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On March 26, visitors to Lifespan.org discussed diabetes and endocrinology online with Marc Laufgraben, MD, an endocrinologist at the Hallett Center for Diabetes and Endocrinology at Rhode Island Hospital. Below are excerpts from the chat. Moderator: Welcome to today's Doc Chat. Dr. Laufgraben is now available to answer your questions about diabetes and endocrinology. Dr. Laufgraben: Hi. I'm happy to answer any questions that anyone may have about diabetes, thyroid or other endocrinology issues. Dr. Laufgraben: Don't be shy. susan: Are children who are overweight at an increased risk of diabetes, even if they slimmed out during adolescence? Dr. Laufgraben: There is some evidence that babies who are either very big or very small at birth have an increased risk of diabetes in adulthood. We're also seeing an epidemic of obesity-related diabetes in children, unfortunately. susan: He was a big baby but now he's 14 and nearly 6'3". Dr. Laufgraben: Slimming out during adolescence is likely to be very helpful. susan: Other than candy, are there food groups (like carbohydrates, for instance) he should avoid? Dr. Laufgraben: The risk of diabetes is often in relation
to both weight and height, which is called the body mass index.
I always recommend a good, well-balanced diet. If you need specific
recommendations a nutritionist can be extremely helpful. Regular
physical exercise also reduces the risk of diabetes. susan: There is no diabetes on his father's side, but his mother's mother has adult onset diabetes, so does that put him at greater risk? Dr. Laufgraben: A grandmother with diabetes probably increases the risk a bit, but I'd be more concerned about a mother or father with diabetes, or a family with many relatives that have diabetes. cubatones: Hi Dr. L, It's Tony. I hope all is well! Dr. Laufgraben: Hi, Tony. susan: Thanks so much for the helpful information, Dr. Laufgraben. Dr. Laufgraben: You're welcome. These issues should certainly be discussed with the boy's pediatrician. cubatones: Do you have any ideas for the folks at the RI Free Clinic. They are planning on starting up a diabetes clinic. What essential components would you recommend they implement? Dr. Laufgraben: Cubatones, I'm not sure what their resources are, but I'd be happy to have them call me. cubatones: Thanks I'll give the message to my wife. Have a great day and I'll see you around RIH and Brown. Dr. Laufgraben: My pleasure. Charlie78: Doctor, I was wondering about late unset diabetes--are some people genetically prone to having it? Charlie78: The older diabetics that I know seem to always be hungry... Dr. Laufgraben: Charlie, yes, adult-onset diabetes has a strong genetic component. There is increased risk if diabetes is in your family. There is also increased risk in certain ethnic groups, such as African American, Hispanic and Asian. Charlie78: I hear that there is some debate about fiber and protein--what do you suggest for diet. Dr. Laufgraben: Diet questions are extremely complicated. I almost always suggest that interested patients speak to nutritionists. Everyone needs a certain amount of protein, but too much protein can be bad for your kidneys. Charlie78: I know that I'm all over the board with these questions, so I thank you for your time. My next question is: how can you spot a lesion area before it opens? Dr. Laufgraben: I'm not sure what you mean. Charlie78: If I am going to get a sore what are the warning signs? Dr. Laufgraben: Do you mean on your foot or leg? Charlie78: On my leg. Dr. Laufgraben: Other than redness, there's nothing specific
that I can think of. It is extremely important that diabetics
have good preventive care of their legs and feet. These areas
should be examined by you every day and any new problems reported
to your physician. That way, worse problems can be prevented. JClifford1: First, Doctor Laufgraben, thank you for your time. I am newly diagnosed with type 2. I am also probably 100 pounds overweight. Are my chances of getting off of the glucatrol and controlling it with diet and exercise good if I knock off the weight? Charlie78: Thank you, Doctor! Dr. Laufgraben: JClifford, that's hard to predict. What I can say is, weight loss, exercise and good nutrition are very helpful in almost every case. JClifford1: Is 5 mg of Glucatrol a fairly low dosage? I've responded real well to it and am hoping that's a sign that I may be close to borderline. Dr. Laufgraben: 5 mg of Glucutrol is a relatively low dose. Be careful about the term "borderline." If you're on Glucutrol, your doctor definitely thinks you have diabetes. JClifford1: Good, that's what I thought. I have a great doc and am trying to learn as much as I can. He does think I have diabetes and I will follow his orders exactly. I'm just hoping to get to a point where he can take me off it. Dr. Laufgraben: It's great that you're trying to learn as much as you can. Patient self-management education is incredibly important. JClifford1: Thanks for your time, Doctor Laufgraben. Dr. Laufgraben: The Hallett Center has extensive diabetes education opportunities for anyone who's interested. JClifford1: Hey, it's my body and my life after all. I'm in the best position to make as much difference as possible. May I take advantage of them even though my doctor is not affiliated with RIH? Dr. Laufgraben: JClifford, for more information about our diabetes outpatient education program, please call Maureen at 401-444-8222. jconti-dutko: Hello, Dr. Laufgraben. My father is 76 and has been receiving care from you for approximately 6 months. He and my family say "You are the best" and we thank you. Dr. Laufgraben: Thank you. That's very kind. JClifford1: Thanks very much! Dr. Laufgraben: Thank you all for your questions. Moderator: That concludes today's Doc Chat. For more information about the Hallett Center at RI Hospital, please visit www.HallettCenter.org. Find out more: |
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