TMH Living Well: New approach, new treatments for diabetes
The focus in diabetes management is shifting from maintaining daily sugar levels to preventing complications caused by the disease. This shift in approach, coupled with new treatment options, makes for a promising new future for patients with diabetics.
“Diabetes has so many ramifications. As it advances, it can affect several internal organs, including the kidneys, coronary arteries and peripheral nerves. When these organs are compromised, renal failure, heart attacks and nerve pain in the feet and hands can ensue,” said Dr. Gerald Myers, internal medicine physician and cardiologist with The Memorial Hospital Medical ClinicThe Memorial Hospital Medical Clinic..
That’s why it’s critical to keep blood sugar levels under control over the long term.
Preventing complications from diabetes
Rather than relying on daily blood sugar checks, physicians are relying more and more on the Hemoglobin A1C to regulate blood glucose levels. This blood test reflects your glucose levels over several weeks.
“In my patients with diabetes, I want to see test numbers consistently under 7, or trending down to avoid problems with vital organs. The higher the Hemoglobin A1C number, the higher the risk of complications due to the disease,” Myers said.
The new trend is part of the American Diabetes Association’s “ABC” guidelines. Besides “A” for A1C levels lower than 7, the guidelines call for “B” — blood pressure readings below 130/80 mm/Hg — and “C” — LDL cholesterol levels below 100 mg/dL.
When blood sugar levels are poorly controlled, plaque builds up in the coronary arteries over time.
“An unfortunate complication of diabetes is that diabetics don’t experience the early warning signs as others do with heart attacks. Instead of chest pain, they may experience indigestion or no symptoms at all — yet when we check their electrocardiogram or echocardiogram we see evidence that they’ve had a heart attack. These heart attacks are considered “silent” heart attacks and they damage the heart each time it happens,” Myers added.
New research, monitoring devices and drugs show promise
If you’ve been living with diabetes for a while, and your treatment has stayed pretty much the same, it might be time to visit with your doctor about new therapeutic options that have recently come into play. Several new drugs have entered the market, along with better monitoring devices and a future with even an artificial pancreas on the horizon. Several companies are already developing bionic pancreas devices, many of which will launch as early as 2018.
“An artificial pancreas can monitor glucose levels and administer insulin on its own. This is very relevant to me, since my 14 month-old grandson was just diagnosed with Type 1 diabetes in early June,” Myers said.
Glucagon, a natural hormone found in our bodies that helps to normalize blood sugar levels, works hand in hand with insulin. Some diabetics are unable to secrete glucagon.
“A device is also coming down the pipeline that will deliver both insulin and glucagon to patients,” Myers added.
While insulin pumps have been around a long time, they continue to be improved by becoming smaller and more effective. One that is ready for release in 2017 is the size of a nickel.
“Diabetes is a life changer and learning to manage it takes time. It’s important to get good glucose control to avoid complications down the road,” Myers said.
Dr. Myers serves as a full-time physician at TMH Medical Clinic, splitting his time between internal medicine and cardiology. As an internist he sees several patients for diabetes and helps them manage their disease. He is accepting new patients in both areas. For an appointment, call 970-826-2400.
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