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  Chat Transcript
Pre-diabetes with Dr. Bingham - October 26, 2011

ayw 16:13:46:
What are the warning signs of pre-diabetes?
K77DF 16:16:34:
Should I worry about getting pre-diabetes if I had gestational diabetes?
ayw 16:31:05:
Who are susceptible to pre-diabetes?
LoveROC 16:37:33:
Diabetes runs on my Mother's side. I'm in my late 20s and healthy. What's the chance I'm going to have diabetes?
LoveROC 16:40:21:
Will be back later.
TSteel 16:44:50:
looks interesting...want to say hi...see you later
missy75 16:50:07:
Are you part of a drug trial? Can I get free meds?
dhooper 16:57:14:
Can smoking lead to diabetes?
missy75 16:59:45:
I heard this is a kind of insulin you can just breathe in. Does it work well?
Dr. Bingham @ Unity 17:01:56:
Welcome to the Unity Diabetes Online Community! I’m Dr. Bingham, an endocrinologist at the Unity Diabetes Center. I’m so glad you could join us for our first online chat today about pre-diabetes. I see many patients that have questions about how to diagnose and manage pre-diabetes. I hope that I can help answer some of yours today.

RULES
Before we get started let me just tell you how we’ll address your questions and comments today. I answer questions one at a time, in the order that they are posted to the site. We’ll do our best to answer all of your questions within the hour.

