Living with Diabetes
Nearly 10% of the population is dealing with diabetes. Dr. Joseph Henske, Director of UAMS Diabetes Program, discusses diabetes and its treatment.
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Learn more about Joseph Henske, MD
Joseph Henske, MD
Dr. Joseph (Joe) Henske is a clinical endocrinologist and director of the diabetes program at UAMS. He graduated from the University of Texas Health Science Center at San Antonio with his medical degree in May 2004. He completed his residency training in internal medicine at Northwestern Memorial Hospital in Chicago, IL in 2007. He completed his fellowship in endocrinology, diabetes, and metabolism at Vanderbilt University in 2010. After fellowship, he worked in full-time clinical practice and served as the department chair of endocrinology for DuPage Medical Group in Chicago, IL until relocating to Little Rock to join UAMS in September 2019.Learn more about Joseph Henske, MD
Transcription:
Living with Diabetes
Scott Webb (Host): Over 30 million Americans live with diabetes. That’s almost 10% of the population. Advances in medicine, treatment and technology have made it possible for people to truly live and thrive with this disease. My guest today is Dr. Joseph Henske. He’s not only the Director of the UAMS Diabetes Program, but he also has diabetes himself. This is UAMS Health Talk from the University of Arkansas for Medical Sciences. I’m Scott Webb. Dr. Henske, thanks for joining me today. Many of us think we know what diabetes is, but you are truly an expert. What is diabetes?
Joseph Henske, MD, FACE (Guest): Well diabetes is a condition that results from elevated glucose levels in the blood. It’s basically sugar that you eat in your food or carbohydrates that is converted to glucose and if your body cannot handle that glucose in the bloodstream; your numbers are going to be elevated and that’s what we call diabetes.
Host: And doctor, I know there’s at least two types of diabetes type one and type two. What are the differences between the two types?
Dr. Henske: That’s a great question. In fact, there’s actually more than two types of diabetes. We used to call them juvenile diabetes or type one diabetes and adult diabetes or type two diabetes. But now we understand that there’s a lot more nuances. For most individuals, they have either type one or type two diabetes.
Type one diabetes is caused by the body’s own immune system attacking the pancreas which causes a deficiency in the ability to make insulin. Type two diabetes is caused by fundamentally insulin resistance often associated with being overweight and ultimately can result in the end with an insulin deficiency or an inability to make enough insulin in response to the insulin resistance.
Host: That’s a great explanation doctor. Thank you. And how common is it to have something other than type one or type two diabetes?
Dr. Henske: I would say it’s probably in less than five percent of patients have other types of diabetes. Some patients have sort of a hybrid between type one and type two diabetes, we call type one and a half diabetes. Some people have diabetes due to medications they may have taken. Some people have diabetes associated with pregnancy. Some people have diabetes related to a genetic disorder that they may have been born with as well.
So, there are things to look out for and some people might have diabetes caused by other hormonal conditions. Again, these are much less rare but for someone whose diabetes is not responding to their conventional therapy; sometimes, we think about these other causes as well.
Host: And doctor I may have this wrong, but in my mind, I’m thinking okay some people are born with diabetes while others develop diabetes. Do I have that right?
Dr. Henske: Very extremely rare that people are actually born with diabetes. People are born with a genetic predisposition to diabetes in some cases. Some people with type one diabetes may have a family history. Some people with type two diabetes may have a family history. But that rarely manifests at a very early age. It’s usually triggered by some secondary event. I mean some cases with type one diabetes we feel that there is a virus or something that may be a trigger, but we really don’t know what the triggers are for type one diabetes. For type two diabetes, a lot of it is related to that again, genetic underlying predisposition but also in the setting of excess weight. And what we find is that even if you have that genetic predisposition; if you are able to control your weight, you can avoid developing diabetes and, in some cases, if you’ve already developed diabetes, by losing weight, you can get rid of the diabetes.
