Transcription:

Scott Webb: Roughly 10% of Americans suffer from diabetes. And though it is fairly common, it's also highly treatable and, in many cases, reversible. And joining me today, tell us about the signs, symptoms, and treatment options for diabetes is Allison Dale. She's a board-certified nurse practitioner who specializes in endocrinology with Genesis.

This is Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. I'm Scott Webb. Allison, thanks so much for your time today. We're going to talk about diabetes, which of course is common, type 1, type 2, pre-diabetes. We're going to get to all that today. But as I said, it is common, but it's also treatable. So as we get rolling here talking about diabetes, what are the warning signs?

Allison Dale: So pre-diabetes doesn't necessarily have any warning signs Once you progress to diabetes, you can have many warning signs. Most people complain of increased hunger or increased urination, or just general malaise, not feeling well. So those sometimes trigger people to seek out medical attention.

Scott Webb: Yeah. And about pre-diabetes, before we get too far into this, and I've spoken with some other experts over the years, when we hear pre-diabetes, you think, "Oh, that's the thing before diabetes. It's not really diabetes." But pre-diabetes is, in and of itself, its own thing, right? It shouldn't be just thought of as the thing before diabetes. Do I have that right?

Allison Dale: Yeah. So, pre-diabetes certainly is a period of time before diabetes initiates, but it can be the end. You can have pre-diabetes and reverse it or never go to have diabetes, so it is certainly its own diagnosis.

Scott Webb: Yeah, that's good to know. I think that, of course, we as patients, we all want to know that there's options and treatments available, but the cool thing about pre-diabetes is, if it's diagnosed early and addressed properly, it can be reversed, right?

Allison Dale: That's correct.

Scott Webb: That's great. So let's talk about, in general, when we think about diabetes, and I don't know if you want to start with type 2 and move to type 2, but most of us as we people might develop type 2 over the years, they may have some risk factors, whatever that is, diet, lack of exercise, smoking, all the, you know, sort of greatest hits. So who is it the highest risk for diabetes?

Allison Dale: So in terms of type 1 diabetes, there's a lot that we still don't know. So there is some genetic predisposition, meaning that if you have a family member with type 1 diabetes, you may be at an increased risk. But we don't know all the risk factors for type 1. When it comes to type 2 diabetes, we know that there are quite a few risk factors. Pre-diabetes is certainly a risk factor for type 2 diabetes. And obesity, being overweight and having a poor diet increases your risk as well. And for a long time, risk was thought to increase with age. And now, that's kind of changed a little bit. But certainly as we age, you are more at risk as well. Family history, generally people with type 2 diabetes have a very strong family history and can name many people that have type 2 diabetes in their family. So those are some of the general risk factors.

Scott Webb: Yeah, definitely. As we all learn, unfortunately, Allison, we cannot outrun our family history, right? Genetics, family history, predisposition plays a big role in some of these things.

Allison Dale: Absolutely.

Scott Webb: So let's talk about how we can address, let's assume that we had pre-diabetes. We moved on to type 2 diabetes. Let's talk about what we can do to then sort of eradicate that, to remove that from our lives, whether that's diet, exercise, the types or amount of exercise. What do you recommend?

Allison Dale: So what's known to be the most helpful are certainly lifestyle modifications. So diet and exercise are considered first line treatment. Generally, the exercise recommendation is 150 minutes of exercise a week. Especially if you're starting with not much exercise, even just walking is a great start, a great way to incorporate exercise.

And diet's very important too. So diabetes and pre-diabetes, it's all about sugar and carbohydrates. So decreasing the amount of carbohydrates you consume, sugars, fats, eating more fruits and vegetables, all of those things are thought to help as well as some weight loss. Weight loss is great because it increases insulin resistance and brings those sugars down quite a bit.

Scott Webb: Yeah. Let's be honest, Allison, most of us could probably stand to lose a few pounds. But as you say, obesity, which is in and of itself its own disease, can be a contributing factor, put people at higher risk either for pre-diabetes or type 2 diabetes.

And I've never spoken to a medical professional who recommended smoking, who said smoking was good. And it does seem that it always seems to come back to that no matter whom I'm speaking with and what medical condition we're talking about, that smoking is bad and needs to be stopped. Maybe you can sort of through that lens, talk about smoking and its relationship to diabetes.

Allison Dale: So smoking is very bad, especially for people with diabetes because, if you look at diabetes and complications of diabetes, they're all related to the vascular system. So that's why complications are things like heart attacks and loss of limbs, neuropathies, nerve pains, things like that. And smoking makes all of those things a higher risk and much, much more severe. So smoking and diabetes, they certainly are not a good combination.

Scott Webb: Right. Yeah. So you mentioned earlier that, especially with pre-diabetes, folks just may not have any signs and symptoms. But whether it's pre-diabetes or type 2, let's talk about screenings and early screenings. And so if you had a family history and genetics and predisposition, obviously maybe you'd want to be screened earlier than other folks. But in general, talk about screenings and diagnosis.

Allison Dale: Yeah, that's correct. So generally, they recommend screenings, the American Diabetes Association, with something called an A1c, so a blood test that kind of gives us a glimpse of the past three months of your blood sugars, and it gives us a percentile range. So for instance, if that range is 5.7, then we know that you have pre-diabetes. If it's 6.5, we know that you have diabetes. So that range helps us diagnose you and check to see if there's any warning signs or problems that we might think you're headed towards prediabetes or diabetes. And the guideline recommendations vary depending on who you are and what your risk factors are. Generally, the recommendation is to start screening at age 45 and to have an A1c done every three years. But people that are at higher risk, they might start at a younger age. And the recommendation might be every 12 months.

Scott Webb: Yeah. And you mentioned, if you've been diagnosed with pre-diabetes or type 2 especially, that behavior and lifestyle modification are probably going to be needed, whether that's diet, exercise, quitting smoking, all the above. So let's talk about the treatment options. In addition to what we can do to help ourselves, what can you do to help folks?

Allison Dale: Yeah. So with pre-diabetes, the best thing is lifestyle change, so diet and exercise on your part. There are some medications that help with pre-diabetes, mainly medications that focus on helping other conditions to mitigate any complications if you were to develop diabetes or to help with weight loss. Outside of that, when you have a type 2 diabetes diagnosis, there are many different medications that can be used to help bring your sugars down and keep you healthy.

Scott Webb: Yeah, it's been really educational. As we wrap up here, when we think about prognosis or outcomes for folks who have prediabetes or any type of diabetes, what should their level of optimism be, that they can deal with this, that they can tackle this, that they can remove it or live with it or whatever the right way is to put it? What's your advice?

Allison Dale: You know, things change, technology changes, medications change. Diabetes is certainly tough. It requires a lot of self-management and a lot of work, it absolutely does. But there is great hope that you can manage, or sometimes even reverse pre-diabetes and manage diabetes well enough where you live a completely normal life and don't have any complications. So it's certainly a big burden, but just having a positive attitude and a good mindset and surrounding yourself with people that you mesh with and can really help you is probably the most important thing.

Scott Webb: Yeah, that's perfect. Well, Allison, thanks so much for your time today. You stay well.

Allison Dale: Thank you. You too.

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.