The More You Know, The Better You Can Manage Your Health
A Specialist Talks About Steps to Take for Improved Diabetes Management
If you have a chronic or progressive condition like diabetes, then learning more about it - and seeing a specialist if it's not well controlled - is a good idea.
Prasad Katta, M.D., an endocrinologist with Washington Township Medical Foundation, says that patients with diabetes represent 65 percent to 70 percent of his patient population.
"Seeing this type of majority in my practice indicates that the incidence of diabetes is becoming more and more common for a variety of reasons, including physical inactivity and poor diet in kids," Dr. Katta says. "Type 2 diabetes is more common, representing 90 percent to 95 percent of all cases while type 1 patients, who need insulin from the get go, represent only 5 percent to 10 percent.
"Additionally, we're seeing more patients with type 2 in younger age groups now. Type 2 diabetes previously was a disease of the elderly; now we are seeing type 2 as early as age 7, 8, 9, and 10, whereas in the past, kids had type 1 almost exclusively."
Dr. Katta says the demographic shift has occurred during the last 10 years, mostly because of an increase in obesity and our population's increasingly sedentary lifestyle.
"These days kids don't exercise as much, schools don't encourage physical activity, and PE is cut from the curriculum," Dr. Katta says. "One of the important statistics for people to understand is that every third child born after the year 2000 will be diabetic in their lifetime - that is one-third of the population that will be diabetic."
So, how is Dr. Katta tackling the diabetes epidemic in his own practice?
"A lot of it has to do with education on diet and exercise," he says. "Most of the time, patients and also their physicians tend to under-estimate what we can do, and when patients realize the power they have to improve their condition, they have better outcomes."
Dr. Katta notes that one of the positive things to happen in the past 10 years as far as diabetes is the release of several medications to combat different aspects of the disease.
"Before, medications focused on insulin production," he explains. "We used to try to make the pancreas produce more insulin, or we would give insulin to patients. Now, we are tackling other problems that raise blood sugars, and there are new drugs, including ones that act on the pancreas, act on fat cells to make you more insulin sensitive, or act on the liver to make it so that the glucose is metabolized more easily."
According to Dr. Katta, 90 percent to 95 percent of patients see their primary care physician for routine diabetes management; the other 5 percent to 10 percent see an endocrinologist.
"If your diabetes is not under control, it's a good idea to see a specialist," he notes, adding that a particular challenge with diabetes its progression as patients get older.
"We can't stop aging, but we always have to keep two steps in front of the diabetes, not one step behind. Our goal is to make sure that the diabetes is very well controlled."
Insulin is one of the treatments of choice, even early on, but many patients feel it's a failure, like they haven't taken care of themselves, Dr. Katta says.
"As a physician, you have to let them know that the disease's progression means they will need insulin eventually. By eight to 10 years after their diagnosis, most people will need to use insulin," he says. "However, with new medications, it's easier to control the condition without insulin, and some patients can go as long as 12 to 15 years without it."
Dr. Katta calls diet, exercise, and medications targeted to treat diabetes the mainstays of diabetes management. Other steps to keeping diabetes under control include:
- Checking blood sugars regularly and at different times of day, including two hours after eating (when the reading should be less than between 140 to 160)
- Scheduling regular visits to the primary care physician or endocrinologist
- Getting blood work done two to three times a year (four times annually if sugars are not well controlled) in order to adjust medications if necessary
- Checking A1C levels, which account for blood sugar levels during the last three months
- Keeping blood pressure to less than 130/80 - or ideally 120/80
- Managing cholesterol (HDL "good" cholesterol should be at 40 for men and 50 for women; LDL "bad" cholesterol should be less than 100 and preferably less than 70)
- Checking the feet for cracks and sores
- Seeing an eye doctor once a year
"It has been shown that the patients who receive education at the time of diagnosis do a lot better than patients who don't receive education," Dr. Katta says. "Diabetes education does give you more confidence in taking care of your disease."
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For more information about Washington Township Medical Foundation and its more than 60 board-certified physicians with expertise in a broad range of medical specialties - from neurosurgery to pediatrics - visit www.mywtmf.com.