Patient Education · Endocrinology

Diabetes: Understanding, Managing & Living Well

A guide to diabetes types, diagnosis, treatment, and technology — written for our patients.

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Understanding Diabetes Symptoms & Diagnosis Treatment Complications Technology

If you have questions about your diabetes care or would like to discuss monitoring technology or treatment, we invite you to contact our office. All care is individualized to your specific history and goals.

Understanding Diabetes

What is diabetes and how does it develop?

Diabetes is a group of metabolic conditions defined by chronically elevated blood glucose. Glucose is the primary fuel for most cells, but it can only enter cells with the help of insulin — a hormone produced by beta cells in the pancreas. When insulin production is insufficient or the body’s cells become resistant to its effects, glucose accumulates in the bloodstream while cells are starved of energy.

Chronically elevated glucose damages blood vessels and nerves throughout the body, leading to the long-term complications that make diabetes one of the leading causes of blindness, kidney failure, lower limb amputation, and cardiovascular disease worldwide.

What is the difference between Type 1 and Type 2 diabetes?

Type 1 diabetes is an autoimmune condition in which the immune system destroys the insulin-producing beta cells, requiring insulin therapy for survival.

Type 2 diabetes develops when cells become resistant to insulin’s effects. Over time, the pancreas exhausts its compensatory capacity and insulin production declines. Type 2 is strongly influenced by genetics, body weight, and lifestyle, and accounts for approximately 90–95% of all diabetes cases.

What is LADA?

Latent Autoimmune Diabetes in Adults (LADA) is an autoimmune form of diabetes that resembles Type 2 at diagnosis but is mechanistically similar to Type 1. It is frequently misclassified, leading to years of ineffective treatment.

LADA accounts for an estimated 5–10% of adults diagnosed with “Type 2.” If you were diagnosed with Type 2 but have not responded well to oral medications, or if you are lean and active, LADA should be considered. We routinely test for GAD antibodies and C-peptide when the picture doesn’t fit.

What is prediabetes?

Prediabetes refers to blood glucose levels that are above normal but below the diabetic threshold. Without intervention, approximately 15–30% of people with prediabetes will develop Type 2 diabetes within five years. With structured lifestyle changes, progression can often be prevented or substantially delayed.

Symptoms & Diagnosis

What are the symptoms of diabetes?

Classic symptoms include excessive thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, and slow-healing wounds.

Type 2 diabetes is often silent. Many patients have no symptoms for years while silent organ damage accumulates — which is why screening is important even in the absence of symptoms.

How is diabetes diagnosed?

Test	Normal	Prediabetes	Diabetes
Fasting Glucose	Below 100	100–125	126 or above
HbA1c	Below 5.7%	5.7–6.4%	6.5% or above
2-hr Glucose (OGTT)	Below 140	140–199	200 or above

Treatment

What medications are used to treat Type 2 diabetes?

Metformin

The established first-line agent. Reduces hepatic glucose production, improves insulin sensitivity, and is associated with modest weight loss. Inexpensive and well-tolerated.

GLP-1 Receptor Agonists Semaglutide (Ozempic) · Tirzepatide (Mounjaro)

A transformative class. Stimulate insulin secretion, suppress glucagon, slow gastric emptying, and reduce appetite. Produce meaningful weight loss and have demonstrated cardiovascular and kidney protective effects.

SGLT-2 Inhibitors Empagliflozin (Jardiance) · Dapagliflozin (Farxiga)

Cause the kidneys to excrete excess glucose in the urine. Lower blood pressure, reduce body weight, and have demonstrated robust cardiovascular and renal protective effects. Now recommended early in patients with heart failure or chronic kidney disease.

Insulin

Required for all Type 1 and LADA patients, and for many with Type 2 as the disease progresses.

Why does diabetes affect so many parts of the body?

Over time, elevated blood glucose damages both small blood vessels (the eyes, kidneys, and nerves) and large blood vessels (the heart, brain, and legs). This is why comprehensive diabetes care looks well beyond the glucose number alone — we screen for and manage the complications that drive most of the long-term harm. Good control of glucose, blood pressure, and cholesterol together is far more protective than focusing on any one of them in isolation.

What complications do you screen for?

As part of ongoing care we monitor for several recognized complications:

Eyes (retinopathy) — regular dilated eye exams to catch retinal damage early.
Kidneys (nephropathy) — periodic urine and blood testing to detect early protein loss and assess kidney function.
Nerves (neuropathy) — foot exams and symptom review to identify nerve damage.
Heart and blood vessels — attention to blood pressure, cholesterol, and overall cardiovascular risk.

Catching these early, when they are still silent, is what allows us to slow or prevent their progression.

How is cholesterol (lipid) management part of diabetes care?

Cardiovascular disease — heart attack and stroke — is the leading cause of death in people with diabetes, and abnormal lipids are a major, modifiable contributor. Because diabetes itself raises cardiovascular risk, the cholesterol targets we aim for are typically more aggressive than for the general population. We assess your lipid panel alongside your overall risk and use lifestyle measures and, when appropriate, statins or other lipid-lowering therapy to bring LDL cholesterol to goal. Managing lipids is one of the highest-impact things we do to protect your long-term health.

What is diabetic neuropathy, and how is it treated?

Diabetic peripheral neuropathy is nerve damage that most often affects the feet and legs, causing numbness, tingling, burning, or shooting pain. It develops gradually and is closely tied to long-term glucose control, so the foundation of treatment is optimizing blood sugar to prevent further nerve damage, along with careful foot care to avoid ulcers and injury. For painful neuropathy, several treatments can help — including oral medications and, for localized foot pain, the in-office topical treatment Qutenza, which we now offer at both locations. We tailor the approach to your symptoms and what you have already tried.

Technology

What is continuous glucose monitoring (CGM)?

CGM uses a small sensor placed under the skin to measure glucose every 1–5 minutes, providing real-time readings, trend arrows, and alerts — all without fingerstick testing. CGM is standard of care for all Type 1 diabetes patients and is increasingly used in Type 2, particularly for those on insulin.

We initiate and manage CGM in-office — including device selection, training, app setup, and interpretation of your data at every visit.

What are hybrid closed-loop systems?

Hybrid closed-loop systems pair an insulin pump with a CGM and an algorithm that automatically adjusts insulin delivery in response to real-time glucose levels. Current systems (Tandem Control-IQ, Omnipod 5) have dramatically improved outcomes for Type 1 patients. We initiate, train, and optimize pump therapy in-office.