Diabetes

The Rising Cost of Insulin in the U.S.: A Looming Crisis?

Insulin is a hormone that is naturally produced by the body in order to metabolize carbohydrates and to regulate blood sugar levels. People with type 1 diabetes, whose pancreas produces little to no insulin, are insulin-dependent – needing shots of insulin to replenish what their body is not manufacturing. Similarly, those who have type 2 diabetes may also need to have insulin shots to regulate their glucose levels.

The men who discovered insulin in 1923 sold the intellectual property rights for just 3 Canadian dollars. Today, the average price of insulin in the United States is $98.70, with some rates going as high as $250 per vial.

Diabetes is big business for pharmaceutical manufacturers. Even as far back as 1941, several companies were indicted on antitrust and price-fixing charges when they were caught inflating the prices of insulin.

Expensive Insulin – Who Is to Blame?

For those of us who have diabetes, these rising costs are becoming more and more painful in the wallet. Diabetics in the United States pay at least eight times the cost of insulin as compared to those who live in other high-income nations.

The insulin market is broken, from the insulin manufacturers and their lobbyists to the wholesalers and retailers to governmental and nongovernmental regulatory bodies. Insulin prices will continue to rise with no real policy-level solutions.

What then can be done to help patients with diabetes afford the cost of insulin?

What Family Medicine Providers Can Do

Some providers are proactive in helping their patients to better manage their disease. The local family medicine providers may not be able to singlehandedly change the system, but they can provide low-cost options such as human insulin – which is doable and effective.

Moreover, drug manufacturers offer affordable treatment options to certain healthcare facilities through the 340B program, of which more than 12,000 facilities are participating. As a patient, ask your family medicine provider whether you have access to this or to something similar.

Family Medicine Provider in Wellington and Royal Palm Beach, Florida

The skilled and experienced healthcare team here at Advanced Medical Clinic specializes in diagnosing and treating patients with endocrine disorders, including diabetes. Dr. Ishan Gunawardene, our internal medicine family medicine provider, aims to help his diabetes patients find insulin that they can afford to control their disease.

His wife, Shariffa Gunawardene, is a board-certified nurse practitioner who can treat patients of all ages. Together, they can serve the medical needs of your whole family. We are highly flexible and take a personalized approach for your family’s optimal health.

If you have any questions or would like to schedule an appointment, contact our friendly staff today by calling us at (561) 434-1935 or by filling out our easy-to-use appointment request form online now. We have convenient locations in Wellington (off SR7/441, north of Lake Worth Road) and in Royal Palm Beach (near the intersection of Okeechobee Boulevard and Royal Palm Beach Boulevard), and we look forward to being your family’s healthcare partner!

Type 1 vs. Type 2 Diabetes

There are a number of different types of diabetes, but two of the most common are type 1 and type 2 diabetes. The complications of diabetes, regardless of the type, can be serious if the disease is ignored and left untreated.

Many people have prediabetes or type 2 diabetes without any knowledge that they have the disease. The high levels of glucose in the bloodstream can negatively impact circulation, which can thereby impact the nerves and lead to diabetic neuropathy.

Causes of diabetes are still unknown, although we do know how to treat it once it is discovered. Let’s talk about type 1 diabetes and type 2 diabetes, and what you can do about each of them.

What Is Type 1 Diabetes?

This type of diabetes is often diagnosed in childhood or early adulthood, so it is also referred to as juvenile diabetes. Patients with type 1 diabetes do not naturally produce insulin, or they produce very little insulin, which is the hormone the pancreas produces to convert sugar (glucose) into energy. Insulin is also needed by the body to store glucose for future use, thereby regulating your blood sugar levels.

Ongoing insulin therapy is imperative to maintaining the good health of someone with type 1 diabetes. With insufficient levels of insulin in your body, you can experience dangerously low energy levels and high blood sugar levels.

This condition requires close monitoring of blood sugar levels and regular insulin shots. In the case of type 1 diabetes, most patients are born with it and cannot prevent or cure it.

What Is Type 2 Diabetes?

