Diabetes

Individuals with diabetes have an elevated blood glucose (sugar) level. Diabetes develops when the body does not produce enough insulin or when cells don’t respond properly to the insulin that is present. If blood sugar remains elevated for a long time, diabetes can lead to damage to the heart, blood vessels, eyes, kidneys and nerves.

The two most common forms of diabetes are type 2 diabetes and type 1 diabetes.

Type 2 Diabetes

Type 2 diabetes usually develops in people over the age of 40, although it is becoming increasingly common in younger adults and adolescents as well. About 90 to 95 percent of adults with diabetes have type 2 diabetes.

In people with type 2 diabetes, the pancreas may produce some insulin, but the body does not respond to the insulin effectively. This condition is known as insulin resistance.

Obesity frequently contributes to insulin resistance.

The first step in treating diabetes is an appropriate diet and exercise program. At The GW Medical Faculty Associates, patients with diabetes meet with trained diabetes educators and dieticians to fashion individual plans that enable patients to maintain an appropriate weight, eat a healthy diet and exercise regularly.

If diet and exercise fail to keep the blood glucose in or near the normal range, oral medications may be prescribed. Some patients do not respond to oral medications and may require insulin or another injected medication.

Type 1 Diabetes

Type 1 diabetes develops most often in children and young adults. In patients with type 1 diabetes, the immune system mistakenly attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. People with type 1 diabetes always require insulin.

Diabetes Treatment

Managing diabetes can be overwhelming. At The GW Medical Faculty Associates, our multi-disciplinary clinical and educational services team helps make life easier—and safer—for our patients with diabetes.

In addition to ongoing evaluation and medical care, counseling and support are part of the treatment plan for all of our diabetes patients. We provide diabetes education, diabetic foot care and nutritional counseling.

Our certified diabetes educator develops individually tailored diet and exercise plans, and teaches our patients the skills they need to confidently manage their diabetes.

Insulin therapy

Insulin cannot be taken orally; it must be injected. Many patients are anxious when told that they must start taking insulin. Modern, small needles and self-contained “pen” devices make administering insulin easier than patients expect.

Patients on intensive insulin programs—taking multiple injections of insulin and frequently adjusting their insulin doses—may benefit from some of the new technologies that are now available. Insulin pump therapy, continuous glucose monitoring and computer display systems allow patients to carefully monitor and manage their blood glucose levels. Our staff can help patients master the newest technologies available for diabetes care.

Diabetes and pregnancy

Pregnancy poses special challenges for women with diabetes. A healthy pregnancy requires vigilant blood sugar control from conception onward.

Ideally, women with diabetes who are planning to become pregnant should schedule a thorough evaluation by an endocrinologist before conception. Careful planning and treatment adjustments can reduce or avoid many of the risks that diabetes can pose to mother and baby.

At The GW Medical Faculty Associates, the endocrinologist, diabetes educator and dietician work with obstetricians to provide support to women with diabetes who are pregnant. Frequent monitoring contributes to a healthy pregnancy and a healthy baby.

Gestational diabetes

Sometimes diabetes develops during pregnancy. If untreated, gestational diabetes may lead to problems for the mother and the baby. Complications include high blood pressure for the mother and abnormally large size for the baby: both can lead to risks during delivery. If blood sugar is not well controlled, the baby can be born prematurely. Because women with gestational diabetes generally have no symptoms, most obstetricians screen women for diabetes during pregnancy.

Gestational diabetes can usually be managed with diet and exercise. If diet and exercise modifications are insufficient, then medication, including insulin, may be required.

Gestational diabetes generally resolves at delivery. However, it is a warning sign that the woman is at increased risk to develop type 2 diabetes later in life. Post-delivery, our endocrinologists continue to see patients who have had gestational diabetes, in part to develop and encourage a sensible diet and exercise plan that will keep them healthy.