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Sadia Ali, M.D. Answers Questions On Managing Diabetes

Sadia Ali, M.D. Answers Questions On: Managing Diabetes

What do people need to know about managing diabetes?

The bodies of people with Type 1 diabetes don’t produce insulin at all. Because insulin is a hormone we all need to survive, these patients will always require intensive insulin therapy, strict blood-sugar control, and a modified diet to stay healthy.

People with Type 2 diabetes produce insulin, but their bodies don’t use it correctly. Many cases can be managed with proper diet, but some patients do require insulin.

When left untreated or poorly managed, both types of diabetes can cause serious whole-body complications over time, both macrovascular and microvascular. These complications include cardiovascular disease (heart and blood vessels), diabetic retinopathy (eyes), nephropathy (kidneys), and neuropathy (nervous system).

Is there anything new in the management of diabetes?

Technological advances continue to make it easier to manage diabetes – primarily Type 1 but also in some cases of Type 2, particularly in patients with hypoglycemia.

For example, insulin pumps deliver insulin 24 hours a day, eliminating the need, in some patients, for insulin shots. Continuous glucose monitors (CGMs) alert patients when their glucose levels drop or get too high. These exciting technologies are great for patients, and we use them a lot.

In addition, a “virtual pancreas” should be available within the next several years, which is very exciting. This single device combines insulin and the drug glucotrol in a continuous pump and also includes a continual glucose monitor (CGM). Many patients currently must wear two separate pump and CGM devices, but the virtual pancreas combines those devices and adds glucotrol.

The developer has conducted clinical trials, and the results are very promising. The virtual pancreas will help us better manage diabetes, and it will be much more convenient for patients.

What does Parkland Hospital’s inpatient glycemic management team do?

We’re a team of physicians and nurse practitioners who help hospital patients – both with and without diabetes – manage their glucose levels. We promote recovery by working to prevent high blood-sugar levels and minimize low blood-sugar levels, which can be dangerous to some people.

We also work to transition the patients who need it to outpatient care so that we can follow up with them in the clinic. That continuity of care really helps to improve patients’ glycemic control.