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Reversing Course on Diabetes Progression

L. Priyanka Mahali, MD and Amber Rossi
L. Priyanka Mahali, MD, an endocrinologist with Northeast Medical Group, counsels patient Amber Rossi about prediabetes and steps for reversing its progression to diabetes.

Perhaps you have been told you need to lose weight, get more exercise, and eat a healthy diet low in carbohydrates and devoid of processed foods. For a lot of people, lifestyle changes like that can be hard to make. But if you’re at risk for developing diabetes – on the cusp of a diabetes diagnosis – would you make these changes if you could stop the progression of disease?

“Early intervention is key,” said L. Priyanka Mahali, MD, an endocrinologist with Northeast Medical Group who specializes in the treatment of type 2 diabetes as well as other endocrine and metabolic conditions. “If we capture prediabetes early, there is a lot of data from the National Diabetes Prevention Program that says lifestyle interventions can prevent progression from prediabetes to diabetes.

“Lifestyle interventions include weight loss, reducing consumption of carbohydrates and eliminating processed foods, like sodas and juices, exercising 150 minutes per week, and smoking cessation,” Dr. Mahali said.

Diabetes on the rise

In the United States, type 2 diabetes is on the rise. According to the American Diabetes Association, 37.3 million adults in the United States in 2019 had type 2 diabetes, the most common form of diabetes. An additional 96 million had prediabetes, prior to the development of type 2 diabetes, where their blood glucose levels were higher than normal, but no other symptoms of diabetes were seen.

Having type 2 diabetes means there is too much sugar (glucose) in your bloodstream. Insulin resistance occurs in type 2 diabetes, which means the body is unable to effectively use the insulin produced by the pancreas, and there is dysregulation of glucose metabolism. At its worst, complications of uncontrolled diabetes include heart attack or stroke, kidney disease, vision loss, nerve damage, skin complications, wounds that do not heal and limb loss.

“A lot of people will have prediabetes for a long time before they are diagnosed with type 2 diabetes,” Dr. Mahali said. “This is because most of them don’t have any symptoms.”

Who’s at risk?

“It used to be that older people developed diabetes, but now with the rise in obesity, we’re seeing a lot of teenagers and young adults in their 20s and 30s getting diagnosed as well,” Dr. Mahali said. “Diabetes can run in families, so some of it is genetic and some of it is due to environmental factors, like a sedentary lifestyle and a diet that is high in carbohydrates and processed foods.”

Asian Americans, Native Americans, Hispanics and African Americans or non-Hispanic Blacks are at increased risk for type 2 diabetes, she said.

Because prediabetes is often asymptomatic, see your doctor if you think you are at risk or have symptoms, such as frequent urination, increased thirst and hunger, unexplained weight loss, fatigue and blurred vision.

Treatment for diabetes

If you are diagnosed with type 2 diabetes, it is important to take the steps necessary to manage it effectively.

Dr. Mahali explained that medications are now available that will not only help with diabetes, but with weight loss, heart issues and kidney disease. “Treatment can be tailored to other medical conditions you may have, so that’s why it’s important to seek medical evaluation early and get started on a treatment regimen that is tailored to you,” she said.

Bridgeport Hospital offers Medical Nutrition Therapy services on an outpatient basis for patients with diabetes who have a referral. To learn more, please call 203-384-4553.