Understanding Type 2 Diabetes

Diabetes is a growing problem in the U.S. In fact, according to the American Diabetes Association, 25.8 million children and adults have diabetes.

If you are told you have prediabetes or full blown diabetes, there are some very important steps you can take to manage your condition and take control of your health.

Eloy Zamarron, MD discusses what you need to know about type-2 diabetes and the lifestyle changes you can make to help control it.
Understanding Type 2 Diabetes
Featured Speaker:
Eloy Zamarron, MD
Eloy Zamarron, MD is a doctor of internal medicine and a member of the medical staff at Doctors Hospital of Laredo.

Learn more about Eloy Zamarron, MD
Transcription:
Understanding Type 2 Diabetes

Melanie Cole (Host): Diabetes is a growing problem in the United States. In fact, according to the American Diabetes Association, almost 25 million children and adults have Type II Diabetes. If you're told you have pre-diabetes or full-blown diabetes, there are some very important steps you can take to manage your condition and take control of your health. My guest today is Dr. Eloy Zamarron. He's a family medicine physician and a member of the medical staff at Doctors Hospital of Laredo. Welcome to the show, Dr. Zamarron. So, I'd like to first ask you what is Type II diabetes? It used to be called “adult-onset” but now you're seeing it even in children? What exactly is it and who is most at risk?

Dr. Eloy Zamarron (Guest): Thank you, Melanie. Type II diabetes is the lack of control of the sugar levels by our bodies and the Type II diabetes is called in this way because like the difference from Type I, Type II diabetes patients has their pancreas releasing insulin but this insulin is not enough to control the diabetes and there are contributing factors to that. But, in general, this is the main difference between both of them.

Melanie: Who is at risk for this type of diabetes?

Dr. Zamarron: The main cause of Type II diabetes is overweight. That's one of the first causes and that can start happening at a very early age in life. So, overweight is the first factor. There are some people, not a lot, 20%, who are not overweight, but nevertheless, they are already eating more than what they really need. But, in the bottom line is overweight.

Melanie: Would somebody know? Are there some symptoms that they might experience if they are pre-diabetic or have diabetes? How would they know?

Dr. Zamarron: And, that's a very interesting question because that starts happening at a very early age and this is classic to see in young children when they are already chubby and they are very hungry and they are eating all the time. So, if you have a child who is eating all the time and hungry all the time, even though he or she already had a good meal and is already asking for more, that's a wake up call. That kid needs to be checked because it's very likely that the diabetes or pre-diabetes is starting already. Now to tell in adults, which is the same situation, people start being hungrier than normal and hungry all the time and eating frequently. So, that is one of the first symptoms that patients can have. Other symptoms when the diabetes is already ongoing, people start having problems to urinate a lot, they urinate frequently, they are very thirsty because the high levels of sugar create a dehydration. The body needs more water to control the building of the very concentrated sugar in the bloodstreams. People start having, as I said before, overweight. So all are, in general, the very first signs.

Melanie: Would this be something, Dr. Zamarron, that people would know when they get their annual physical and they have a blood test? Is there anything in the blood test that would signal to a doctor, "Hey, this is prediabetes or diabetes and we need to start looking at this condition,"?

Dr. Zamarron: Definitely. One of the tests that shows very early chances of the body already having problems to control the sugar is the creatinine level. A low serum creatinine is the way the body starts responding trying to fight the high levels of sugar and this is even before the patient has already his or her sugar higher than normal. Of course, there are other tests once the diabetes is already set, the high sugar levels, and then insulin levels can be checked also and those can be checked before the sugar is high. In cases with pre-diabetes, insulin and another test called “P-peptide” is also a test that can help us to determine the pre-diabetes condition as well.

Melanie: If someone is diagnosed as prediabetic or you tell them that they have diabetes, what is the first line of defense, Dr. Zamarron? What do you tell them that they have to do right away to start controlling and managing some of those symptoms?