Host: Well thanks for clearing that up. I think I get a better picture now that it’s that people have a predisposition, but it doesn’t necessarily mean that they are going to develop diabetes. So, what are ways patients can incorporate technology into their lives? I know that my daughter had a teammate of her's on one of her baseball teams who had diabetes, and this was when he was eight or nine years old. And they were always constantly checking his levels and making sure that he was okay, and he was able to live with it and able to play and all of that. So, let’s talk about the technology. I think there’s some really cool stuff out there.
Dr. Henske: I think the revolution in diabetes technology is really what’s made managing diabetes much easier over the last decade or 20 years. I think back when individuals were diagnosed with diabetes 10, 20, 30 years ago; there was no glucose monitoring in the home where you could stick your finger even and know what your blood sugar was. You would have to use a urinary measurement of your glucose or you would have to wait until you saw the doctor.
Over the last 20 years, there’s been more home glucose monitoring and now there’s what’s called continuous glucose monitoring where you can wear a device on either your abdomen or your arm and it will give you real-time read out of what your blood glucose levels are doing. And this is extremely useful for anyone with diabetes, particularly people who take insulin who experience large fluctuations in their glucose to know on a minute by minute basis what their blood sugars are running.
It can be really a safety issue as well if someone is prone to having low blood sugars. These devices can even alert you to a low blood glucose in the middle of the night and this information can even be shared with family members or loved ones who want to keep track of you. You can imagine if you were a parent of a child with type one diabetes and you were wondering what is my child’s blood sugar right now; it’s much easier to look at your phone and be able to read their glucose levels on your phone and be reassured then to have to ask your child to let you stick their finger again to find out the glucose value.
Host: That is truly amazing just kind of brings a smile to my face just thinking about kids and parents and how we need to monitor them or at least we feel like we do and to be able to do that from your phone is really amazing. Can you talk about what you wish the public knew or better understood about diabetes management?
Dr. Henske: I think I want the public to feel really engaged and empowered about managing diabetes. I think that we want to get to a point where there’s a real connection between the patient or the individual with diabetes and their doctor and it’s a really a two way street because I think that’s the way that diabetes is most effectively managed. I think there’s a lot of tools out there for patients to be engaged to see what their own patterns are with their glucose values to see what happens when they eat certain foods and to monitor their blood sugars and determine what are the best foods for them to eat and I think that doctors really are receptive to patient’s suggestions and ideas and thoughts and doctors are encouraged when patients are engaged and involved in their care.
So, I know for myself, and the other doctors that I work with; we really encourage our patients to be proactive, ask a lot of questions, maybe about things that your read about or have seen on TV and get involved and know that this is something that’s completely treatable. The complications that have been long associated with diabetes including eye disease, and kidney disease and amputations and a lot of those things that are extremely scary for people to think about; those are all completely preventable. If you are able to control your blood glucose levels and keep them in a range similar to someone without diabetes; there’s no reason that you can’t have a full life expectancy without any complications of diabetes.
Host: So, doctor what’s the correlation between good exercise habits and managing diabetes?
Dr. Henske: That’s a great question. I absolutely believe in exercise being a very crucial part of diabetes management. When I think about on a very simplistic level, how do you control diabetes? I think about it in terms of the glucose levels in the blood stream and I think you have glucose coming in and glucose coming out. And obviously we know that glucose coming in is from the diet in a lot of ways and we all know that we need to address diet as an important factor in diabetes management, but we don’t think how do we get more glucose out of our blood stream. We know that medications are part of that but really the most efficient way to get glucose out of our blood stream is with exercise and with aerobic exercise.
When you do that, the glucose gets utilized in an efficient way. It’s a healthy way to strengthen your heart and your body, control your body weight. Even small amounts of exercise, thirty minutes a day is extremely effective at bringing down blood glucose levels. Things that can be as simple as walking. You don’t have to do extremely strenuous exercise. You can do even light aerobic activity to control your blood sugars. Recent studies showed that walking ten minutes after each meal was even more effective than walking thirty minutes at a random time throughout the day. So, that can be something that you can incorporate, and, in some cases, you can use exercise to avoid having to take additional medications which again, always are associated with additional costs and side effects.
