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A prevalence of prediabetes

Medical: New treatments and lifestyle changes help manage pre- and Type 2 diabetes

Posted: November 4, 2011 1:55 a.m.
Updated: November 4, 2011 1:55 a.m.

George Charnock, M.D., endocrinologist and staff physician at Henry Mayo Newhall Memorial Hospital, illustrates how to use Victoza, a medication for Type 2 diabetes, to patient Bala Balakumar at his Valencia office.

It started with excessive thirst, followed by a sudden drop in energy and weight. Bala Balakumar, of Canyon Country, knew the signs all too well, coming from a family with diabetes.

“I was young, in my 30s, so I was just surprised it happened so early,” he said.

Balakumar’s diagnosis, which he received in 1994 and still receives treatment for, was Type 2 diabetes, the most common form of diabetes. Over the last few decades, diabetes has become widespread in the United States.

According to the American Diabetes Association, more than 25.8 million children and adults suffer from diabetes (Type 1 or Type 2), and an estimated 79 million adults aged 20 years and over have prediabetes.

There’s a simple reason for that, according to Dr. George Charnock, a board-certified endocrinologist and staff physician at Henry Mayo Newhall Memorial Hospital in Valencia.

“If you look around, there are more overweight people than ever before. People are getting less physical activity and eating the wrong kinds of food,” Charnock said. “We have a big problem with kids now, too. Unhealthy lifestyle choices can result in excessive weight gains, even for children. While it’s not good to be overweight when you’re young, having diabetes when you’re older is a real disaster.”

In Type 2 diabetes, there is an aggressive decline in the ability of the pancreas to produce enough insulin, and this can lead to a host of other health problems, including stroke, kidney disease, heart disease, amputation and blindness.

The good news is that there are steps that can be taken to prevent or delay the development of Type 2 diabetes. For example, early diagnosis and treatment of prediabetes may prevent Type 2 diabetes as well as the associated complications.

Prediabetes is the state that occurs when a person’s blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. Studies have shown that many people with prediabetes develop Type 2 diabetes within 10 years and have an increased risk of stroke and heart disease.

“It can be difficult to know if you have prediabetes, because there are usually no symptoms,” said Dr. Michael Garcia, a board-certified endocrinologist and staff physician at Henry Mayo. “However, if you fall into the risk category of Type 2 diabetes, you should be tested by a physician because there are things you can do to prevent full-blown diabetes.”

If someone suspects they may be diabetic, Garcia recommended immediately speaking with his or her primary care physician about having a fasting blood sugar check. A diagnosis of prediabetes is a warning symbol to make significant changes to one’s lifestyle.

“Studies show that the prediabetes patient population who participated in 30 minutes of physical activity, five days a week, and who also reduced their weight by 5-10 percent, were able to prevent or delay the development of Type 2 diabetes by up to 58 percent,” Garcia said. “Something as simple as a 30 minute walk every day can help to lower elevated blood glucose levels.”

A healthy diet is also key, Charnock said.

“People don’t understand the consequences of fast food and high-calorie, high-fructose drinks. It’s important to limit these items and to eat a balanced diet of produce, whole grains and lean meats,” Charnock said. “It’s hard work to monitor your diet and stay in shape, but the effort taken today will reduce complications down the road.”

Even with his diagnosis, Balakumar, an information technology manager, struggled at first. A self-professed dessert-lover, he had a hard time staying away from cookies and cakes, and because he’s of Asian descent, rice, a carbohydrate, was a staple of his daily diet. Things got so bad four years ago, he started having to use insulin.

Today, Balakumar has been helped by a new type of medication for Type 2 diabetes called Victoza.

“It’s a once-a-day shot, a GLP1 analog that’s 97 percent similar to human physiology. It controls blood sugars without causing hypoglycemia,” Charnock said. “It’s almost like a miracle drug. We’ve had a paradigm shift from working on insulin resistance to preserving beta cell function. It’s fixing physiology.”

For Balakumar, Victoza has been a blessing. Coupled with increased physical activity and a lowered consumption of sugars and carbohydrates, Balakumar is feeling better than ever. “For the first time since I was diagnosed, my sugar-level readings are in the range they’re supposed to be,” he said. “It’s brought me a lot of hope.”

Symptoms of diabetes can include increased thirst, excessive urination, fatigue and small skin tags or hyper-pigmented skin in the neck area. Individuals experiencing symptoms of diabetes, or who have a family history of diabetes, should schedule regular health checkups with their physician.


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