Much more common than type 1 diabetes is type 2 diabetes. The causes are usually poor diet and a sedentary lifestyle. Smoking has also been shown to contribute to the development of type 2 diabetes.

Having someone in your immediate family (parent, sibling, child) with type 2 diabetes increases your risk of developing it. This is the type of diabetes that people are often unaware of until the symptoms become more apparent and complications occur; however, almost everyone with type 2 diabetes had prediabetes first, so regular checkups by your family medicine provider will detect it before it becomes an issue.

With type 2 diabetes, either the diabetic’s body does make insulin but there is a problem with the absorption of glucose by the cells (insulin resistance), or the body does not produce enough insulin. Type 2 diabetes is often an adult-onset disease, but more and more children are now being diagnosed with it due to high obesity incidence among children.

Symptoms of Diabetes

Regardless of whether you have type 1 or type 2 diabetes, the symptoms can include:

  • Feeling very thirsty
  • Feeling very hungry
  • Urinating frequently
  • Losing weight for no apparent reason
  • Having blurry vision
  • Feeling extremely tired

Treatment for Type 1 vs. Type 2 Diabetes

Treatment for type 1 diabetes involves regular insulin injections as necessary to maintain normal blood sugar levels. However, treatment for type 2 diabetes typically involves making lifestyle changes, such as exercising and dietary changes. Medication and diabetic foot care is also part of the treatment to avoid limb loss.

Advances in technology and research have greatly extended the average lifespan of patients with diabetes. Today, both of these two types are manageable diseases, and you can live a normal and active life.

Diabetes Management in Wellington and Royal Palm Beach

Our board-certified internal medicine family medicine providers here at Advanced Medical specialize in the diagnosis and treatment of chronic medical conditions, such as type 1 and type 2 diabetes. We will help you manage your symptoms and prevent complications so that you can enjoy life.

To schedule a consultation, call Advanced Medical today at (561) 434-1935 or request an appointment via our online form now. We look forward to being your healthcare partner!

Diabetes

There are more than 100 million Americans who have diabetes or pre-diabetes – encompassing almost a third of the country’s entire population. About 84 million have pre-diabetes, and 30 million do have the condition, according to the Centers for Disease Control and Prevention (CDC).

Diabetes is a serious, chronic disease that affects the body’s ability to process glucose (sugar). Glucose provides the energy necessary for the cells in our muscles and tissues to work properly, but diabetes leads to high sugar levels which can cause serious health problems.

In 2015, diabetes was among the top 10 causes of death in this country, ranking at #7. That is why it is so important to catch the disease early, at the pre-diabetic stage, before it turns into type 2 diabetes.

Types of Diabetes

There are several different types of diabetes. Let’s take a look at the most common forms of this condition:

Gestational Diabetes

Gestational diabetes occurs only in pregnant women. If a woman develops this condition, it usually first appears in the middle of pregnancy. This condition normally disappears after the baby has been born.

If gestational diabetes is ignored, it can cause the baby to be too large. This can create problems during delivery, and the baby can develop nerve damage because there tends to be too much pressure on the baby’s shoulder during the birthing process.

A woman with gestational diabetes also has a greater chance of developing type 2 diabetes later. Therefore, it is important for the woman to continue following a healthy lifestyle of diet and exercise.

Pre-Diabetes

If a person has pre-diabetes, it is necessary for them to modify their diet in order to avoid developing type 2 diabetes. Regular exercise that the person enjoys and a healthy diet comprising foods the person likes are essential to maintaining a healthy body going forward.

If you have pre-diabetes and you continue to follow an unhealthy lifestyle, eating high-fat foods and being notably overweight, you are likely to develop type 2 diabetes within five years. That is the dangerous stage of diabetes, so it should be carefully avoided.

Type 1 Diabetes

Type 1 diabetes is a serious form of this disease, and its exact cause remains unknown. It is believed to be either an inherited disorder or caused by a virus.

This type of diabetes causes a person’s pancreas to release very small amounts of insulin or no insulin at all. Without insulin, sugar levels will continually build up in the bloodstream, causing severe side effects.

