– Hi, I’m Susan Taylor with Scripps Health in San Diego, California. According to the Centers for Disease Control and Prevention, more than 34 million people in the United States have diabetes. And people dealing with diabetes are particularly vulnerable to complications should they come down with COVID.

Joining us to talk about this is Dr. Matthew Levine, an endocrinologist at Scripps Clinic in La Jolla, California. Dr. Levine thanks for being with us. – Thank you for having me, Susan. – Let’s start with the basics.

What is diabetes and what’s type 1 and type 2 diabetes? – Great questions, so diabetes is a state of high blood sugar usually the result of the body just not being able to produce as much insulin anymore.

Sometimes in the setting of resistance that we have to our own insulin. Type one diabetes is an absolute deficiency of insulin, so patients need insulin to live is used to be called Juvenile Diabetes.

Type 2 diabetes is more common 90% of all diabetes and this used to be called adult-onset and is a the result of a mixture of lack of insulin production plus a resistance that the body has to insulin.

– So who’s at risk for getting diabetes? – So usually the risk factors are people who are older in age but even more importantly those who are overweight or obese, those who have a sedentary lifestyle.

There is a large genetic component to this as well, people who have an unhealthy diet, particularly for adult-onset which as I mentioned or Type 2 which is the most common type of diabetes. – And what are the symptoms of diabetes because a lot of the symptoms I understand are silent, you really don’t know what’s going on? – That’s correct, for most people Susan there are no symptoms of diabetes and that’s what makes checking and monitoring for this condition so important.

The symptoms that people might hear about urinating all the time, thirst, fatigue unintentional weight loss, typically only occur when blood sugars are floridly elevated but that’s the minority of situations.

– So how can you prevent diabetes? – So the main way to prevent diabetes is to make sure you’re getting regular checkups and make sure you’re getting proper blood work to screen. But if you know you’re at risk because of your genetics you need to make sure that you’re eating right, staying healthy, keeping your weight managed and under control, losing weight if you are overweight or obese, regular exercise.

– So you talk about the genetic component If a parent has diabetes what’s your risk of getting it? – It could be as high as 50% or more in many cases. – Are you seeing a higher incidence of worsening diabetes and related conditions because of the pandemic, because folks are they’re staying home they may be eating more, exercising less? – That’s a great question Susan and the answer unfortunately is yes, in many cases.

For many of the reasons that you mentioned, patients have taken to comfort eating, to cope with the pandemic, to cope with unfortunately social isolation in many cases. So that increased calories is driving up people’s weight, their outlets for exercise are not as accessible, gyms that they might use for example are not available or are closed.

Some people are not able to afford their medications or their insulin that they might need for diabetes, which is a problem even prior to COVID. But particularly so now when people’s incomes are short all of this has served to raise blood sugars and worse than a patient’s diabetes in many cases.

– So what happens if you have diabetes and you come down with COVID? – So anytime there’s an infection when somebody has diabetes the immune system is weakened, but in the higher risk conditions for a more complicated case of COVID such as diabetes, unfortunately many such patients can have worse than symptoms worsened respiratory complications and increased risk for hospitalization and increased risk for intubations and unfortunately an increased risk potentially of death.

– If you don’t get a handle on diabetes what can happen in the long-term? – So we know that if blood sugars are not well controlled regardless of the type of diabetes that can lead to damage in the eyes including blindness, damage to the kidneys including a need for dialysis, damage to the nerves including in the feet, including a need for possible foot amputation.

And we also know that having diabetes especially type 2 diabetes for a long period of time can lead to increased risk for heart disease, heart attack, stroke. In fact, that’s how many patients with type 2 diabetes pass away.

– To get control of your diabetes, when should you go see your doctor and what type of doctors should you see. You’re an endocrinologist. So explain what that is versus a primary care physician? – Absolutely.

the reality is there aren’t enough unfortunately endocrinologists to manage everybody with diabetes. So if somebody is at risk and knows they’re at risk for diabetes because of their family history, for example they really need to make sure that they’re seeing their primary care physicians.

Their primary care physician should be able to screen at least once a year during a general physical exam, with a test for blood sugar to make sure things aren’t going in the wrong direction. Endocrinologists such as myself, our hormone and metabolism specialists and management of diabetes is sort of our bread and butter.

And we certainly are available to treat patients with diabetes whose courses become more complicated or if management of diabetes becomes more complicated than a particular primary care physician is comfortable working with.

And of course, if there are any questions that arise on the part of a patient or a physicians. – And it’s safe to come and see your doctor? – Absolutely, we want patients to come to Scripps to get their care, to make sure that their diabetes is well controlled for the reasons that I mentioned.

Precautions are being taken from sanitation to mask wearing, to eyewear among the physicians. Patients who have COVID are seen separately from other patients who are coming in to manage their chronic conditions.

Video visits, telemedicine visits are an option as well for those who don’t want to come in to see their physician in person. So there are all kinds of ways to continue to come into clinics like Scripps, to get your care without having to shy away from your healthcare.

– Any final thoughts doctor? – I thank you for having me Susan, I just wanna emphasize how important it is especially now during the pandemic for patients who have diabetes to continue to come in to see their physicians, to get care and to get their blood sugars under as good of control as can safely be achieved to lessen their risk of complication, should they become infected.

The clinics again are open, We don’t want patients to neglect their chronic health care needs. – Dr. Levine thanks so much for taking the time to be with us, we appreciate it. – Thank you for having me.

