deficiencies. Many medications, new and old, work well to treat this complex and common disease, which affects about 8 percent of Americans and more than one quarter of adults 65 and older.
Proper management of diabetes requires a great deal of self-care. Even so, lifestyle changes such as weight loss and improvements in diet, still outperform medications to treat type 2 diabetes. But therein lies the problem: Our success effecting such changes remains dismal. For example, less than 5 percent of people in the U.S. lose weight and keep it off for more than a year. But as examples like Nancy’s show, that doesn’t mean it’s time to throw in the towel.
The wonderful thing about my job is I get to help people overcome their greatest challenge to manage diabetes. On a national and personal level, weight loss remains the biggest obstacle we face to optimal health. Practicing moderation in a land of plenty is the battle of a lifetime, and it’s one worth fighting.
Dr. Dawn Ayers, a highly rated, board-certified endocrinologist, is medical director of Riverview Hospital Diabetes Center in Noblesville. She practices at Noblesville Diabetes & Endocrinology.