Insulin is a hormone that enables glucose to enter our cells for energy. We get glucose from the foods we eat after the food is processed by the digestive system.

This form of the disease was previously called juvenile diabetes. It usually appears during childhood or adolescence, and it requires daily insulin injections to stay alive because the pancreas is not providing the proper insulin support.

Type 2 Diabetes

Type 2 diabetes is the most common form of the disease, and it can develop at any age in a person’s life – but it usually affects people over the age of 40. With type 2 diabetes, the body doesn’t use insulin properly, even though it still produces it.

This form develops over many years, and symptoms may not be obvious. With proper nutrition, daily exercise, and maintaining a healthy weight, the development of type 2 diabetes can be delayed and even prevented.

Complications from Diabetes

Having diabetes dramatically raises the risk of many cardiovascular problems, such as a heart attack or a stroke. The presence of excessive sugar in the bloodstream can lead to nerve damage, especially in the legs – which, if left untreated, can cause a loss of all sensation in the affected limbs.

Complications often affect the feet and legs of diabetic patients. This can lead to the need for amputation of the foot, leg, or both in order to keep the diabetic person alive.

Kidney damage can also be caused by diabetes. Severe kidney damage can lead to kidney failure, which may require dialysis or a kidney transplant.

Diabetes can damage the blood vessels in the retina, potentially leading to issues in the eye. This can cause glaucoma, cataracts, and even blindness.

Family Medicine Provider in Wellington and Royal Palm Beach

Our skilled and experienced medical team at Advanced Medical Clinic is here to assist you in all of your health care needs. We practice family and internal medicine – and if you have any risk factors for diabetes, we can provide a full evaluation and treatment if necessary.

Call us at (561) 434-1935 today, or request an appointment online right now. Let us help put your mind at ease about diabetes.

Managing Diabetes: 6 Tips for Type 1 Diabetes

Contrary to popular belief, type 1 diabetes is not only a childhood disease. Although it usually strikes in people under the age of 20, it can occur at any age, in every race, and to people of every shape and size.

Diabetes is a disease that affects how the body uses glucose, a sugar that is used as a source of fuel for the body. Normally, the hormone insulin helps glucose enter the cells where it is used for energy.  People with type 1 diabetes do not produce insulin. As a result, glucose does not get into the body’s cells and stays in the bloodstream. Too much sugar in the blood makes people ill and can result in medical complications. Therefore, people with type 1 diabetes have to monitor their blood glucose levels constantly and appropriately administer insulin every day of their lives.

Unfortunately, there is no cure for type 1 diabetes, but there are many things you can do that will help you manage your condition in order to live a long and healthy life.

Get the Right Support

Every person who has diabetes should have a personal plan and a health care team. You’re in charge of putting that plan into action, but you don’t have to compile it on your own. Speak to your family medicine provider about setting up the right support for you. This should include an endocrinologist, a nutritionist, or a dietitian, and you may even want to include a podiatrist and an ophthalmologist and a diabetes educator to explain to you how to live better with the condition.

Get Regular Checks with Your Health Care Team

Talk with your health care team regularly, and keep them in the loop on your condition. High blood sugar can affect organs and tissues throughout your body. Even if your diabetes is controlled well, health problems can still arise – so it is important to get checked out regularly and watch for warning signs such as sores that don’t heal, swelling, tingling, or numbness in your hands and feet, and blurred or double vision. You should report these concerns early on so they can be treated quickly before getting worse. You can slow or even stop the damage if you act quickly.

It is vitally important to see your endocrinologist at least every 90 days and have your longer-term blood sugar levels checked. A Hemoglobin A1c test tells you and your family medicine provider what your blood sugars are doing over a 90-day period and helps tremendously in managing the disease.

Watch What You Eat and When You Eat

It is a good idea to have a healthy meal plan in place which includes complex carbohydrates, protein, fiber, lots of green, leafy vegetables, and limits to the amount of fat in your diet – especially saturated fats such as bacon, sausage, and full-fat dairy. Saturated fat raises your chance of heart disease, and with diabetes this increases your risk further. Making smart food choices can lower that risk.