Let’s get started!
missy75 17:02:27:
Thank you, Doc.
Dr. Bingham @ Unity 17:03:30:
In reference to the question about drug trials – we currently do not have any research trials at this time.
lwaecker 17:03:40:
What are the symptoms of pre- and Type 2 Diabetes?
Dr. Bingham @ Unity 17:04:43:
In reference to the question of whether smoking causes diabetes – the answer is not to my knowledge but smoking markedly increases the risk of complications from pre-diabetes or diabetes.
missy75 17:04:50:
Okay.
Dr. Bingham @ Unity 17:06:25:
Pre-diabetes doesn't have any symptoms. Type 2 diabetes with mildly elevated blood sugars can also be without symptoms. If a person has Type 2 Diabetes and markedly elevated blood sugars they can have frequent urination, increased thirst, weight loss and blurry vision.
TSteel 17:07:52:
Want to find out if I'm going to have diabetes if my Mom and maternal grandparents all have diabetes…
Dr. Bingham @ Unity 17:08:39:
There was an earlier question regarding the risk of developing diabetes if a parent has diabetes. Diabetes does tend to run in families, and a family history increases the risk – I can't give a specific percentage. The best way to minimize the risk of developing diabetes is regular exercise and maintaining a normal body weight.
TSteel 17:09:09:
That's me. I'm in my late 20s and healthy.
TSteel 17:10:03:
Good to hear.
KMcCarthy 17:12:41:
Can following a vegetarian/vegan diet truly make a difference in pre-diabetes?
Dr. Bingham @ Unity 17:13:01:
Sorry – got bumped offline. Earlier there was a question about gestational diabetes and risk of pre-diabetes.
ayw 17:13:14:
If there is little symptom of pre-diabetes, does that mean there isn't much we can do to monitor it?
Dr. Bingham @ Unity 17:14:05:
Gestational diabetes markedly increases the risk of developing Type 2 diabetes – in fact 40% of women with gestational diabetes will develop Type 2 diabetes within 10 years of delivery.
Dr. Bingham @ Unity 17:14:49:
Some research has shown that following a vegan/low fat diet decreases the risk of developing chronic diseases including diabetes.
Dr. Bingham @ Unity 17:15:50:
As there are no symptoms of pre-diabetes – it is true that a patient can't monitor for pre-diabetes, but their doctor can check simple blood tests to determine if you have pre-diabetes or diabetes.
Dr. Bingham @ Unity 17:17:21:
A bit more on the question about gestational diabetes – in a large study…
TSteel 17:17:50:
Do you recommend regular blood tests for checking diabetes? If so, how frequently should I do it if I want to prevent diabetes?
Dr. Bingham @ Unity 17:18:15:
they looked at women with gestational diabetes and what (if any) factors could predict whether they would or would not develop diabetes.
Dr. Bingham @ Unity 17:19:09:
The only factor in this study that was significant was that if the mother got back to her pre-pregnancy weight within one year after delivery, her risk of developing Type 2 diabetes was significantly lower.
Dr. Bingham @ Unity 17:19:57:
I think it is very reasonable for people who have risk factors for diabetes to be screened for diabetes/pre-diabetes every 1-3 years.
Dr. Bingham @ Unity 17:21:10:
Risk factors would include being overweight, having a family history of diabetes, prior history of gestational diabetes, history of polycystic ovarian syndrome, high blood pressure or high cholesterol.
K77DF 17:21:31:
What kinds of tests should I be asking my doctor about to screen for pre-diabetes?
ayw 17:21:53:
Can exercise reduce these risk factors?
lwaecker 17:22:01:
Does eating a diet high in fat contribute to pre-diabetes and insulin resistance?
Dr. Bingham @ Unity 17:23:45:
There are three tests that can be used to screen for pre-diabetes. They include a hemoglobin A1C (a test that tells us what your average blood sugar has been over the last 3 months).
Dr. Bingham @ Unity 17:25:02:
A fasting blood sugar (after not eating for 8-12 hours) is also a good screening test – if it is between 101-126 it indicates pre-diabetes, if it is over 126 it is likely to indicate diabetes.
Dr. Bingham @ Unity 17:26:20:
Finally your doctor can order a glucose tolerance test where they check a fasting blood sugar, they give you a defined amount of sugar in a very sweet juice, and then check the blood sugar two hours later.
Dr. Bingham @ Unity 17:26:47:
If the two hour blood sugar is between 141-199 it indicates pre-diabetes, if it is over 200 it indicates diabetes.
JmBruckel 17:28:10:
My name is josh, I am a type one diabetic. I have a service dog named Rigel that is a diabetic alert dog. He can detect my high and low blood sugar. If there are any questions I'd be happy to answer.
Dr. Bingham @ Unity 17:28:13:
Yes – exercise is THE BEST way to prevent diabetes. In a study of patients with pre-diabetes, walking 30 minutes a day 5 days a week will decrease the risk of developing diabetes by over 60%.
LoveROC 17:29:16:
What's the risk of pre-diabetes in overweight kids? My daughter is 8 and she is slightly overweight...
Dr. Bingham @ Unity 17:30:04:
In reference to the question of whether a high fat diet can cause pre-diabetes – not directly – but a high fat diet can lead to obesity which then causes insulin resistance and pre-diabetes.
K77DF 17:31:11:
For Josh – how does your dog KNOW if your blood sugar is low or high?
TSteel 17:31:29:
Smart dog :-)
Dr. Bingham @ Unity 17:31:37:
Often a modest amount of weight loss (5-10 lbs) can significantly decrease the risk of pre-diabetes.
Dr. Bingham @ Unity 17:33:08:
I can't answer the question specifically about the risk of pre-diabetes in children, as I only care for adults. However, I know that my colleagues in pediatric endocrinology are seeing many teenagers who are markedly overweight who have already developed Type 2 diabetes.
LoveROC 17:35:31:
No problem. Thanks anyway!
Dr. Bingham @ Unity 17:36:20:
These have been some really great questions so far – any other questions?
ayw 17:37:14:
Is pre-diabetes reversible?
TSteel 17:38:53:
Will Unity arrange a service dog for a diabetes patient?
Dr. Bingham @ Unity 17:40:12:
Yes – pre-diabetes is reversible – I had pre-diabetes – I started to exercise regularly, and in 6 months my fasting sugar dropped from 107 to 67. The key is really exercise – because in large studies the amount of weight loss was not that much – about 5 pounds.
ayw 17:41:19:
What kind of exercise is the most effective, aerobics, running, swimming, etc.?
Dr. Bingham @ Unity 17:41:37:
Unity does not arrange for guide dogs – maybe Josh you could give us some information. If not – I would contact the local American Diabetes Association office.
Dr. Bingham @ Unity 17:42:35:
Any type of aerobic exercise is the best – 30 minutes a day at least 5 days of the week. It does need to be a continuous 30 minutes (not walking up a flight of stairs once an hour for 8 hours).
missy75 17:45:05:
What kind of insurance do you accept?
Dr. Bingham @ Unity 17:45:43:
One interesting fact concerning pre-diabetes is that pre-diabetes is a risk for heart disease, while pre-diabetes usually does not put you at risk for other complications of diabetes.
Dr. Bingham @ Unity 17:48:29:
Most insurances are accepted, you may need to check with your provider to see if pre-authorization or a referral is needed – particularly for our education services. If anyone wants to schedule an appointment – please call (585) 368-4560.
TSteel 17:48:50:
Does Unity offer any group exercise programs?
Dr. Bingham @ Unity 17:49:54:
We do offer exercise programs through Unity Cardiopulmonary Rehab – conveniently located next door to the Unity Diabetes Center.
Dr. Bingham @ Unity 17:50:46:
The cardiopulmonary rehab center participates in the silver sneakers program and offers a preventative exercise program (PEP) – that phone number is 368-4374.
TSteel 17:53:03:
Thank you very much, Dr. Bingham. Have a good evening! Bye...
Dr. Bingham @ Unity 17:54:09:
We have about 5 minutes left – any other questions tonight?
Dr. Bingham @ Unity 17:57:21:
A couple of facts about pre-diabetes – there are 18 million people with diabetes who know they have diabetes, about 7 million who have diabetes and don't know it yet, but 57 million people with pre-diabetes. The number of people with diabetes has increased 97% over the last 10 years.
Dr. Bingham @ Unity 17:58:51:
That’s all the time we have for today. I’ve really enjoyed our conversation and hope that I was able to provide some insight for you about pre-diabetes. If we didn’t get to your question today or you think of another question later on – feel free to jump into the conversation in the forum, or submit a question using our “Ask an expert” feature. This online community is a great resource, so I invite you to stay awhile, and look at all of the different kinds of information on the site.
 
 
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