With her direct primary care model, Dr. Kelley Stahl, MD, with Stahl Primary Care in Cumming, Georgia, provides real benefits for patients with chronic illnesses like diabetes. It can also be a critical part of preventing this life-changing medical problem if a patient is at risk. With proper medical care, patients can manage active diabetes or successfully avoid it with tailored lifestyle changes.
Diabetes refers to illnesses that affect blood sugar and how the body utilizes it. Glucose, or sugar, is essential to body functioning because it supplies the fuel all cells need. When a patient has diabetes, the body doesn’t manage glucose properly, so there’s too much in the blood. When all this sugar builds up in the bloodstream, it’s a sign that the cells are not getting the fuel needed to thrive.
There are three basic forms of this disease. Type 1 diabetes, which is sometimes called juvenile because it tends to strike at a young age and is chronic; Type 2 diabetes is what most people associate with aging; and gestational only occurs during pregnancy. All three conditions have one thing in common: difficulties with insulin.
Insulin works like a key that unlocks cell membranes to allow glucose to enter. Without it, the sugar is literally locked out of the cell. Insulin is a hormone secreted by the pancreas. Once manufactured, it’s released into the bloodstream to circulate to the cells, allowing them to utilize the glucose.
When a patient has type 1 diabetes, the immune system attacks the insulin-producing cells in the pancreas, so the body stops making the hormone. This leaves the cells with a lock but no key.
Patients with type 2 diabetes may still make insulin, but the cells become resistant to it, so the key doesn’t fit the lock anymore.
With gestational diabetes, the placenta produces a hormone that makes the cells resistant to the insulin -- similar to type 2 -- but it stops once the pregnancy ends. In this case, the patient lost the key but will find it later.
It’s unclear why some patients develop diabetes, but the most likely answer is a combination of genetics and environment. Most diabetes is manageable with medical help and smart lifestyle choices, however.
Prediabetes is the precursor to type 2 and indicates a state that’s still reversible with lifestyle changes. Eating habits and exercise play a significant role in the development of type 2 diabetes. If a patient is found to have prediabetes, starting to eat right and exercise is all it takes to avoid this condition. Dr. Stahl may monitor the patient’s blood sugar levels with regular A1C tests, as well, to guide the process.