Carbohydrates are found in many foods including grains, fruits and vegetables, dairy products, and sugars. They are your body’s main source of energy, but they raise your blood sugar levels faster than any other food – so knowing how many and what type of carbs you can eat can affect how well you manage your diabetes.

It is a good idea to work with your family medicine provider or dietician to establish a personalized eating plan to figure out how many grams of carbs you should be eating throughout the day and try to ensure you are eating a healthy, balanced diet.

Eating little and often rather than the usual three meals a day is more likely to keep your blood sugar levels stable than going long periods without eating.

Get Active

Regular physical activity can help you lose extra weight, keep blood sugar levels healthy, and lower your blood pressure. It can also improve your sleep, mood, and reduce feelings of stress and anxiety, which can all negatively affect blood glucose levels.

Just 5 minutes of walking can dramatically reduce your blood glucose levels. Try to find a form of exercise you enjoy, whether this be individually or in a group.

It is important to keep a close eye on your blood sugar levels before, during, and after exercise, because it can raise or lower your levels and can even trigger hypoglycemia.

Take Advantage of Advancements

Diabetes management has come a long way. Be sure to take advantage of the tools and technology that exist to help aid in the daily management of the disease.

Make sure you have a blood glucose monitor and that you do regular checks (at least four per day). Most monitors use a very small drop of blood and display the results very quickly. There is even a monitor available that requires no finger sticks at all.

Consider getting a CGM as well. A CGM is a continuous glucose monitor. The device is a small sensor you wear on the skin that reads and displays blood sugar results every 5 minutes automatically. This allows you to know what your blood sugars are doing 24 hours per day. The results display through your smartphone, and alarms signal an oncoming low or high, allowing you to stay ahead of blood sugar changes.

Instead of injections, consider an insulin pump. An insulin pump can help you manage your diabetes by matching your insulin to your lifestyle, rather than getting an insulin injection and matching your life to how the insulin is working. Insulin pumps deliver short-acting insulin 24 hours a day through a catheter placed under the skin. You then deliver insulin through the pump based on the number of carbohydrates you will eat at mealtime or to correct a high blood sugar. There is even a wireless pump available that allows you to wear it discreetly on multiple places on the body as well as swim and shower with it.

Be Kind to Yourself

Living with diabetes and its daily demands can be stressful, so it’s really important to focus on and feel good about your achievements. Don’t be overly critical of yourself if you fall short of a goal, and give yourself credit when you are successful at managing your blood sugar. Remember to do the best you can do and keep a positive attitude.

At Advanced Medical, PA, we pride ourselves in providing personal and individualized, quality health care. Our experienced medical staff take the time to get to know our patients, and we are here to help you manage diabetes and other chronic conditions. To learn more about us and the services we offer, or to arrange a visit, call us at (561) 434-1935 or request an appointment. We are always happy to answer any questions you may have about our practice and the primary care services we provide.

What Does Being a Pre-Diabetic Patient Mean?

Being diagnosed as pre-diabetic may seem like a serious sentence, but it really is more of a warning that your condition need not become permanent if you are committed to making some lifestyle changes. Here is what being pre-diabetic means, and what you can do about it.

Two Types of Diabetes – Type 2

There are two different types of diabetes, Type 1 and Type 2. While Type 2 can be alleviated and possibly even backtracked with proper diet and exercise, Type 1 diabetes cannot. As opposed to Type 2 diabetes, Type 1 is characterized by the body’s inability to produce insulin, the hormone necessary to process the sugar your body takes in. Pre-diabetes refers to the stage before your body is diagnosed with Type 2 diabetes and occurs when your blood sugar level is higher than what is deemed normal, but has not yet reached the level of Type 2 Diabetes.

