Diabetes

Why do we get Diabetes Mellitus (DM)?

The pancreas, an organ behind the stomach, produces a hormone called Insulin. Insulin helps uptake of glucose into the cells. Once inside the cells, glucose is broken down for immediate energy, or some of it is converted to be stored for future use. When insulin is either deficient or only little compared to the needs of the body or the body can't use the insulin that is produced, it results in elevated blood glucose levels.

What are Type 1 and Type 2 Diabetes Mellitus?

What are the common symptoms of DM?

• Excessive Thirst, Excessive hunger, Excessive urination
• Fatigue, Dehydration, Weight loss

What is the screening test?

• Pre Diabetes
  • Fasting plasma glucose 100-125 mg/dl or
  • OGTT 140-199 mg/dl or
  • HbA1c 5.7- 6.4 %
• DM
  • Fasting plasma glucose > 126mg/dl or
  • OGTT with 2hr plasma glucose >= 200 mg/dl or
  • HbA1c >=6.5% or
  • Classic symptoms of Hyperglycemia /crisis with random plasma glucose >=200 mg/dl

What is HbA1c?

• It measures your average blood sugar level over the past three months
• A1C < 5.7% is normal
• 5.7 - 6.4% indicates prediabetes
• > 6.5% indicates you have diabetes

How to manage DM?

• Intense lifestyle modification, weight loss
• Oral medications
• Insulin

What are some of the complications of DM?

• Eye - Retinopathy (damage to blood vessels in the back of the eye)
• Heart - Coronary artery disease (early blockage of heart blood vessels)
• Kidney - Nephropathy (Kidney failure), albuminuria (protein spillage in urine)
• Neuropathy -Pain, tingling, numbness, burning, skin ulcers
• Brain - Stroke

What is Diabetic ketoacidosis?

• It is the most life-threatening acute complication of diabetes
• Patients develop hyperglycemia, ketosis, and severe dehydration. Sometimes can lead to a coma.
• Patients need to be admitted to the hospital, often to the intensive care unit, for intravenous insulin
• It is often the presenting manifestation of DM Type 1

What is Gestational Diabetes?

• Diabetes that is diagnosed for the first time during pregnancy
• This can cause complications like pre-eclampsia(uncontrolled high blood pressure), premature delivery, large babies(risk of clavicle fractures, nerve injuries during delivery, and high risk for c - section), and stillbirth.
• By appropriate early screening (24-28 weeks of pregnancy) and controlling blood glucose, most of the complications can be avoided.

What do we do in our clinic?

We offer a comprehensive evaluation for Diabetes. We monitor your blood glucose closely, help improve your HbA1c and work with you and related specialists in preventing and managing complications associated with diabetes.
We manage Insulin pumps and use Continuous Glucose Monitoring in patients with appropriate indications.

Continuous Glucose Monitoring

Traditionally, blood glucose is measured with a fingerstick method. This involves multiple sticks in a day and only gives a snapshot of blood glucose at that time. However, blood glucose might fluctuate and change in-between measurements.
Continuous glucose monitoring tracks your blood glucose at all times. You can better balance a day by monitoring the trends and adjusting medicines, diet, and activity. It has alarms that notify when glucose is dangerously high or low. It also tracks and saves the data, so you don't need to worry about noting the glucose levels or losing the information. The data can be downloaded by your physician to help in your care.

Insulin Pumps, Delivery Devices, and Continuous Glucose Monitoring Systems

Thyroid

The thyroid gland is located in the front of the neck. It produces hormones that are important for metabolism and affects many other organ systems.

What Is Hyperthyroid?

• Increased thyroid hormones - Free T4 and T3, Low TSH
• Patients can have heat intolerance, palpitations, atrial fibrillation, weight loss despite a good appetite, nervousness, emotional lability, increased sweating, and menstrual irregularities.
• If not treated, it can progress into a life-threatening situation called thyroid storm.

What Is Hypothyroid?

• Decreased thyroid hormones - Free T4, Increased TSH
• Patients can have fatigue, myalgia, cold intolerance, constipation, weight gain, and menstrual irregularities.
• If left untreated, it can progress to a life-threatening emergency called myxedema coma.

What Is Thyroid Nodule?