– The Scripps is ranked by US News and World Report as among the best in the nation for diabetes care. If you’d like more information just click on the link or go to scripps.org forward slash videos.

Want more critical information about your health, please subscribe to our Scripps Health Youtube Channel and follow us on social media @scrippshealth. I’m Susan Taylor, thanks for joining us. (upbeat music) hi i’m susan taylor with scripps health in san diego california according to the centers for disease control and prevention more than 34 million people in the united states have diabetes and people dealing with diabetes are particularly vulnerable to complications should they come down with kovit joining us to talk about this is dr matthew levine he is an endocrinologist at scripps clinic in la jolla california dr levine thanks for being with us thank you for having me susan uh let’s start with the basics what is diabetes and what’s type 1 and type 2 diabetes great questions so diabetes is a state of high blood sugar usually the result of the body just not being able to produce as much insulin anymore sometimes in the setting of resistance that we have to our own insulin type 1 diabetes is an absolute deficiency of insulin so patients need insulin to live this used to be called juvenile diabetes type 2 diabetes is more common 90 of all diabetes and this used to be called adult onset and is uh the result of a mixture of lack of insulin production plus a resistance that the body has to insulin so who’s at risk for getting diabetes so usually the risk factors are people who are older in age but even more importantly those who are overweight or obese those who have a sedentary lifestyle uh there is a large genetic component to this as well people who have an unhealthy diet particularly for adult onset which as i mentioned uh or type 2 which is the most common type of diabetes and what are the symptoms of diabetes because a lot of the symptoms i understand are silent you really don’t know what’s going on that’s correct for most people susan there are no symptoms of diabetes and that’s what makes checking and monitoring for this condition so important the symptoms that people might hear about urinating all the time thirst fatigue unintentional weight loss typically only occur when blood sugars are florally elevated but that’s the minority of situations so how can you prevent diabetes so the main way to prevent diabetes is to make sure you’re getting regular checkups and make sure you’re getting proper blood work to screen but if you know you’re at risk because of your genetics you need to make sure that you’re eating right staying healthy keeping your weight managed and under control losing weight if you are overweight or obese regular exercise so you talk about the genetic component if a parent has diabetes what’s your risk of getting it uh it could be as high as 50 or more in many cases are you seeing a higher incidence of worsening diabetes and related conditions because of the pandemic because folks are they’re staying home they may be eating more exercising less that’s a great question susan and the answer unfortunately is yes in many cases for many of the reasons that you mentioned patients have taken to comfort eating to cope with the pandemic to cope with unfortunately social isolation in many cases so that increased calories is driving up people’s weight their outlets for exercise are not as accessible gyms that they might use for example are not available or are closed some people are not able to afford their medications or their insulin that they might need for diabetes which is a problem even prior to covid but particularly so now when people’s incomes are short all of this has served to raise blood sugars and worsen uh patients diabetes in many cases so what happens if you have diabetes and you come down with covid so any time there’s an infection when somebody has diabetes the immune system is weakened but in the higher risk conditions for a more complicated case of covid such as diabetes unfortunately many such patients can have worsened symptoms worsened respiratory complications and increased risk for hospitalization and increased risk for intubations and unfortunately an increased risk potentially of death if you don’t get a handle on diabetes what can happen in the long term so we know that if blood sugars are not well controlled regardless of the type of diabetes it can lead to damage in the eyes including blindness damage to the kidneys including a need for dialysis damage to the nerves including in the feet including a need for possible foot amputation and we also know that having diabetes especially type 2 diabetes for a long period of time can lead to increased risk for heart disease heart attack stroke in fact that’s how many patients with type 2 diabetes pass away to get control of your diabetes when should you go see your doctor and what type of doctor should you see you’re an endocrinologist so explain what that is versus a primary care physician absolutely the reality is there aren’t enough unfortunately endocrinologists to manage everybody with diabetes so if somebody is at risk and knows they’re at risk for diabetes because of their family history for example they really need to make sure that they’re seeing their primary care physicians their primary care physician should be able to screen at least once a year during a general physical exam with a test for blood sugar to make sure things aren’t going in the wrong direction endocrinologists such as myself are hormone and metabolism specialists and management of diabetes is sort of our bread and butter and we certainly are available to treat patients with diabetes whose courses become more complicated or if management of diabetes becomes more complicated than a particular primary care physician is comfortable working with and of course if there are any questions that arise on the part of a patient or a physician and it’s safe to come and see your doctor absolutely we want patients to come to scripps to get their care to make sure that their diabetes is well controlled for the reasons that i mentioned precautions are being taken from sanitation to mask wearing to eyewear among the physicians patients who have covered are seen separately from other patients who are coming in to manage their chronic conditions video visits telemedicine visits are an option as well for those who don’t want to come in to see their physician in person so there are all kinds of ways to continue to come into clinics like scripps to get your care without having to shy away from your health care any final thoughts doctor i thank you for having me susan i just want to emphasize how important it is especially now during the pandemic for patients who have diabetes to continue to come in to see their physicians to get care and to get their blood sugars under as good of control as can safely be achieved to lessen their risk of complication should they become infected the clinics again are open we don’t want patients to neglect their chronic health care needs dr levine thanks so much for taking the time to be with us we appreciate you for having me scripps is ranked by u.

s news and world report as among the best in the nation for diabetes care if you’d like more information just click on the link or go to scripps.org forward slash videos want more critical information about your health please subscribe to our scripps health youtube channel and follow us on social media at scripps health i’m susan taylor thanks for joining us

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