Today, nearly 3 million Texans are living with diabetes. Another 6.8 million have been medically diagnosed as having prediabetes. People with diabetes are at increased risk for developing health complications that include everything from vision problems to heart disease and stroke – as well as kidney disease and amputation. However, with early diagnosis and expert treatment, these complications can be prevented or delayed.

This month, as part of our commitment to fighting the diabetes epidemic, we want to be sure you know what diabetes is, its symptoms, treatments and where to find excellent diabetes care.

There are three main types of diabetes: Type 1, Type 2 and Gestational.
 

Type 1 Diabetes
Type 1 diabetes is an autoimmune disease that typically occurs in children, teens and young adults when their pancreas is no longer able to produce insulin needed to metabolize glucose (blood sugar), which is the fuel for all cells in the body. Without insulin, these sugars are not able to move into the body’s cells and be used to create energy. Instead, glucose accumulates in the bloodstream and causes high blood glucose levels, which damage the nerves, kidneys, heart and other organs.

People with type 1 diabetes must have daily insulin via injections or an insulin pump to live. Relying on a dedicated team of diabetes experts, like those at UT Health Diabetes, to help monitor their blood glucose levels, improve their eating habits and make necessary treatment adjustments, Type 1 diabetics are able to live long, active, healthy lives.

Specific blood tests, urine tests and autoantibody and other specific blood tests will help your primary care physician accurately diagnose type 1 diabetes and refer you to a diabetes specialist.

Type 1 diabetes symptoms:

• Frequent urination
• Extreme thirst
• Lose weight without trying
• Feel very tired for no reason
• Nausea
• Vomiting
• Stomach pain
• Sudden vision changes
• Increased appetite
• Fruity, sweet, or wine-like odor on breath
• Heavy, labored breathing
• Stupor or unconsciousness

Type 2 Diabetes

Type 2 diabetes is the most common type of diabetes and is most often associated with being overweight and typically diagnosed in people over 45 years old. People with type 2 diabetes are said to have “insulin resistance” because their cells cannot respond to all the insulin made by their pancreas. This resistance signals the pancreas to make even more insulin, but the pancreas eventually slows down or stops because of the increasing demand to make more and more insulin.

Because the cells in the body do not respond to the insulin normally, they cannot receive the glucose they need to power the body. This causes the amount of glucose in the bloodstream to rise to unhealthy levels.

Gestational diabetes is a form of type 2 diabetes that is brought about by the extra nutritional needs of pregnancy. It usually goes away after pregnancy, but women with gestational diabetes have a very high risk of developing type 2 diabetes later in life. If you are pregnant or planning to have a baby, and have had a history of gestational diabetes, it is important to discuss this with your doctor.

Prediabetes

People who develop type 2 diabetes usually go through a period where they have "prediabetes". This means their blood sugar/glucose levels are elevated, but are not high enough to be considered diabetic. People who are diagnosed as having prediabetes should be tested for type 2 diabetes every one to two years by their primary care physician.

The key to living healthy and preventing complications from diabetes is good medical care and regular self-care by the patient.  This includes monitoring blood sugar levels, eating healthy, regular exercise and finding a dedicated team of diabetes experts, like those at UT Health Diabetes.

Many people with type 2 diabetes are able to effectively manage their condition without medicine through daily exercise, eating meals low in carbohydrates and close communication with their diabetes team. 

Pills to help with insulin resistance, pills to increase insulin production and insulin therapy are often prescribed to treat type 2 diabetes, in addition to healthy eating and exercise.

Often, there are no noticeable symptoms of type 2 diabetes, or they tend to appear slowly over time. However, there are risk factors that can lead to diabetes. These include: being overweight, having a personal or family history of diabetes or gestational diabetes, being older than 45 and being physically inactive.

Specific blood tests will help your primary care physician to accurately diagnose type 2 diabetes.

Type 2 diabetes symptoms:

• Urinate a lot, often at night
• Are very thirsty
• Lose weight without trying
• Are very hungry
• Have blurry vision
• Have numb or tingling hands or feet
• Feel very tired
• Have very dry skin
• Have sores that heal slowly
• Have more infections than usual

UT Health Diabetes is committed to making life better for everyone living with diabetes. We provide exceptional, complete care for managing diabetes. The team at UT Health Diabetes is led by Dr. Ralph DeFronzo. Dr. DeFronzo is recognized worldwide for his research and discoveries leading to the development of effective treatment for individuals with diabetes. You can schedule your appointment with UT Health Diabetes today by calling 210-450-9050.

To learn more about UT Health San Antonio’s commitment to research and improving diabetes treatment, click here.

Ralph DeFronzo, MD, PhD, Endocrinologist, Nephrologist, Researcher

Dr. DeFronzo is directly responsible for many of the advances achieved in diabetes over the last 50 years. He was a leader in developing the concept of insulin resistance, the defining characteristic of Type 2 diabetes, resulting in novel ideas about the development and progression of diabetes. He led the U.S. development of metformin, the first-line medication for treatment of diabetes, and ushered it through FDA approval in 1995.

