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Terry Streetman (Host): Welcome back to Well Within Reach, presented by Riverside Healthcare. I'm Terry Streetman, Marketing and Communications representative. We're here today with Dr. Sara Yap from Riverside Endocrinology Specialists, and we're going to discuss important diabetes related screenings. Thanks for joining us, Dr. Yap.

Sara Yap, MD: Glad to be here.

Host: Before we get started, we'll take a quick break for a message about MyChart.

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Host: Okay, we're back. Dr. Yap, can you remind our listeners, because you've been here before, of your background and your role?

Sara Yap, MD: Yeah, so I'm Dr. Yap. I'm one of the endocrinologists over here at Riverside, and we're actually conveniently located at the fitness center. So we deal with endocrine related concerns and including but not limited to diabetes management, thyroid, pituitary, adrenals, as well as osteoporosis. But the majority of our patients are patients with diabetes.

Host: Okay. Well, within all of those areas that you work in, and within your job, what do you like most about working as an endocrinologist here?

Sara Yap, MD: I like the continuity of care. Able to see patients, trying to find out is the treatment working for them, what is going on? And seeing them get better physically, mentally, is the most rewarding thing.

Host: Well, that's great. Yeah. That personalized care, I think is a big deal for a lot of people. So what does it mean then for patients here to have this kind of care right here in their community?

Sara Yap, MD: It's great to have access right here without needing to drive an hour or two up north or south just to get endocrine care.

The other thing is for our pregnant patients, they require a lot of very close followups, and having it here in the community is really good.

Host: Well, that's great. Good to have that care close to home. So moving on from there. So people may or may not be familiar with the term comorbidity. Can you define what that is and share what common comorbidities occur with diabetes?

Sara Yap, MD: So diabetes can be associated with other health conditions and that defines a comorbidity. There are several comorbidities that we take a look at. One would be cardiovascular disease. That's blood pressure, cholesterol, heart attack or stroke. There's also the kidney disease and that's called nephropathy.

And there's also what we call nerve damage, which is neuropathy and that can lead to foot ulcers when left unchecked. There's also eye damage and that's what we call diabetic retinopathy. And the other thing too is there are metabolically associated fatty liver disease.

Host: Okay. So with all of those conditions then that could occur alongside diabetes, why are regular health screenings important and what sort of screening examples can you give that people might need?

Sara Yap, MD: The importance about these health screenings is it tells us has diabetes affected the other organs of the body? And for those who have these organs affected, is it progressing or getting worse?

That's what we need to know. Some examples of health screening include diabetic eye screening, and that happens about once a year or every two years depending on patient's conditions. We also do annual foot exams, to check if patients can feel the bottom of their feet, not just looking at the feet, but actually testing for sensation. We also check for if there is protein in the urine, how is the kidney function and how's the liver function? And that's going to be done at least once a year as well. And then for patients who have cholesterol issues, we check cholesterol at least once a year as well.

Host: Okay. Another reason that it's great to have that right here in the community so you can keep up on those regular screenings. Before we move on, we will take a quick moment to talk about the importance of primary care. Consistency is being able to count on someone to be there when you need them. At Riverside Healthcare, your primary care provider is dedicated to being in your corner, helping you and your family stay healthy and thrive.

Find the right primary care provider for you at myrhc.net/acceptingnew. From annual screenings to well checks and everything in between, having a primary care provider that you can trust makes all the difference. Okay, we're back. We're going to talk more about some of those health screenings then. What is a glycemic status assessment and who should get one?

Sara Yap, MD: So let me go off tangent a little bit here. The first thing is when do patients actually need to get diabetic screening? And, according to the American Diabetes Association, it's actually everyone who is more than 35 years old and any persons with regardless of age, risk factors, which includes family history of diabetes, history of gestational diabetes, blood pressure, cholesterol, PCOS, among all of those, and so that entails a blood testing and A1C or random glucose testing or an oral glucose tolerance testing which patients have to talk to their primary care about.

Now, kind of moving on, for patients who have diabetes, now we do what we call glycemic status assessment, and that tells us how a person is managing their blood sugar levels. And that is through checking an A1C at least every three months. That is a blood test and checking sugars via either a finger stick glucose, using their glucometer once or twice or three times a day depending on our instructions, and also continuous glucose monitor devices.

Host: Okay. So then let's say, you mentioned earlier, some of those comorbidities and one of them was, diabetic retinopathy. So how do diabetic retinal exams work and how can someone get one?

Sara Yap, MD: Diabetic retinal exams are fairly simple. Don't be afraid of that. You go and get your eyes dilated and they'll look at the back of your eye and see if diabetes has affected the eyes. And that's actually different from a cataract. Now, each of our primary care clinic there is, this device called RetinaVue and it's rotated among the primary care clinics and that helps them check for diabetic retinopathy. Patients can also go see their optometrist as well as their ophthalmologist for this as well.

Host: Well, that's great. Good to have a lot of options there. So you don't have to, you know, always come to the specialist to get that done. So you mentioned before with some of the other ones, how often can you remind us should these exams and assessments be done?

Sara Yap, MD: For diabetic retinopathy at least once a year or two years, depending on this patient's status. We have a foot exam that's once a year. Blood work would be once a year or more depending on glucose control. Now I always want to make sure that patients don't forget regular health maintenance screening and that is going to be mammograms, colon cancer screening, lung cancer screening, dental health every six months, immunizations, mental health as well as osteoporosis screening. One of the most important things we tell patients is that they should have a primary and that they should see them at least once a year.

Host: Well, that's great. And I think another great thing here at Riverside then is a lot of that can be taken care of within our system. And all that information is within your MyChart, so making that a little bit easier to manage. So we're getting towards the end here. What would you say is the biggest takeaway that you want people to have from this episode?

Sara Yap, MD: So, diabetes is a chronic condition. Your primary care as well as us, your endocrinologists, are here to help you with that. But the most important thing is for our patients to take into account their own health, have effort and motivation to take care of their health.

Host: Awesome. Well, thank you so much for joining us today and for all that great information.

Sara Yap, MD: Thank you.

Host: So as Dr. Yap mentioned, it's important to have a primary care provider. So in order to find one, if you don't have one, you can visit myrhc.net/acceptingnew. And if you're interested in more about Riverside Endocrinology Specialists, you can visit myrhc.net/endocrinology. Thanks for tuning into Well Within Reach, presented by Riverside Healthcare. Please take a moment to rate and leave a review for well within Reach on Apple, Spotify, or wherever you get your podcasts.

To learn more about Riverside, visit riversidehealthcare.org.