In these cases, your body may not be properly processing sugar, or glucose, after you ingest it. This means the sugar begins to accumulate in your body instead of fueling your muscles and tissues as it normally should. So, each time you consume food, for instance, a sandwich, the sugar from it will enter your bloodstream. Without insulin, it will not enter the cells and you will not feel the energy from said sandwich.

Patterns to Watch

So, what kind of patterns should you be keeping track of that could put you at risk for pre-diabetes? For starters, check your diet. What you’re consuming could be impacting how you continue processing sugar. Red and processed meats make your body work very hard to process it. Also, sugary drinks like juices, sports drinks and sodas are big culprits that elevate your sugar levels, putting you at a higher risk of pre-diabetes. You should also monitor your weight regularly; being overweight puts you at a higher risk of getting diabetes.

Quick and Easy Long-term Fixes for Pre-Diabetes

Again, being diagnosed as a pre-diabetic patient doesn’t have to be permanent if you take serious steps to make a change. Committing to lowering your sugar levels, eating more whole foods, fruits and vegetables, and exercising regularly to keep your weight down will all make a significant difference in bringing your sugar levels back to normal.

The Importance of Regular Diabetic Screenings

It’s important to talk to your family medicine provider and have regular health screenings if you do believe you could be at risk for pre-diabetes, as the condition itself displays almost no obvious signs or symptoms. You may feel sluggish due to your body’s inability to properly process sugar, but it can vary. The more diligent you are with regular monitoring and healthy living, the more likely you are to prevent the long-term effects that come with full-on Type 2 diabetes.

The friendly staff at Advanced Medical welcomes your call and looks forward to serving you for any primary care services, including diabetes screening and care. For a full medical workup, to check your body’s sugar levels and to learn your risk for pre-diabetes or developing Type 2 diabetes, speak to the medical experts at Advanced Medical Clinic. Call us at (561) 434-1935 to schedule an appointment, or you can use our secure online appointment request form.

How Walking Can Prevent Diabetes

Diabetes is a metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy, and those with diabetes have problems metabolizing it.

When someone is diabetic, the pancreas, an organ that lies near the stomach, does not produce enough insulin, which is what helps glucose get into the cells of our bodies. Diabetes can also interfere with your body’s ability to fight infection. Therefore, exercise is crucial in helping keep your immune system healthy and help prevent other diseases, such as cardiovascular disease and strokes.

If you have diabetes or have a family history of diabetes, and would like to prevent it from developing, physical activity is crucial. It is also important to maintain your blood glucose levels with a healthy meal plan and lifestyle. Exercising has many benefits, which include:

  • Lowers blood pressure
  • Controls weight and keeps weight down
  • Increased level of good cholesterol (HDL)
  • Leaner, stronger muscles
  • Stronger bones
  • More energy
  • Improved mood
  • Better sleep
  • Stress management

Walking is the best medicine and form of exercise to prevent diabetes. Research has shown that walking can dramatically boost energy levels, burn fat, and protects your heart. In other words, if you have high blood sugar, or if you have been diagnosed with prediabetes or diabetes, walking can be a lifesaver. An active lifestyle can help perpetuate a total body wellness, where more of a focus goes towards diet and exercise.

Obesity is an epidemic that affects more than 35 percent of people in the United States, and is one of the biggest factors leading to type-2 diabetes. Walking shrinks your abdominal fat, reducing your risk of diabetes. Excess fat around your abdomen causes inflammation in cells, making them even more resistant to insulin, a hormone that controls blood sugar; this increases your odds of developing the disease. According to everydayhealth.com, walking for 30 minutes a day, can reduce your risk of diabetes by 30 percent.

To learn more about how regular exercise and activity can help prevent diabetes, call Advanced Medical PA at (561) 434-1935 to request an appointment, or request one online.

Pre-Diabetes: When to See Your Family Medicine Provider?

Prediabetes is also known as borderline diabetes or impaired glucose tolerance, a condition that develops before someone receives a diagnosis of Type 2 Diabetes. It occurs when there is a glucose intolerance, meaning your blood sugars are at a higher level than normal, but not enough to be put in the diabetes diagnosis category.

