Transcription:

Scott Webb: Diabetes is common and treatable and recognizing the signs and symptoms can help with early diagnosis. And joining me today to tell us about diabetes, the treatment options, and more is Dr. Tufail Ijaz. He's the Medical director Of Genesis Endocrinology.

This is Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. I'm Scott Webb. Doctor, thanks so much for your time today. I know that diabetes is common, right? And a lot of folks have it. Some know they have it, some are undiagnosed. So we're going to talk today about diabetes signs, symptoms, diagnosis, how to manage it and so on. But just as a baseline here, as we get rolling, how do you diagnose diabetes?

Dr. Tufail Ijaz: So, the typical sign and symptoms of diabetes include like patient will be urinating a lot. They'll be feeling more thirsty. They may have increase in their appetite. They may be losing weight. So those would be the typical symptoms of diabetes. Now, we diagnose diabetes with three different kinds of tests. If their fasting blood sugar is 126 or above, that's one of the diagnosis, or we do what we call two-hour glucose tolerance test. In that test, if they're glucose two hours after the glucose load is more than 200, then that's also consistent with diabetes. And there is a third test, we call it hemoglobin A1c. If that is 6.5 or above, that's also diagnostic of diabetes.

Scott Webb: All right. So that's a good jumping off point there. So I think my natural follow up is who's at the greatest risk for diabetes, whether that's behavior, lifestyle, family history, I'll let you cover all that. But who should be most concerned about developing diabetes?

Dr. Tufail Ijaz: So there are two kinds of diabetes, type 1 and type 2. Ten percent of diabetes is type 1 diabetes, and there are really no risk factors. It's an autoimmune disease. But the most common type of diabetes is type 2 diabetes. So there are several risk factors for developing type 2 diabetes. Family history is important. Anybody with history of type 2 diabetes in the family should be checked for type 2 diabetes. Anybody who is obese or overweight should also be checked for diabetes. Then, as we grow older, the risk of type 2 diabetes increases. And if they have some other conditions like polycystic over syndrome or, if they take some medicines like steroids, then these kind of people are at higher risk of developing type 2 diabetes.

Scott Webb: Yeah. And when we think about lifestyle choices, sort of behavior and lifestyle, right? So, factors are alcohol, smoking, those types of things that folks kind of do to themselves, can they make things worse? Can they sort of nudge people towards developing diabetes?

Dr. Tufail Ijaz: In addition to bad diet and not doing enough exercise, smoking is a risk factor for type 2 diabetes. And when patients do develop diabetes and if they don't quit smoking, it is difficult to control their diabetes. Too much alcohol consumption can also contribute to diabetes. So, smoking is definitely not recommended, it should be stopped. And once you develop diabetes, if somebody's still smoking, they are at higher risk of developing diabetes.

Scott Webb: Yeah, definitely. So let's talk about diet for folks who've been diagnosed with diabetes. Why is managing diet so important or good diets so important in managing diabetes?

Dr. Tufail Ijaz: Once somebody's diagnosed with diabetes, diet is very important. And that's the first thing we need to do, we need to change our diet. A diet that is not healthy definitely will increase blood sugars and will make it very difficult to manage diabetes with medicines. So, a healthy diet is extremely important. There are different parts of a diet. There are starches, proteins and fats. So starches or carbohydrates should be taken in moderation. We recommend to avoid simple starches like sugars and juices, pops, those kind of things should be definitely avoided. Other starches like white bread should also be taken in moderation. And then, proteins, which is mostly chicken, fish and meat, they don't have sugars or starches, so they can be used as needed. And then, fats and oil should be also consumed in moderation and vegetables, most of them don't have any bad carbohydrates or starches, and then they can be taken as needed.

Scott Webb: Let's talk about checking blood sugar. I know that the technology has come a long way between watches and implantables and smartphones and all of that. Let's talk about the importance of checking blood sugar if you have diabetes and how folks are doing that now.

Dr. Tufail Ijaz: So it's extremely important to check blood sugars on a daily basis. Now, in the office, like every three months, we do a test it's called hemoglobin A1c that tells us about diabetes control. But what patients can do at home is either their fingersticks, which is the old way. So depending on if they're on pills or insulin, we tell them like how many times they need to check their blood sugars. And now, more recently, we use a device that's called continuous glucose monitor. Patient attach it to either to their arm or abdomen for two weeks. And then, that will check their sugars continuously. They don't need to do fingersticks anymore. That device has a lot of information. It's helpful for us. And when patients are more aware of their sugars, they're more careful with their diet and their activity. And we see all the time they're just using their continuous glucose monitor, improves their diabetes significantly because they're aware of what's going on.

Scott Webb: So they put it on their arm or their abdomen, right? But then, they're able to see their blood sugar, see the numbers in real time right on their watches or maybe on their phones, right?

Dr. Tufail Ijaz: That's correct. Yeah. So either there is a device which they can use or, if they have a smartphone, they can continuously look at their smartphone and they can see in which direction their sugar is going after meals and after exercise. So patients tell us all the time that now they know which meals will increase their sugars, how much, so they are being more careful now.

Scott Webb: And we've talked about managing diets, eating better, cutting out smoking, things like that. Let's talk about exercise, the types of exercise, the amount of exercise. What do you recommend?

Dr. Tufail Ijaz: Yeah. So once somebody's diagnosed with type 2 diabetes, we recommend they should lose at least 5% of their body weight. That's the starting point. And of course, they should always try to go towards the ideal body weight, which is a BMI of less than 25. So at least they should walk 30 minutes a day for at least five days a week. There's the minimum. There's the starting point. And of course, they can do more exercise if they need to lose more weight, but that's the minimum.

Scott Webb: This has been really helpful today. As we wrap up here, doctor, what are some things that folks with diabetes should watch out for? So they know they have diabetes now, what do they need to be on the lookout for?

Dr. Tufail Ijaz: Diabetes can cause many complications. So it can cause problems in your eyes which can lead up to blindness. They can develop kidney failure. So we check for all those different tests. We want them to see an eye doctor at least once a year. So if there is any diabetic damage in the eyes, that we can treat it promptly. And then, in the feet, patient can develop what we call diabetic neuropathy. So they lose their sensations and also they develop peripheral arterial disease. So the blood supply to the feet decreases. In that case, they become more prone to infections. And since they don't have sensations in their feet, they can easily develop cuts and ulcers on their feet. And because of the less blood supply and less sensations, they can develop infections, which are very difficult to treat. So in some of the extreme cases, they may require amputations of their toes or feet. So it's very important to look at your feet regularly to make sure patients don't get any cuts or ulcers on their feet. They're supposed to see a foot specialist, a podiatrist regularly. And then, they're supposed to wear not very tight-fitting shoes, rather nice soft shoes, which should be easy on their feet.

Scott Webb: Well, that's perfect. Great advice from an expert today, doctor. Thanks so much. You stay well.

Dr. Tufail Ijaz: Thank you.

Scott Webb: And for more information, visit genesishcs.org. And thanks for listening to Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. If you found this podcast to be helpful, please be sure to tell a friend and subscribe, rate and review this podcast and check out the entire podcast library for additional topics of interest. I'm Scott Webb. Stay well.