Dr. Gates is Talking About…Type 1 and Type 2 Diabetes

November 16, 2023

The following piece was written by Wood River Health's Chief Medical Officer Dr. Jonathan Gates and published in the Westerly Sun in November 2023.

Dr. Gates is Talking

November is Diabetes Month. It serves as a reminder to raise awareness about preventing a disease that 12% of Americans live with, according to the CDC. As most people know, there are two types of diabetes. People with Type 1 need insulin because their bodies stop producing it, causing their blood sugar to rise uncontrollably. Type 2, the more widespread variety, occurs when a body becomes resistant to the insulin the pancreas releases. Providers often spot Type 2 taking shape before it is obvious, so remember to get your annual physical so they can monitor your risk. The first signs include abnormal cholesterol levels and a touch of obesity—maybe 20-30 pounds beyond your ideal weight.

With Type 2, the interplay of Nature vs. Nurture comes into play. Our family tree plays the Nature role, with about 10 genes in the mix. Meanwhile, obesity, exercise, and diet play the Nurture role. If you are pre-diabetic, there are ways to decrease your risk of developing diabetes. First, check with your provider about increasing your exercise program. Consider a diet journal app on your phone for help with budgeting your calories. Sometimes focusing on your diet and exercise alone is enough to eliminate the need for adding insulin or insulin-friendly drugs such as metformin.

If changes to your diet don’t help you lose weight, you can explore weight-loss drugs, which work exceptionally well for blood sugar control in patients with Type 2 diabetes. GLP-1 medications promote weight loss, cause no hypoglycemia by themselves, and directly reduce one’s appetite. If you’ve developed Type 2 and have a BMI of 35, you can also consider discussing weight-loss surgery with your primary care provider. Just remember: a good program involves a pre- and post-talk with a nutritionist and a counselor to aid in a smooth transition. Reach out to your primary care provider to start the conversation.