ReachMD

Announcer:
Welcome to Diabetes Discourse on ReachMD. On this episode, we'll hear from Dr. Claresa Levetan, an endocrinologist at Grand View Health in Lansdale, Pennsylvania. Dr. Levetan is here to share her experiences on communication strategies with her diabetic patients. Let's hear from Dr. Levetan now.

Dr. Levetan:
It is so important to ask your doctor, ask your healthcare provider, "Am I at risk for diabetes?" because most of us Americans are. And in terms of strategies, it's really important to, I believe, wake up each morning and set your own health goals. Everybody says, 'Dr. Levetan, I need to lose weight. I want to lose weight.' It's every day that's what I hear. And I think that right now I most of the time say, 'Let's not focus on losing weight. Let's focus on you waking up in the morning and setting a health goal. Let's focus on you feeling healthier, and let's just take this one day at a time.' And I usually say to patients, 'If you're not exercising, do five minutes a day, whether that's walking, dancing, anything you want to do that's more active than you were doing.' And I also have a list of chair exercises I give to patients so if they want they can just do soup cans and raise them up while they're watching television, but five minutes a day is what I recommend as a place to start.

There's not a lot of rules I have for patients with diabetes or prediabetes. I generally recommend patients not drink fruit juices or sugar sodas because those are simple carbohydrates which don't have any nutritional value. I do allow patients to have as many natural fruits and vegetables as they like, but I like to just find out what each patient's health goal is and strongly encourage that they know their A1C, and let them set their goal.

I think what's kind of interesting, if we go back to the studies even from the 1980s and '90s when we started to really learn for the first time with the study called The Diabetes Complication and Control Trial in type 1s and the United Kingdom Prospective Diabetes Study in type 2 patients, both of those studies, if you ask the question 'What's the A1C that there is no risk for complications?' it's not 5.7 percent, which is where we say is we have prediabetes, but the number where we see no increased risk for cardiovascular disease, increased risk of death, strokes, complications, blindness, is actually the number is 5.5 percent. And we've seen that in studies with type 1, type 2, and even those patients who don't have any history of diabetes. When we look forward, the number is 5.5 percent. In my practice when you ask, 'What do I do?' we have this big diabetes wall of fame, and we have a lot of patients who started out with A1Cs of 15 and 20 and they get down to 5.5 percent, so it's pretty inspiring to me to see, how excited patients can get when they set their own goals and they know their own status of where they start.

Announcer:
You just heard from Dr. Claresa Levetan on how she communicates the seriousness of diabetes to her patients and how she motivates them to lower their A1C. To access this and other episodes in the series, visit ReachMD.com/diabetes-discourse, where you can Be Part of the Knowledge. Thanks for listening!