Jaime Lewis (Host): According to the Centers for Disease Control, diabetes is one of the top 10 leading causes of death in the United States. And according to the American Diabetes Association, 37. 3 million Americans had diabetes in 2019. That's a little over 11% of the total population. So, what is this disease that affects so many of us? Today, we'll get answers to that question and many others with Dr. Kimberly Aucoin, a board-certified family physician with Cumberland Healthcare. This is

Healthier You, a podcast from Cumberland Healthcare. I'm Jamie Lewis. Hello, Dr. Aucoin. It's great to have you on the podcast.

Dr Kimberly Aucoin: Hi. Thanks for having me.

Host: Well, most of us have heard about diabetes. Many of us know what it is. But for those of us who don't, what is diabetes?

Dr Kimberly Aucoin: Yeah. So, I wanted to talk about type 2 diabetes today, because it's a very common condition. So, sometimes we can forget how important it is and how good management of it can impact our health and our overall quality of life. So, diabetes is when there's a problem with how your body uses sugar. Typically, our pancreas will produce insulin, which helps the body process the sugar. But if you have type 2 diabetes, the body stops responding to the insulin, so the sugar builds up in your body. And then, eventually, the pancreas may stop making insulin altogether.

This is different from type 1 diabetes, where the immune system basically attacks the cells in the pancreas to stop making insulin, but that's a whole other topic. And then, there's pre-diabetes, where your sugars can be elevated, but not high enough to be diagnosed with full diabetes, and will not necessarily need medication. But this is a stage that's like a warning flag where you can actually start working on reversing the effects that the high sugars can have on the body nice and early.

Host: Okay. What puts a person at risk for having type 2 diabetes?

Dr Kimberly Aucoin: Multiple things can make each of us at risk. Our diet, so the food that we eat; the amount of exercise you get, how much we move our bodies; being overweight or obese, particularly those people who carry their weight in their bellies is a risk factor. Also, having a history of gestational diabetes, so if you had diabetes during a pregnancy, no matter how long ago it was, that makes you at increased risk. And then, of course, family history or genetics, so if you have a parent or a sibling with diabetes, then you are more likely to be diagnosed as well.

Host: Okay. So, why should I care about how at risk I am?

Dr Kimberly Aucoin: If you have diabetes, you are two or three times more likely to have a heart attack or stroke. Big things to care about, right? And if you do have a heart attack, you're more likely to have it at a younger age and for it to be more severe. Also, diabetes can lead to kidney disease, vision loss, nerve damage, erectile dysfunction for the men and even amputations. And that's not said to scare anybody, but for all of us to realize that diabetes is not just a normal, regular thing that lots of people have. It can be a very serious illness if it's left uncontrolled or not managed well.

Host: Definitely. So, I actually had gestational diabetes during my second pregnancy. And I treated that through monitoring my blood sugars four times a day and diet and exercise. I've heard it said that a mother with gestational diabetes automatically becomes pre-diabetic. Is that accurate?

Dr Kimberly Aucoin: No, actually. So, pre-diabetes would only be if your sugars stayed high after your pregnancy in that initial postpartum period. It is true that you'll always be at risk for diabetes or pre-diabetes in the future. So, that's something that we would want to be watching for.

Host: Okay. How do I know if I have diabetes? What are the symptoms?

Dr Kimberly Aucoin: There are symptoms that include urinating frequently or peeing a lot, being really thirsty or blurry vision. But it would actually be better for us to catch this on a screening test or a blood test before it got to that point. So, a blood test that your doctor can order, it doesn't even need to be fasting in some cases. A typical one would be a hemoglobin A1c or an A1c for short. It'll show your sugars over the last three months or so. That number can be in the diabetes range or totally normal or somewhere in between would be that prediabetes range.

Other blood tests would be just a blood sugar on its own or a glucose challenge test. That's when you drink that sweet drink and have your sugar tested afterwards. A lot of people who've been pregnant will be familiar with that one. And then, that's kind of why you're getting your yearly physical or your blood work done, if it's needed, with your doctor can be so important in keeping up with it, so you're screening for diabetes nice and early.

Host: what about prevention? How can I prevent diabetes?

Dr Kimberly Aucoin: Yeah. So, diabetes can be prevented, even if you have a family history. So, your diet, and it's not just about restrictions, you want to be doing lots of veggies, whole grains, dairy products that are low in fat, lean meats like fish and chicken and, yes, trying to avoid those sweet, fried, fatty foods.

Exercise is great. Ideally, 150 minutes a week. So, say, you do 30 minutes five times a week. But some people need to start at, you know, 10 minutes or even five minutes at a time of just walking, and that's great too. Managing your weight can prevent diabetes. But even if you never lose one pound, if that's your goal, the exercise has its own independent health benefits, so it's still a great thing to do. Also, stopping smoking and minimizing alcohol use can help prevent diabetes as well.

Host: Right. Okay. So, that's prevention. What about if I am diagnosed with type 2 diabetes? How can I get it treated?

Dr Kimberly Aucoin: Right. So, all the same things to prevent it, those things don't go out of the window just because you have the diagnosis, watching your diet, exercising, stopping smoking, minimizing alcohol plus, of course, our medications. Common ones are metformin, so that's a pill that you take once or twice a day; insulin, so an injection that you may do once or multiple times a day. And there's lots of other medications, including the ones you see the commercials for like Invokana or Ozempic. They each have their own potential side effects, which can happen with any medication that we take, like stomach issues or low sugars, so you may need to make a switch. But no matter what medicine you and your doctor settle on, a key thing to do is to take it consistently every day as prescribed to keep those sugars controlled over time, because we're playing the long game with diabetes, you know, the 10, 20, 30-year game to keep those sugars in a normal range and throughout your lifetime.

Host: Is there anything else I should do or keep in mind?

Dr Kimberly Aucoin: Yep. You want to be keeping an eye on your blood pressure as well as your cholesterol since those things are all related. Diabetes, hypertension and high cholesterol are like a trio that tend to occur together at times. We want to be monitoring your kidney function. This might be done by your doctor every like three to six months or so with blood work. You want to get your yearly eye exams, so our optometrists are playing a big role here. You want to do regular foot checks, whether that's by yourself or looking at your own feet, a family member or a doctor, including a podiatrist or a foot doctor if needed. And then, keeping up-to-date on the vaccines that are recommended for you, like the pneumonia shot, for example.

Host: Okay. Well, with all of this information, there's probably a lot of information that we could also get that would help. So, where can I learn more?

Dr Kimberly Aucoin: You can see your primary care physician or provider. They can see you to help prevention, for testing, for treating you if needed. We also have our registered dieticians and diabetic educators. They're a great resource that you can learn so much from, like from what foods to eat or how to do your injections. They have a wealth of information. And also, hospitals like our own may have a diabetes prevention program. So at Cumberland Healthcare, we do groups that get together with our dietician for learning more about diabetes and how to manage it.

Host: Excellent. Well, Dr. Aucoin, this has been so helpful. Thank you for everything you do and everything you shared.

Dr Kimberly Aucoin: Thank you so much!

Host: I'm Jamie Lewis. Thank you for joining me on another episode of Healthier You, a podcast from Cumberland Healthcare. To learn more about diabetes, symptoms, treatment and care, visit cumberlandhealthcare. com.