So, I encourage people as much as possible to take advantage of that in their management of their diabetes.
Host: That’s fantastic to know that people don’t have to have a fancy gym membership. Put on a pair of decent walking shoes and go for a walk and that can help them manage their diabetes and live with it. Dr. Henske, thanks so much for your time and insights today. For more information on Dr. Henske and diagnosis and treatment options visit www.uamshealth.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics that may interest you. This is UAMS Health Talk. Thanks for listening.
Living with Diabetes
Scott Webb (Host): Over 30 million Americans live with diabetes. That’s almost 10% of the population. Advances in medicine, treatment and technology have made it possible for people to truly live and thrive with this disease. My guest today is Dr. Joseph Henske. He’s not only the Director of the UAMS Diabetes Program, but he also has diabetes himself. This is UAMS Health Talk from the University of Arkansas for Medical Sciences. I’m Scott Webb. Dr. Henske, thanks for joining me today. Many of us think we know what diabetes is, but you are truly an expert. What is diabetes?
Joseph Henske, MD, FACE (Guest): Well diabetes is a condition that results from elevated glucose levels in the blood. It’s basically sugar that you eat in your food or carbohydrates that is converted to glucose and if your body cannot handle that glucose in the bloodstream; your numbers are going to be elevated and that’s what we call diabetes.
Host: And doctor, I know there’s at least two types of diabetes type one and type two. What are the differences between the two types?
Dr. Henske: That’s a great question. In fact, there’s actually more than two types of diabetes. We used to call them juvenile diabetes or type one diabetes and adult diabetes or type two diabetes. But now we understand that there’s a lot more nuances. For most individuals, they have either type one or type two diabetes.
Type one diabetes is caused by the body’s own immune system attacking the pancreas which causes a deficiency in the ability to make insulin. Type two diabetes is caused by fundamentally insulin resistance often associated with being overweight and ultimately can result in the end with an insulin deficiency or an inability to make enough insulin in response to the insulin resistance.
Host: That’s a great explanation doctor. Thank you. And how common is it to have something other than type one or type two diabetes?
Dr. Henske: I would say it’s probably in less than five percent of patients have other types of diabetes. Some patients have sort of a hybrid between type one and type two diabetes, we call type one and a half diabetes. Some people have diabetes due to medications they may have taken. Some people have diabetes associated with pregnancy. Some people have diabetes related to a genetic disorder that they may have been born with as well.
So, there are things to look out for and some people might have diabetes caused by other hormonal conditions. Again, these are much less rare but for someone whose diabetes is not responding to their conventional therapy; sometimes, we think about these other causes as well.
Host: And doctor I may have this wrong, but in my mind, I’m thinking okay some people are born with diabetes while others develop diabetes. Do I have that right?
Dr. Henske: Very extremely rare that people are actually born with diabetes. People are born with a genetic predisposition to diabetes in some cases. Some people with type one diabetes may have a family history. Some people with type two diabetes may have a family history. But that rarely manifests at a very early age. It’s usually triggered by some secondary event. I mean some cases with type one diabetes we feel that there is a virus or something that may be a trigger, but we really don’t know what the triggers are for type one diabetes. For type two diabetes, a lot of it is related to that again, genetic underlying predisposition but also in the setting of excess weight. And what we find is that even if you have that genetic predisposition; if you are able to control your weight, you can avoid developing diabetes and, in some cases, if you’ve already developed diabetes, by losing weight, you can get rid of the diabetes.
Host: Well thanks for clearing that up. I think I get a better picture now that it’s that people have a predisposition, but it doesn’t necessarily mean that they are going to develop diabetes. So, what are ways patients can incorporate technology into their lives? I know that my daughter had a teammate of her's on one of her baseball teams who had diabetes, and this was when he was eight or nine years old. And they were always constantly checking his levels and making sure that he was okay, and he was able to live with it and able to play and all of that. So, let’s talk about the technology. I think there’s some really cool stuff out there.
