intro: Duly Noted, a health and care podcast, is the official podcast series of Duly Health and Care. Each podcast features physicians or team members discussing groundbreaking topics and innovations that help listeners reimagine and better understand an extraordinary health and care experience.

Amanda Wilde (Host): Diabetes affects millions of Americans, and there is no cure. So can you have diabetes and still be healthy? Endocrinologist, Dr. Falguni Vasa offers insight into managing complications and long term risks of diabetes on this episode of Duly Noted, a health and care podcast. I'm Amanda Wilde. Dr. Vasa, welcome to the podcast.

Falguni Vasa, MD, FACE: Thank you, Amanda. Pleasure to be here.

Host: What are some of the complications that people with both Type 1 and Type 2 diabetes might encounter?

Falguni Vasa, MD, FACE: So there are many complications of both types of diabetes. I think the common ones that we hear about the most involve the eye, the kidney, and the nerves. So diabetes is the leading cause of blindness in adults, and also the leading cause of kidney disease, as well as a very prominent cause of nerve damage. Patients with diabetes are also twice as likely to develop heart disease and stroke, so there are definitely a lot of long term consequences to diabetes if left uncontrolled.

Host: So, there are some serious effects people may face. If you're diagnosed with diabetes, what actions can we take to prevent these kind of complications?

Falguni Vasa, MD, FACE: So the most important thing that a person can do is to keep good control of their blood sugar. And this is monitored by a blood test called the hemoglobin A1c, which looks at average blood sugar control over time.

And it's very important that this level be kept within target to minimize the risk of developing all of the complications we talked about. And the target A1C, can be different for people depending on what other conditions they may have and what other risk factors they may have. So it's important to personalize that target, but to remain within that target, to make sure that we're preventing these complications.

In addition to blood sugar control, it's also important to manage other risk factors specifically for heart disease. So things like high blood pressure, cholesterol, weight, sleep, all of these things factor into controlling diabetes well.

Host: So you personalize treatment based on the patient's other conditions. What are some of the different treatment options available?

Falguni Vasa, MD, FACE: So there fortunately are many, many options available now. Diabetes is actually a very exciting field to be a part of these days because of the new therapies that are emerging. And all of the medications that are available work in different ways.

So diabetes at a very basic level, is when the body cannot utilize sugar properly. And so that extra sugar is floating around in the bloodstream where it should not be. And many of our medications work at different organs and different tissues in the body to help bring that sugar into that tissue or organ.

So these therapies all work in a complementary fashion to bit by bit affect all the different places that diabetes can affect you in the body. So some will work by causing your pancreas to make extra insulin. Some will work by making the tissues more sensitive to the insulin and so that allows the sugar to come into the cells.

Some will work by getting rid of the extra sugar through your kidneys. And then, of course, there's always insulin, which is just putting insulin back into the body if your body is unable to make it.

Host: So insulin is an old standard, and then there are many other advanced treatment options and therapies. Are there also emerging treatments for diabetes?

Falguni Vasa, MD, FACE: Oh, for sure. There are many new injectable therapies and also pills that have come out that not only help with diabetes control and sugar management, but also have additional benefits in protecting the kidneys or protecting the heart. So these are some very exciting new therapies that we have available to us.

And these therapies can all be used either by themselves or sometimes in combination. And many times combination therapy is required to keep the blood sugar under control.

Host: Now you talked a little about what can happen if diabetes is left untreated, but what role does preventive care play in diabetes prevention and detection?

Falguni Vasa, MD, FACE: That's a great question because Type 2 diabetes, which is the diabetes that affects the majority of the population, is largely preventable. By keeping your weight at a healthy weight and modifying your diet, you can essentially at least delay or even prevent the onset of diabetes. So, things like not gaining weight as you get older, or losing weight if you're not at a healthy weight, and keeping your diet healthy and balanced, as well as getting enough sleep and exercise.

All of these things will allow your pancreas to function in its optimal state and produce insulin the way that it's supposed to. And eventually, and it's been shown, this can at least delay or even prevent the onset of diabetes.

Host: That is significant. If someone does find themselves in a situation where they are facing long term complications of diabetes, what can they do? Who should they reach out to for support?

Falguni Vasa, MD, FACE: Your first point of contact really should be your primary care physician as they know you best and they would be able to determine really the extent of where your blood sugar is and how the control is and whether that requires referral to a specialist. They may require you to see an endocrinologist or a neurologist, a cardiologist depending on the complication that is coming up.

They may also be able to maybe adjust your treatment plan to get things under better control. The name of the game with complications is definitely prevention, but even if complications are present, it's still important to bring the blood sugar under control to prevent new complications and also to minimize the current complications from getting worse.

So it's definitely better late than never, even if complications are present, to make sure that we're working toward good glucose control.

Host: That's encouraging. There are treatments, there is management, and there is even prevention, and you need to work hand in hand with your doctor on that. Thank you, Dr. Vasa, for these really enlightening insights into the long term complications of diabetes.

Falguni Vasa, MD, FACE: Thank you for having me.

Amanda Wilde (Host): That's Dr. Falguni Vasa, Endocrinologist at Duly Health and Care. For more information, visit DulyHealthAndCare.com. And if you found this podcast helpful, please share it on your social channels and check out our full podcast library for additional topics of interest. This is Duly Noted, a health and care podcast from Duly Health and Care.