Maggie McKay (Host): If you've been newly diagnosed with diabetes, you probably have a lot of questions. Joining us today is Elizabeth Haun, a board-certified family nurse practitioner, to fill us in on diabetes 101 for beginners.

Welcome to Mountain Medicine, a podcast from Northern Inyo Healthcare. I'm Maggie McKay. Elizabeth, thank you so much for making the time to be here today and share your expertise.

Elizabeth Haun: Pleasure's mine. Thank you.

Host: Could you give us an overview of what diabetes looks like here in the U.S.?

Elizabeth Haun: So, unfortunately, diabetes is not looking great. There's about 30% of the population that is either prediabetic or diabetic. And a lot of those, especially the prediabetics, don't know that they have prediabetes. And so, it makes it a little difficult to diagnose. And the other aspect of that is that with the increasing overweight and obesity of the population, we're expecting more and more people to be getting diabetes in the future. It's only going to get worse before it gets better.

Host: Uh-oh. Not what we want to hear, I'm sure. what are the risks diabetes brings with it, especially when it's not managed.

Elizabeth Haun: Oh, there's a lot. The risks are the risk of amputation of toes, high blood pressure, blindness, you can get kidney damage, and you end up on dialysis. It kind of goes on and on. It affects every aspect of your body, really.

Host: And is that only if it's not managed or even when it is?

Elizabeth Haun: That's generally if it's not managed. If you can manage the diagnosis of diabetes, then you can expect to have at least as long a life as anybody who does not have diabetes. It's pretty positive. People tend to take it as a death sentence or that they're going to die earlier. But with a little work and devotion and education, you can manage it pretty well.

Host: Well, that's encouraging. What should a newly diagnosed diabetic understand about this disease?

Elizabeth Haun: What they must understand initially is that, one, we, you know, we want to be really supportive for people who get this diagnosis because it is life-changing and it can be distressing to the patient, so we need to be really supportive and make sure that they understand the condition and that it's not a death sentence. So depending on how bad the diagnoses in terms of how bad their diabetes is uncontrolled, they just need to understand that they're going to have to make some changes in their life in terms of diet and exercise, lifestyle management, as well as they're probably going to end up taking some medications, and not only medications for diabetes, but we tend to put them on cholesterol lowering medications and generally blood pressure medication as well, even if their cholesterol is not really high and their blood pressure is not really high.

Host: Elizabeth, what can the newly diagnosed expect when it comes to the medical management side of things?

Elizabeth Haun: The newly diagnosed can expect-- well, there's two situations we need to address here, and one of them is depending on what kind of diagnosis they get. There's the type 1 diabetes and type 2 diabetes. Type 1 is, generally, they just need insulin because they're not producing any insulin at all in their body. And I don't need to go into the whole physiology about it. But type 2 diabetes, which is the most common, is typically managed by different kinds of medications. And often, this depends on other situations that are going on in their bodies. If they're having kidney problems or high blood pressure or high cholesterol, we kind of have to factor in everything else that's going on with them before we decide what kind of medication.

But generally, we put them on an oral medication once or twice or three times a day. Sometimes, depending on how difficult it is to manage, they might have to go to an injectable medication and sometimes even add in a little bit of insulin as well. There's a myriad of medications available right now for diabetics and it makes it sometimes complicated, but it also makes it easier to manage, especially if someone has a diagnosis that's insulin resistance and blood sugar that's difficult to manage. We have multiple choices.

Host: And what changes in lifestyle can someone new to this journey expect?

Elizabeth Haun: What we like to do is we like to get a care team together for the patients and this often involves the primary care person, a dietician, and sometimes even physical therapy or a lifestyle exercise management person. It's threefold really. It's medications, it's your lifestyle, in terms of exercise, and then diet, because diet and exercise are very important to help manage the diabetes. And even if you're taking medication, diet and exercise are important because it makes it so that you don't have to take as much medication as you would if you were not managing those two other factors.

There's another factor that we're just really learning so much about is the amount of sleep that you get in terms of managing chronic diseases like diabetes. So, minimum seven hours of sleep at night. And so, we help kind of figure out that aspect as well.

Host: I was just going to ask you that. I was thinking sleep has to be a factor, like it is in most things, right?

Elizabeth Haun: Oh, yeah, we're just learning more and more about the effects of sleep. And it's actually very difficult. People don't sleep well here in the United States.

Host: That is for sure. Elizabeth, is there anything else you'd like to add in closing?

Elizabeth Haun: I think it's just important for people to know that we are now starting to screen people for type 2 diabetes at an earlier age. If we determine that you have certain risk factors, then we'll start the screening at about age 35. So, it's important to know that to go in and see your primary care provider and get your routine screenings so that if you are starting to move into diabetes or prediabetes that it can be caught early and we can help you to make the changes necessary that potentially you won't need to go on medications right away.

Host: That's good to know. Thank you so much for sharing this important information. We appreciate it.

Elizabeth Haun: Thank you.

Host: Again, that's Elizabeth Haun. To learn more about Family Medicine Services at Northern Inyo Health Care District, visit nih.org/ruralhealthclinic. That's nih.org/ruralhealthclinic, or call 760-873-2849. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you.

I'm Maggie MacKay. Thanks for listening. This is Mountain Medicine presented by Northern Inyo Healthcare District.