More recently, he discovered a new approach to diabetes treatment that targets glucose reabsorption in the kidneys. This work led to the development and approval of other widely used drugs, including dapagliflozin, empagliflozin and canagliflozin. DeFronzo is the author of more than 800 publications dating back to 1967. His more recent work has led to potential cures for diabetes by producing new cells in the pancreas. Dr. DeFronzo has achieved national/international recognition as a distinguished researcher, teacher, and clinician. He currently serves as professor of medicine and chief of diabetes in the Long School of Medicine at UT Health San Antonio, where he has been on faculty since 1988.

Lisa Gorn, DO, Endocrinologist

Dr. Gorn is a board-certified endocrinologist specializing in diabetes. She attended Nova Southeastern University medical school and a residency at Mount Sinai Medical Center and then completed an endocrinology fellowship at the University of Miami Jackson Memorial Hospital.

Anna Velasco-Neaves, MSN, APRN, FNP-BC

Anna is a nurse practioner and has more than 25 years experience in healthcare. She is a veteran of the US Air Force, and has nursing degrees from the University of the Incarnate Word as well as UT Health San Antonio School of Nursing.

Barbara Walz, RN, BSN, CDE
Barbara is a registered nurse and has been a certified diabetes educator since 1986. She has worked extensively in diabetes care and education for the past 30 years. She has worked with Dr. DeFronzo on diabetes research and clinical programs for more than 15 years and is actively involved with the American Association of Diabetes Educators (AADE), as well as the Texas Diabetes Council where she is on several sub-committees.

Stephanie R. De Leon, MS, RD, CSSD, LD, CDE

Ms. De Leon is a Registered and Licensed Dietitian, Certified Diabetes Educator and Board Certified Specialist in Sports Dietetics. Stephanie holds a Master of Science degree in Nutrition from the University of the Incarnate Word in San Antonio, Texas. Stephanie draws from the health coaching philosophy of encouraging individuals to set and achieve their health goals.

You can schedule your appointment with UT Health Diabetes today. Call 210-450-9050 or visit their web page.

Top Tips for Foot Care
The most important thing you can do for your feet is to take care of your diabetes. Other tips include:

• Checking your feet every day for red spots, cuts, swelling and blisters. You can use a mirror or ask someone for help you see the bottom of your feet.
• Be more active.
• Wash your feet every day.
  
  If you have diabetes or any concerns about your feet, call UT Health Podiatry. We treat a wide variety of conditions, including the diabetic foot. Call 210-450-6800 for an appointment.

Learn more about diabetic foot care from the online UT Health library.

Our new office is conveniently located between Boerne and San Antonio and has the care you've been waiting for, including:

Having a primary care provider is essential to your health and well-being. All of our board-certified primary care providers are trained to prevent and treat a wide variety of medical conditions for patients of all ages, from newborns to older adults. Our providers collaborate with our network of more than 700 physician specialists to make sure you have the most comprehensive and seamless care possible.

Call today for same day appointment availability at UT Health Hill Country: 210-450-6800.

Diabetes is a chronic disease that allows glucose (sugar) levels in your blood to rise higher than normal. This is also known as “hyperglycemia.” Constantly having high glucose levels can lead to increased risk of heart attack, stroke, blindness, kidney failure, and lower limb amputation. According to the World Health Organization, “the number of adults living with diabetes has almost quadrupled since 1980 to 422 million adults. In 2012 alone diabetes caused 1.5 million deaths.”

Type 2 diabetes occurs when your body does not use make and/or use insulin properly. Insulin is important to the body, because it helps the body process glucose. Without insulin, your body’s glucose levels rise to dangerous levels. Risk factors for development of type 2 diabetes include:

• A history of high blood sugars, prediabetes, and/or gestational diabetes,
• Overweight and obesity,
• Physical inactivity,
• Family history,
• Race and ethnicity, and
• Age

Some people with type 2 diabetes can control their blood sugars with healthy eating and increasing their activity level. However, your health care provider may need to prescribe medication to help meet your target glucose levels. Of note, type 2 diabetes can get worse over time. Some people who may not need medications at first need medication later on.

It is important to follow-up with your health care provider for management of diabetes. Once established, your health care provider will:

• Review of your glucose readings (bring your glucometer or a written blood sugar record to your all of your appointments),
• Check your blood “Hemoglobin A1C” test, which is a measure of your average glucose for the past 3 months,
• Review and adjust your medications, if needed,
• Check your feet for loss of sensation,
• Check your urine for protein, which can be a sign of kidney damage from diabetes,
• Schedule you for a yearly dilated eye exam,
• Monitor your blood pressure,
• Check your cholesterol, and
• Make sure your vaccinations are up to date.

The main goals of diabetes treatment are to make sure you feel well in your day-to-day activities and to prevent or delay long-term complications. Taking your prescribed medications correctly, meal planning, and physical activity are the best ways to reach these goals. Most importantly, diabetes management is a team effort. Communication with your physician and your health care team is critical. Your care team can help you take control the disease and continue to enjoy life.

If you have diabetes or simply want to see a primary care provider at our new Hill Country location, call 210-450-6800.