Newswise — NYU Langone Medical Center endocrinologists can comment on all aspects of diagnosing and treating diabetes, including topics such as:
Diagnosing Type 1 and Type 2 Diabetes-Two Primary Tests and their Results Combine to make the Diagnosis of Diabetes: In diagnosing diabetes, physicians depend upon two main tests to measure the presence of blood sugar problems: the Fasting Blood Glucose Level test and the Oral Glucose Tolerance test. Dr. Michael Bergman can speak about what patients can expect with each test, talk about how accurate they are and discuss tools used to accurately diagnose diabetes.
The Fasting Blood Glucose Test is the gold standard for diagnosing diabetes is an elevated blood sugar level after an overnight fast of no eating after midnight. A value above 140 mg/dl on at least two occasions typically means a person has diabetes (normal people have fasting sugar levels that generally run between 70-110 mg/dL). The Oral Glucose Tolerance Test is one that can be performed in a doctor's office or a lab. The person being tested starts the test in a fasting state (having no food or drink except water for at least 10 hours but not greater than 16 hours). An initial blood sugar is drawn and then the person is given a "glucola" bottle with a high amount of sugar in it (75 grams of glucose or 100 grams for pregnant women). The person then has their blood tested again 30 minutes, 1 hour, 2 hours, and 3 hours after drinking the high glucose drink. -Michael Bergman, MD, clinical associate professor, Department of Medicine
Latent Onset Type 1 Diabetes: Latent Autoimmune Diabetes in Adulthood (LADA) is a form of Type 1 Diabetes that occurs in individuals who are older than the typical ages expected for a condition which is known as Juvenile Diabetes. It is estimated that as many as 20 percent of adult patients who are initially thought to have Type 2 diabetes have LADA. Initially, patients are given drugs to treat the condition, but soon falter. The best treatment for the condition is insulin therapy. Endocrinologists at NYU Langone Medical Center can talk about the symptoms, treatment and prevention of Type 2 diabetes in older adults.-Loren Greene, MD, clinical associate professor, Department of Medicine
Continuous Glucose Monitoring DevicesThe continuous glucose monitoring system (CGMS) has recently been approved by the FDA. This device allows patients and their physicians to follow trends in blood sugar throughout the day and night. Experts at NYU Langone can tell you if you are a candidate for this device and describe how it can help patients with difficult to manage diabetes.
Up until now, the information used to manage a diabetics’ blood sugar was based on home glucose monitoring. In order for some patients to get good control of their blood glucose, they needed to test their blood at various times throughout the day. The CGM systems measure and display a blood sugar value every 5 minutes for several days via a tiny glucose-sensing device inserted just under the skin of the abdomen. The sensor measures the level of glucose in the tissue and sends the information wirelessly to a pager-sized device called a “monitor” that can be attached to a belt or the waistline. Results of at least three or four finger stick blood sugar readings taken with a standard glucose meter are entered into the monitor for calibration. Any insulin taken, exercise engaged in, and meals or snacks consumed are both entered into a paper based “diary” and recorded into the monitor (by pressing a button to make the time of the meals, medication, exercise and other special event you wish to record). The information stored in the CGM is downloaded into a computer. Patient and doctor can review the blood sugar levels in relation to the other data collected and make any necessary adjustments in your diabetes management plan. -Stuart Weiss, MD, clinical assistant professor, Department of Medicine
New Drugs for the Treatment of DiabetesPatients can easily feel overwhelmed by all the new drugs to treat Type 2 diabetes. NYULMC physicians are available to give a primer on available diabetes drugs and how they work and what drugs may be right for you.Traditional drugs to treat Type 2 diabetes directly boost insulin production and lower glucose levels, but there are new drugs in use and on the horizon that work differently and can be combined with additive effects. Newer drugs can improve the body’s ability to respond to insulin because they can improve the production of insulin and lower glucagon (a glucose raising hormone) levels. New drugs in development called SGLT-2 inhibitors are a class of medications being investigated to lower blood sugar -- working directly on the kidney. Though medications can be overwhelmed by a “bad” diet, these and other medications in development can make glucose easier and safer to control. -Stuart Weiss, MD, clinical assistant professor, Department of Medicine
About NYU Langone Medical Center:NYU Langone Medical Center, a world-class patient-centered integrated academic medical center, is one of the nation’s premier centers for excellence in health care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is comprised of three hospitals—Tisch Hospital, a 705-bed acute-care tertiary facility, Rusk Institute of Rehabilitation Medicine, the first non-military rehabilitation hospital in the world, with 174 beds and extensive outpatient rehabilitation programs, and the 190-bed Hospital for Joint Diseases, one of only five hospitals in the world dedicated to orthopaedics and rheumatology—plus the NYU School of Medicine, one of the nation’s preeminent academic institutions. For more information, visit http://www.med.nyu.edu/.
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