Fortunately, during the prediabetes phase the pancreas still produces insulin, but your blood sugar still remains too high, because the insulin doesn’t remove the sugar out of your bloodstream. This is a condition called insulin resistance, and requires a visit to your family medicine provider.

Someone who has prediabetes may not even know that they have it, as symptoms are not always present, and if they are, they can be mistaken or misdiagnosed for another condition. It is often the case where someone who struggles with insulin resistance may develop type 2 diabetes, if not treated properly. That’s why going to see your provider to get tested is important, especially if some common symptoms are present. Symptoms of prediabetes include:

  • Obesity
  • High blood pressure
  • High cholesterol
  • Having a family history of diabetes
  • Lack of exercise
  • Blurry vision
  • Increased thirst
  • Tiredness/fatigue
  • Cuts that won’t heal
  •  Inflammation in your gums

As mentioned before, prediabetes is a silent condition, so getting a checkup is important in early detection and diagnosis. If left untreated, other systems in your body will be affected. If there is concern, your provider will perform the following tests, to see if the insulin in your body is doing what it should. These tests include:

1. A fasting blood glucose test: This test measures your blood sugar before you eat, and after you drink something sugary.

2. A1c (HbA1c) test (Hemoglobin)

3. Oral glucose tolerance test (OGTT)

Being on a proper diet plan and exercise regimen will help you reduce your risk of developing type 2 diabetes. To learn more about prediabetes, call Advanced Medical in Wellington and Royal Palm Beach, at (561) 434-1935 to request an appointment, or request one online.

Why Eating Fresh Fruit Can Lower Your Risk for Diabetes

Eating fresh fruit is one of the great and delicious ways to eat healthy and still pack more flavor into your diet. Not only is fresh fruit a wonderful way to help balance your diet and lose weight, it may help you avoid developing type II diabetes. Medical researchers have known for some time that the risks for developing diabetes are heavily tied to daily lifestyle habits.

Studies, for instance, have consistently shown that a diet rich in fresh fruits and vegetables, whole grains, and heart healthy fats can significantly lower your risk for developing adult onset, or type II diabetes ­– especially when combined with other healthy choices such as walking or other regular exercise.

Healthy Eating Can Lower Your Risk for Diabetes, Heart Disease, and Certain Cancers

Fresh whole fruits may also boost your immune system and lower your risks of both heart disease and even certain cancers. As with any diet, it is important to remember to add a wide variety of natural, healthy food sources rather than simply eating just one or two kinds of fruit. You should also talk to your family medicine provider to create a comprehensive diet and exercise program that works with your body to help you sustain a healthier lifestyle.

Keep in mind that the best diets reduce or eliminate poor food choices such as saturated fats, empty calories, high fructose corn syrup and sugar, adding heart and blood sugar healthy foods like fresh fruit and vegetables, and lean protein sources instead.

Surprisingly, fresh fruits are not the only thing that may help prevent diabetes. Peanut butter has a high fiber content, and monosaturated (good) fats that people enjoy eating. Be sure to carefully note portion sizes though, as it can ratchet up your calories. And even with fresh fruit, while overwhelmingly healthy, too much of a good thing can cause unwanted weight gain.

Fresh fruits should be eaten as whole as possible, removing only what is inedible such as the outer peel or rind. The skins of some fruits like apples also contain additional vitamins and trace minerals. Just be sure to thoroughly wash them to remove any pesticide residue that may have been used in growing them, or look for organic varieties instead.

Be aware that fruit juices or processed fruit may have added sugars, or have stripped away healthy fiber, which can cause a rise in blood sugar levels (fiber slows down absorption and improves blood sugar levels). A diet rich in whole grains, fresh fruits, nuts, berries and vegetables is a tasty way to reduce your chances of developing diabetes.

If you are concerned about how your diet is affecting your chances of developing diabetes, Dr. Ishan Gunawardene of Advanced Medical Clinic can answer all of your questions. To make an appointment with us in Wellington or Royal Palm Beach, request an appointment online or call (561) 434-1935 today.