Tag Archives: Pasadena

Understanding Pre-Diabetes: A Chance to Change Your Future

Type 2 diabetes is a serious health problem in the U.S.  Previously referred to as “adult-onset” diabetes, this condition is being diagnosed more and more in children.  Unfortunately, the rise in diabetes relates directly to the rise in obesity rates.  Long-term complications associated with diabetes can include heart and blood vessel disease, kidney problems, and vision impairment or loss, among others.

The good news is that doctors are working closely with patients to diagnose early signs of the disease, when it is still considered “Pre-Diabetes.”

“We want patients to understand that there are risk factors for developing diabetes that are in our control, such as weight and physical activity.  If we can intervene before someone develops full-fledged diabetes, we’ve saved them a life-long struggle with a complicated disease,” says Dr. Loraine Dailey, of MPCP Pasadena.

What is Pre-Diabetes?

Diabetes is a disorder of the endocrine system in which blood sugar levels in the body consistently stay above a normal range.   There are two classifications of the disease: Type 1, which affects 5-10 % of people and is unpreventable, and Type 2, found in 90% of diabetics, and which can often be prevented or sometimes reversed.

Pre-diabetes is the condition where your blood glucose levels are higher than normal, but not high enough to be diagnosed as Type 2 diabetes.  There are often no symptoms and it’s expected that nearly 75 million people in the U.S. over age 20 have pre-diabetes.  While not all people who have this condition will develop full Type 2 diabetes, research shows that the majority will within 10 years.

 Are You at Risk?

As with many diseases, there are some risk factors for pre-diabetes that are beyond our control, but several that we can control or influence.

Uncontrollable risk factors include:  Age (most common after age 50), Race (higher rates among African Americans, Latinos and Native Americans), and Family history of Type 2 diabetes.  Some women can develop diabetes during pregnancy (gestational diabetes), which can lead to complications, but usually regresses after delivery.

Now on to the risk factors that we can control:  Primarily, being overweight or obese (especially around the abdomen- “belly fat”), Having high cholesterol, and an Inactive/Sedentary lifestyle.

“We know that obesity and being sedentary contribute greatly to a person’s risk of developing pre-diabetes,” says Monica Erceg, a CRNP at the MPCP Pasadena office.  “When patients change these risk factors, they can often prevent pre-diabetes.   And, notably, if they already have diabetes they can  reduce the levels of insulin they need to take– or even reverse some of the serious side-effects of the disease.”

How is Pre-diabetes Diagnosed?

If you are over age 45, you should have a fasting blood glucose test to determine your risk for pre-diabetes.  Your doctor will likely suggest this as part of a regular physical. He or she may choose to perform an oral glucose tolerance test (OGTT) or hemoglobin A1C (average blood sugar) test first.

However, you should be tested earlier if you are overweight (with a BMI -Body Mass Index-of 25 or over) and have any of the following risk factors/symptoms:

  • Close relatives with diabetes
  • Physically inactive
  • Belong to high-risk ethnic group
  • Have high triglycerides or low HDL (good cholesterol)
  • Have had abnormal blood sugar tests in the past
  • Have a history of heart disease
  • Have previously had gestational diabetes
  • Experience symptoms of increased thirst, frequent urination, blurred vision, extreme fatigue, or darkened skin areas, often around the neck, armpits, elbows or knees

The Good News:  Reducing Risk

Depending on the results of your blood glucose test and risk profile, you and your doctor can come up with a plan to intervene and either reduce your chances of developing pre-diabetes, or start treating it before it progresses.

“With the emphasis on preventing pre-diabetes, we’re often testing patients earlier since there are rarely clear symptoms in the majority of cases,” says Dr.  Dailey.  “This gives us the opportunity to identify lifestyle changes, or treatment options, that are proven to reduce the risk of this disease.”

Make sure to discuss pre-diabetes with your primary care provider.  It may give you the chance for a healthier future.

Loraine M. Dailey, M.D.

Monica Erceg, CRNP

Womens Guide to Guys’ Health

– Key tips for his 30s-70s

We first thought of this article as a “Men’s Guide to Good Health.” But, as primary care doctors we know that many of our male patients would never even see us for a check-up if it weren’t for their wives, mothers or girlfriends. “Men notoriously underestimate their level of disease risk or sickness,” says MPCP physician, Dr. Garth Ashbeck. “They tend to ignore scheduling regular health exams, perhaps because they’re not as used to seeing the doctor on a regular basis as are women. However, it is through those regular check-ups and screenings that we can catch health problems early, often when they’re most treatable,” he adds.

That’s why we’re directing these health tips to women, (but we hope you men will read on…..)

In his 30’s– Men at this age should see the doctor for a baseline check-up and then at least every other year until age 40. A baseline gives the doctor a picture of where your health is now, and some important information about blood pressure, weight, disease risk and family history. Some guys don’t know their family history, so try to find out if cardiovascular disease, cancer, diabetes or other disease runs in the family. While most screenings are done in a man’s 40s, some may need to be done early if he’s at high-risk. “Establishing a good relationship with a doctor early helps form a partnership in keeping the patient healthier throughout their life,” says Dr. Jonathan Forman of MPCP, “The focus can be on prevention versus treating disease after it’s already arisen.”