Dr. Zamarron: Definitely. If a person is a young person, meaning less than 40 years of age, diet. That's a plus, that's a base that everyone should do. And, of course, when a person starts dieting, they may start having symptoms and the person needs to be aware of the symptoms so they won't scared. The other thing is exercise which is also a very, very important part in a young patient. After 40 years of age, then a person can need medications and that's another step that is very important, depending on how bad the diabetes is already by the time it's detected, is the type of medication will be needed along with diet and exercise, as well.

Melanie: Before we get into some of those medications, what are some complications to poorly controlled diabetes or if someone does not find it, what are some things that they might look to? Eye health or foot health? Are there some things you like them to watch out for?

Dr. Zamarron: Yes. Definitely one of the things that the patient can notice themselves, before they are checked with the doctors, sadly the symptoms are already late in the disease but if the patient or the person has a blood test, they already have one of these symptoms, it is urgent to check with a doctor. It's very sad to see a patient in the office when I am checking their feet and then, all of a sudden, I find a nail or a tack and the patient never felt it. Why? Because it's already advanced in the disease where the sensation in their skin is gone so they don't feel injuries; they don't feel infections; they don't feel warmth in their feet. But, besides those complications, it's very sad that the complications that can be detected in a patient, the first thing when diabetes is discovered, is heart attacks. Sadly, very, very late in the disease. Another one is strokes, same thing. And, another one is kidney problems, where their kidneys starts failing and because of the toxins that the kidneys should get rid of, accumulates in the body and they start causing effects that prompts the patient to seek medical attention and, again, it's already late because of the kidneys are already failing.

Melanie: People hear the word “insulin” and they think of those pictures of people giving themselves insulin shots. Tell us about Type II diabetes and what oral medications might be available before they would have to resort to insulin shots.

Dr. Zamarron: Definitely besides diet and exercise, medications nowadays are very helpful. Those medications do not cause many side effects. There are some medications that the doctor can consider necessary that may lower the sugar level a lot but there are others that do not do that too much in a more gradual way so that the patient will not have too many hypoglycemic symptoms and be able to control it. Remember, diabetes is a chronic disease and it's not possible to treat it in one or two visits, you're going to need several visits until the diabetes is controlled and then, after that, regular visits--either one every month or every three months or every six months according to the patient's needs.

Melanie: In just the last few minutes, Dr. Zamarron, what should people who've been diagnosed with prediabetes, or full-blown diabetes, think about to manage their symptoms? What is the most important thing you want them to know about this condition?

Dr. Zamarron: I work a lot with my patients with diet and exercise. The young ones are the ones that I encourage this more. For people already beyond 40 or 50 years of age, then exercise might be more difficult for them, so medication is the next thing to do, going into insulin depending on every case and proceeding with the further treatments, according to their needs and if there's any other complications. But definitely the most important thing is to be compliant with the treatment. Compliance that is very difficult because it's a chronic disease. It's not like an appendicitis, where you remove the sick or ill appendix and the problem is gone. No. This needs persistence; this needs discipline. that is something that the patient and the doctor needs to work very hard on.

Melanie: Why should they come to Doctors Hospital of Laredo for their care?

Dr. Zamarron: The blood test that are needed, the studies that are needed, and the rest of the follow up is an excellent source for me and for my patients because the therapists is excellent and the communication, which is very important, is ideal, so that the care of the patient will continue.

Melanie: Thank you so much, Dr. Zamarron, for being with us today. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information, you can go to www.ichoosedoctorshospital.com. That's www.ichoosedoctorshospital.com. Physicians are independent practitioners who are not employees or agents of Doctors Hospital of Laredo. The Hospital shall not be liable for actions or treatments provided by physicians. Doctors Hospital of Laredo is directly or indirectly owned by a partnership that includes physician-owners, including certain members of the hospital staff. This is Melanie Cole. Thanks so much for listening.