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Dr. Nicholas H. E. Mezitis, M.D.

Endocrinology, Diabetes

Dr. Nicholas Mezitis practices endocrinology in Athens, OH. Dr. Mezitis specializes in preventing, diagnosing, and treating diseases related to hormone imbalance, and the body's glands in the endocrine system. Endocrinologists are trained and certified to treat a variety of conditions, including menopause, diabetes, infertility, and thyroid disorders, among many others. Dr. Mezitis examines patients, determines the means of testing, diagnoses, and decides the best treatment methods.
Learn More About Me
48 years Experience
Dr. Nicholas Henry Elias Mezitis, M.D.
Specializes in:
  • Endocrinology-Diabetes
  • Athens, OH
  • Heidelberg University GERMANY
  • Accepting new patients

Why are my blood sugar levels so high in the morning?

Blood glucose levels in the morning are influenced by the meal composition and the timing of meals consumed after 4 PM the day before. Consuming the bulk of one's daily calories READ MORE
Blood glucose levels in the morning are influenced by the meal composition and the timing of meals consumed after 4 PM the day before. Consuming the bulk of one's daily calories after 4 PM and favoring starchy foods (potato, corn) will result in higher glucose results the morning after. Also, patients taking medications for diabetes may experience hypoglycemia overnight resulting in high morning glucose results. Bear in mind that the body produces hormones such as cortisol that peak in the morning and that naturally raise the blood glucose, but our diet and lifestyle (sleep) can aggravate this tendency

Who is at risk of ketoacidosis?

Ketoacidosis is a dangerous condition where the body starved of its insulin signal shifts to burning fat as emergency fuel generating ketones as byproducts. These substances in READ MORE
Ketoacidosis is a dangerous condition where the body starved of its insulin signal shifts to burning fat as emergency fuel generating ketones as byproducts. These substances in excess generate an acid environment in the blood which causes nausea, vomiting, lethargy and other problems. Untreated in this situation the patient with diabetes may die. Treatment is with intravenous fluids (salt water, potassium) and insulin. The best approach is prevention. Patients with diabetes requiring insulin should monitor their blood glucose and make sure that they are giving insulin in the correct amount for every situation. A specialist will provide detailed instructions and be available for emergencies.

How does PCOD cause sugar fluctuations?

Polycystic Ovary Syndrome (PCOS) represents a condition occurring in females where hormone imbalance affects both insulin and testosterone levels. Resistance to insulin action READ MORE
Polycystic Ovary Syndrome (PCOS) represents a condition occurring in females where hormone imbalance affects both insulin and testosterone levels. Resistance to insulin action causes large amounts of insulin to be produced by the pancreas This exhausts the pancreas over time and may lead to diabetes. Before blood sugar levels rise to the range seen in diabetes, swings in glucose may be experienced with very low glucose results recorded. Prevention of progression to full blown diabetes involves meal planning for weight control.
Unusually high testosterone levels are also seen and may interfere with menstrual periods and cause unwanted hair growth.

Is yoga advisable to manage diabetes?

Exercise that emphasizes rhythm and flexibility is very beneficial in managing diabetes. Yoga incorporates harmony, rhythmic breathing , stretching and gentle muscle strengthening READ MORE
Exercise that emphasizes rhythm and flexibility is very beneficial in managing diabetes. Yoga incorporates harmony, rhythmic breathing , stretching and gentle muscle strengthening without resorting to mechanical devices. Balance improves and injuries are avoided in a supervised setting. Most importantly, mental concentration benefits and good diet habits are encouraged. The smooth glucose profile will reflect these changes in mind and body , which reduce stress.

I have Hashimoto's, I think symptoms have gone into remission while I'm pregnant. Will they return?

Autoimmune thyroiditis can be triggered by many events that cause stress, in persons who have a predisposition .The body forms antibodies that can attack thyroid tissue and this READ MORE
Autoimmune thyroiditis can be triggered by many events that cause stress, in persons who have a predisposition .The body forms antibodies that can attack thyroid tissue and this may lead to high thyroid hormone levels in the bloodstream leaking from damaged thyroid cells. The condition can persist and smolder over years. Thyroid hormone levels can drop to normal or even lower. In pregnancy the condition may appear less active, but frequently flares up after delivery. Follow-up with an endocrinologist is advisable to monitor thyroid function and prescribe treatment during and after pregnancy, as needed.

What should be the ideal HbA1C for a diabetic patient?

You should focus on your blood glucose result before breakfast ('fasting'). The target we recommend is between 80 - 120 mg/dL. If you are consistently in this range and you observe READ MORE
You should focus on your blood glucose result before breakfast ('fasting').
The target we recommend is between 80 - 120 mg/dL. If you are consistently in this range and you observe diet guidelines and exercise regularly, your blood glucose level will stay near this range throughout the day. Your hemoglobin A1c (HbA1c) will improve. Targets for HbA1c are 7 % or less. To use nutrition to your advantage in achieving these goals read my book
'A Blueprint for Healthy Eating: Your Diet Guide for the New Millennium.' available through www.mer-llc.com

Is brown rice helpful in controlling diabetes?

Short grain brown rice is preferable for our diet. The amount of rice on our plate should not be more than one cup. Fat in the form of oil or butter (not fried) may be added to READ MORE
Short grain brown rice is preferable for our diet. The amount of rice on our plate should not be more than one cup. Fat in the form of oil or butter (not fried) may be added to make for a smoother glucose response with the meal. The important feature is balance in the meal with the proper proportions: vegetables (1/2 the plate), protein (1/4 plate), 1 cup carbohydrate (rice), 1 cup fruit. For more detail see my book 'A Blueprint for Health Eating: Your Diet Guide for the New Millennium.' available at www.mer-llc.com

When does medication start for diabetes?