In his 40s– Men may start to feel their age more in their 40s, particularly if they’ve been ignoring their health up to now. “Often the 40s are the decade where men begin to see weight gain, high blood pressure or other problems creep up,” says Dr. Forman. The good news is that it’s a great time to turn your health around. Key screenings that should be done in men’s 40’s are for: high blood pressure, cholesterol levels, blood glucose for diabetes, PSA (prostate-specific antigen), and a skin cancer check. Dr. Ashbeck adds that staying active is crucial in this decade and beyond. “Many men have hectic work and family lives, but regular exercise is a key to staying heart healthy, keeping the weight off, and reducing stress,” he notes.

In his 50’s– The main screening to add at age 50 (for men & women) is for colorectal cancer. Men should also see an ophthalmologist for an eye exam to detect early signs for glaucoma or other vision issues. “This is a time to tell your man not to ignore any warning signs,” says Dr. Forman. “What might seem to be indigestion, can actually be early signs of a heart attack, or those frequent trips to the bathroom at night might indicate an enlarged prostate.” By now men should be getting a full yearly work-up that includes blood tests to check cholesterol and triglyceride levels. Some doctors may even suggest an echocardiogram or stress test if there are any cardiovascular disease symptoms.

In his 60s & Beyond– Research shows that people in their 60s and 70s are markedly happier than at other points in their lives. “If men have stayed on top of their health, these decades are usually very active and rewarding,” says Dr. Ashbeck. “Also, since it’s never too late to get healthier, proper diet, exercise and staying engaged socially are important habits to maintain.” Mixing in some strength training with regular aerobic exercise will help- remember senior does not mean sedentary. Men should also feel comfortable talking to their doctor about sexual function and health “below the belt.” Keeping on top of vision and hearing screenings is also important to staying active and social. Talk with your doctor about other important screenings, vitamin supplements, and recommended vaccinations, including an annual flu shot.

Jonathan Forman, M.D. Dr. Jonathan Forman, an MPCP partner who practices in our Glen Burnie office, is certified by the American Board of Family Medicine. He received his medical degree from Temple University School of Medicine and completed a residency program in Family Practice at University of Maryland Medical Center.
Garth Ashbeck, M.D.Dr. Garth Ashbeck is also an MPCP partner and he practices in the Pasadena office. Certified by the American Board of Family Medicine, he received his medical degree from Georgetown University School of Medicine and completed a residency in Family Practice at Memorial Medical Center.

Osteoarthritis

by Paul Chite, M.D.

Osteoarthritis (OA) is a chronic condition characterized by a gradual loss of cartilage from the joints. Common symptoms of OA include joint pain and stiffness, some loss of joint motion, and distorted joint shape. Osteoarthritis most often affects the hands, knees, hips, and spine. The joint pain associated with OA is aggravated with activity and relieved with rest. Morning stiffness is a common symptom of OA and usually resolves within 30 minutes of rising, although it may recur throughout the day during periods of inactivity. Advancing age is one of the strongest risk factors for OA. Women are two to three times more likely than men to develop OA. Obesity is strongly linked to the development of OA. Exercise and weight loss appears to lower this risk and may reduce joint pain in weight-bearing joints such as the hips and knees.

Physical therapy and exercise improve flexibility and facilitate strengthening of muscles surrounding the joints. Well-cushioned shoes and orthotic shoe inserts may reduce stress on spine and leg joints while braces can provide external joint stabilization. Applying heat and cold to arthritic joints can alleviate joint pain and stiffness. Heating pads should be set on a timer and used for no more than 20 minutes at a time. The heating pad can be reapplied after 20 minutes of no use.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) relieve pain and reduce inflammation. Glucocorticoid (steroid) injections can also suppress inflammation and relieve arthritis symptoms when injected into arthritic joints. Glucocorticoid injections may be recommended for people who have OA confined to a few joints, or who have pain uncontrolled with NSAIDs. Joint injections may also be recommended for people with OA who cannot take NSAIDs. Joint injections are limited to three to four injections per joint per year so as to not cause further joint degradation.

Surgery may be used to realign bones that have become misaligned to shift weight to healthier cartilage and relieve arthritis pain. It may also be used to permanently fuse two or more bones together at a severely damaged joint for which joint replacement surgery is not appropriate. Surgery is generally reserved for severe OA that significantly limits physical activities and does not respond to other treatments.
If you or a loved one suffers from OA, make an appointment with your healthcare provider to discuss options for the treatment of osteoarthritis and the effects of arthritis on daily living.

Paul Chite, M.D.Dr. Chite joined Maryland Primary Care Physicians, LLC in 2011 and is certified by the American Board of Family Medicine. He received his medical degree from American University of the Caribbean, Saint Maarten, N.A. in 2005 and completed his residency program in Family Medicine at Creighton University Medical Center in 2011.