Dr. Henske: I think the revolution in diabetes technology is really what’s made managing diabetes much easier over the last decade or 20 years. I think back when individuals were diagnosed with diabetes 10, 20, 30 years ago; there was no glucose monitoring in the home where you could stick your finger even and know what your blood sugar was. You would have to use a urinary measurement of your glucose or you would have to wait until you saw the doctor.
Over the last 20 years, there’s been more home glucose monitoring and now there’s what’s called continuous glucose monitoring where you can wear a device on either your abdomen or your arm and it will give you real-time read out of what your blood glucose levels are doing. And this is extremely useful for anyone with diabetes, particularly people who take insulin who experience large fluctuations in their glucose to know on a minute by minute basis what their blood sugars are running.
It can be really a safety issue as well if someone is prone to having low blood sugars. These devices can even alert you to a low blood glucose in the middle of the night and this information can even be shared with family members or loved ones who want to keep track of you. You can imagine if you were a parent of a child with type one diabetes and you were wondering what is my child’s blood sugar right now; it’s much easier to look at your phone and be able to read their glucose levels on your phone and be reassured then to have to ask your child to let you stick their finger again to find out the glucose value.
Host: That is truly amazing just kind of brings a smile to my face just thinking about kids and parents and how we need to monitor them or at least we feel like we do and to be able to do that from your phone is really amazing. Can you talk about what you wish the public knew or better understood about diabetes management?
Dr. Henske: I think I want the public to feel really engaged and empowered about managing diabetes. I think that we want to get to a point where there’s a real connection between the patient or the individual with diabetes and their doctor and it’s a really a two way street because I think that’s the way that diabetes is most effectively managed. I think there’s a lot of tools out there for patients to be engaged to see what their own patterns are with their glucose values to see what happens when they eat certain foods and to monitor their blood sugars and determine what are the best foods for them to eat and I think that doctors really are receptive to patient’s suggestions and ideas and thoughts and doctors are encouraged when patients are engaged and involved in their care.
So, I know for myself, and the other doctors that I work with; we really encourage our patients to be proactive, ask a lot of questions, maybe about things that your read about or have seen on TV and get involved and know that this is something that’s completely treatable. The complications that have been long associated with diabetes including eye disease, and kidney disease and amputations and a lot of those things that are extremely scary for people to think about; those are all completely preventable. If you are able to control your blood glucose levels and keep them in a range similar to someone without diabetes; there’s no reason that you can’t have a full life expectancy without any complications of diabetes.
Host: So, doctor what’s the correlation between good exercise habits and managing diabetes?
Dr. Henske: That’s a great question. I absolutely believe in exercise being a very crucial part of diabetes management. When I think about on a very simplistic level, how do you control diabetes? I think about it in terms of the glucose levels in the blood stream and I think you have glucose coming in and glucose coming out. And obviously we know that glucose coming in is from the diet in a lot of ways and we all know that we need to address diet as an important factor in diabetes management, but we don’t think how do we get more glucose out of our blood stream. We know that medications are part of that but really the most efficient way to get glucose out of our blood stream is with exercise and with aerobic exercise.
When you do that, the glucose gets utilized in an efficient way. It’s a healthy way to strengthen your heart and your body, control your body weight. Even small amounts of exercise, thirty minutes a day is extremely effective at bringing down blood glucose levels. Things that can be as simple as walking. You don’t have to do extremely strenuous exercise. You can do even light aerobic activity to control your blood sugars. Recent studies showed that walking ten minutes after each meal was even more effective than walking thirty minutes at a random time throughout the day. So, that can be something that you can incorporate, and, in some cases, you can use exercise to avoid having to take additional medications which again, always are associated with additional costs and side effects.
So, I encourage people as much as possible to take advantage of that in their management of their diabetes.
Host: That’s fantastic to know that people don’t have to have a fancy gym membership. Put on a pair of decent walking shoes and go for a walk and that can help them manage their diabetes and live with it. Dr. Henske, thanks so much for your time and insights today. For more information on Dr. Henske and diagnosis and treatment options visit www.uamshealth.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics that may interest you. This is UAMS Health Talk. Thanks for listening.