• Cyst or outgrowth of thyroid tissue.
• It is extremely common, and most of the nodules are benign. Only about 5-15% are malignant.

What We Do In Our Clinic

After a detailed evaluation, we will be able to develop a comprehensive management plan to achieve the best results.
For patients with nodules, we work closely with interventional radiologists who specialize in thyroid biopsies. In situations needing surgery, we work with surgeons who perform minimally invasive surgery.

Calcium/Parathyroid

We treat the following issues related to calcium and parathyroid levels:

• Hypocalcemia - When a patient's blood calcium levels are too low, they have hypocalcemia. Signs of hypocalcemia include dry skin, depression, memory issues, and sometimes muscle aches. In rare instances, it can cause someone to have seizures and abnormal heart rhythms. That's why it's essential to work with a doctor as soon as you notice hypercalcemia.
• Hypercalcemia - Hypercalcemia is like hypocalcemia, but it's caused by blood calcium levels that are too high. Patients often struggle with myriad ailments, such as fatigue, confusion, gastrointestinal issues, and heart palpitations. When hypercalcemia becomes serious, a patient might feel excessively thirsty while constantly needing to urinate. ARKA Endocrine Clinic is here to answer any questions you may have regarding hypercalcemia.
• Hypoparathyroidism - Hypoparathyroidism (when your parathyroid glands are underactive) isn't the most common condition, but medical assistance is a must when it occurs. When you notice tingling, burning, muscle aches, brittle nails, and hair loss, it might be a sign to have your parathyroid looked at.
• Hyperparathyroidism - Hyperparathyroidism means your parathyroid glands are overactive, causing symptoms of joint pain, muscle weakness, increased thirst, frequent urination, and occasionally high blood pressure. Working with ARKA Endocrine Clinic is essential when dealing with parathyroid issues like this.
• Osteoporosis - Weak and brittle bones might indicate a patient is dealing with osteoporosis. When a patient has osteoporosis, it requires medical attention. We can help patients regain control of their lives, whether their osteoporosis results from age or malnutrition.

Men's & Women's Health

• Hypogonadism (Low Testosterone) - Hypogonadism is a condition in which the body doesn’t produce enough testosterone. Some symptoms include erectile dysfunction, infertility, decrease in muscle mass, body hair growth, and loss of bone mass.
• Polycystic Ovary Syndrome (PCOS) - Females experience polycystic ovary syndrome when their hormones aren't producing correctly. This condition can cause infrequent or prolonged menstruation and can hurt ovary function. It's important to see a doctor as soon as period problems start to occur.
• Menopause - Leading up to menopause, patients can experience hot flashes, menstrual issues, and more. That's why ARKA Endocrine Clinic is here, ensuring this transition from regular menstruation to no menstruation is smooth sailing.

Other Health Conditions

• Adrenal Disorders - Sometimes called adrenal insufficiency, these disorders are produced in the adrenal glands. When they make too many or too few hormones, adrenal disorders occur. Patients should see a doctor about adrenal disorders when they feel tired and confused, have frequent skin bruises, and have blood pressure issues. With the help of ARKA Endocrine Clinic, patients can overcome their adrenal disorders and live better lives.
• Cholesterol Disorders - Otherwise known as high cholesterol, some people have too many lipids (fats) in their blood. While our bodies do need fat to function, our bodies cannot use up all the fat. When this happens, you must see a doctor about high cholesterol and get your cholesterol disorders under control. Our team can help you manage your diet and will advise you to eat less saturated and trans fats. They will also recommend foods that are lower in sodium. That way, you can manage your cholesterol with confidence.
• Metabolic Syndrome - Metabolic syndrome is treatable. It causes weight gain and puts patients at risk for developing heart disease, stroke, Type 2 diabetes, and other issues. That's why you want to work with a doctor who can help you get your metabolic issues under control. It will help you look and feel your best!
• Pituitary Disorders - The pituitary gland is a tiny gland inside your brain. Considered the "control gland," it helps you produce hormones that impact your entire body. Our team works to ensure that pituitary disorders do not impact your overall health.
• Obesity - Our team works to get your hormones under control and assists you with all your nutritional and metabolic needs. That way, you can have an easier time with weight loss.

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