Fratellone Medical Associates

Diabetes

In recent years, both the media and scientific literature have given abundant attention to the role that obesity plays in predisposing an individual to diabetes and cardiovascular disease. The single most important thing you can do to reduce your risk for this disease is to keep your weight down. But with every passing year, more and more Americans carry around surplus pounds.

Diabetes treatment in NYCTwo Types of Diabetes
Treating diabetes At its most basic, diabetes is a condition in which the amount of glucose, or blood sugar, in the blood stream is higher than normal. There are two kinds of diabetes, known as Type 1 Diabetes and Type 2 Diabetes.

Type 1 diabetes (juvenile diabetes or insulin-dependent diabetes mellitus) usually starts in childhood. Only about 5-10 percent of people with diabetes have this kind. The beta cells in the pancreas are destroyed, making it unable to produce the hormone insulin, which carries the glucose to the cells where it is converted to energy. Individuals with Type 1 diabetes must take insulin for the rest of their lives and carefully watch their diet.

Type 2 diabetes is far more common. Unlike Type 1, it can be prevented and even treated with lifestyle changes, including dietary ones. (Although there can be a hereditary component making you more susceptible to Type 2 diabetes, keeping your weight under control, eating properly and staying fit can help you beat the odds.) In the early stages of Type 2 diabetes, individuals usually still make insulin but the cells have become resistant to the signal insulin transmits. As a result, blood sugar levels can become dangerously high. It is only after many years of the pancreas pumping out more and more insulin in an increasingly futile effort to lower blood sugar that the hormone becomes depleted and it is necessary to administer insulin. The earlier the diagnosis and intervention, the more likely that lifestyle changes can alone moderate blood sugar levels and stop the advance of the disease. (See The Importance of Diet.)

Diagnosis of Diabetes
Diabetes is insidious—it can lurk in your body long before it makes itself obvious, all the while doing tremendous damage, including heart disease, blindness, neuropathy and gangrene. The condition called pre-diabetes, formerly known as impaired glucose tolerance, may occur many years before a diagnosis of diabetes is made. For this reason, at Fratellone Medical Associates, we routinely check blood sugar levels in cardiac patients.

We use two tests to diagnose diabetes and pre-diabetes:

Fasting Blood Sugar: Your blood is drawn and tested after a fast of 8 to 12 hours.
Oral Glucose Tolerance: After a high carbohydrate meal or drink, your blood sugar is tested every hour during the 5-hour process.

Treatment of Diabetes

At Fratellone Medical Associates, patients diagnosed with diabetes are prescribed an individualized nutritional program (see An Individualized Diet), with a focus on a moderate intake of unrefined carbohydrates (vegetables, some fruits and whole grains) in combination with quality proteins and good fats. Foods with sugar and high fructose corn syrup and any other foods with a high glycemic index (GI) must be avoided. A personalized exercise program is also prescribed. Finally, an individualized supplement program designed to control blood sugar may include some or all of the following:

When these lifestyle changes are followed, most of our patients with diabetes or who are at risk for the disease have been able to get their blood sugar under control. Many Type 2 diabetics have been able to reduce or eliminate their intake of insulin. (See Glucose Stabilization.)