Fasting (pre-breakfast) blood glucose levels above 126 mg/dL are diagnostic of diabetes mellitus. You should be making an effort with diet and exercise (and weight reduction) to READ MORE
Fasting (pre-breakfast) blood glucose levels above 126 mg/dL are diagnostic of diabetes mellitus. You should be making an effort with diet and exercise (and weight reduction) to achieve a fasting blood glucose between 80 and 120 mg/dL. If these lifestyle changes are not sufficient in realizing goals, we would begin with medications. Your doctor will decide on the proper time to begin with medication and a selection will be made from many available options depending on your situation.

Do natural remedies help in reversing diabetes type 1?

Type 1 diabetes defines a condition where blood glucose levels rise unchecked because insulin is not being produced by the pancreas. These individuals require insulin injections READ MORE
Type 1 diabetes defines a condition where blood glucose levels rise unchecked because insulin is not being produced by the pancreas. These individuals require insulin injections or transplantation of insulin-producing pancreatic tissue. Some remedies may help in the digestion of meals to make for controlled release of glucose to the circulation. Other supplements may gratify sweet cravings without causing blood glucose surges. They do not cure diabetes mellitus type 1, nor do they replace the need for insulin.

My husband is a diabetic and has been experiencing premature ejaculation. Are the two related?

Diabetes mellitus can damage the delicate nerves and blood vessels involved in providing a normal erection. Signals from the brain delivered through the spinal cord to the penis READ MORE
Diabetes mellitus can damage the delicate nerves and blood vessels involved in providing a normal erection. Signals from the brain delivered through the spinal cord to the penis in response to local stimulation can be scrambled disrupting the sequence of events leading to climax. Medications to improve local blood flow for intercourse, such as pills or injections, may serve to sustain the erection. Improving diabetes control may also prevent further loss of erectile function.

Does insulin cause weight gain?

Insulin is a growth hormone. It stimulates the appetite and it promotes fat deposition among its other activities. In addition, it may cause fluid retention known as 'insulin edema'. READ MORE
Insulin is a growth hormone. It stimulates the appetite and it promotes fat deposition among its other activities. In addition, it may cause fluid retention known as 'insulin edema'. For this reason we emphasize lifestyle and diet change in order to minimize the need for insulin in treating diabetes. Our objective is to maintain the best possible glucose profile using the least amount of insulin possible.

Can my blood pressure be worsening my diabetes?

Many patients with diabetes mellitus have problems with their blood pressure. This feature, together with obesity, high cholesterol and gout, characterizes a condition popularly READ MORE
Many patients with diabetes mellitus have problems with their blood pressure. This feature, together with obesity, high cholesterol and gout, characterizes a condition popularly known as the 'metabolic syndrome'. Stress associated with depression, acute illness, surgery mobilizes hormones that drive up blood glucose and blood pressure. When the familiar profile for a patient's blood pressure or blood glucose is destabilized, it is usually a sign of underlying problems developing (e.g. infection) or side effects of new medications introduced. A careful evaluation by your physician will help identify the problem.

Can yoga be used to treat diabetes?

Diabetes mellitus reflects a disturbance in body rhythm which expresses itself in abnormal blood glucose fluctuation. Yoga emphasizes coordination of breathing and movement in READ MORE
Diabetes mellitus reflects a disturbance in body rhythm which expresses itself in abnormal blood glucose fluctuation. Yoga emphasizes coordination of breathing and movement in its exercises with harmonic background sound. As such it establishes rhythm in our chaotic lifestyle and relaxes mind and body. Our metabolism benefits from such harmony. This form of exercise benefits the patient with diabetes and may serve to improve their glucose profile. Like with any exercise it is important to have expert guidance to select the most appropriate style of yoga, that does not strain the body excessively.

Do medicines lose their effectiveness if taken for a long period of time?

Medications prescribed for diabetes target a variety of organs including the pancreas in order to improve blood glucose levels. If lifestyle changes are not made, the medications READ MORE
Medications prescribed for diabetes target a variety of organs including the pancreas in order to improve blood glucose levels. If lifestyle changes are not made, the medications may either lose their efficacy or higher doses will be required to control blood glucose.

My husband feels very hungry with his diabetic medication. What should I do?

Many diabetes medications stimulate the appetite and promote weight gain and this may prove counterproductive in the management of the problem. In this situation a change to a READ MORE
Many diabetes medications stimulate the appetite and promote weight gain and this may prove counterproductive in the management of the problem. In this situation a change to a medication such as a GLP-1 analogue (Victoza, Trulicity, Byetta, Ozempic) which curbs appetite while reducing blood glucose, may be considered. I prefer to introduce an appetite suppressant such as phentermine, early in the course of management for obese patients with diabetes, knowing that weight loss will solve many of their problems.

My mothers feet are turning black and extremely itchy. What should we do?

Poorly controlled diabetes mellitus can damage the lining of blood vessels and nerves. This can eventually restrict blood flow to the feet, among other areas. Leg cramps can interrupt READ MORE
Poorly controlled diabetes mellitus can damage the lining of blood vessels and nerves. This can eventually restrict blood flow to the feet, among other areas. Leg cramps can interrupt walking. Feet which are poorly perfused can appear more red and shiny than usual. In later stages their color may even turn black, meaning that the tissues are dying (gangrene). Nerve damage is expressed as numbness or unusual sensitivity ("pins and needles," burning), particularly at night. Itching is less frequently reported. Controlling the blood glucose may improve the nerve sensitivity and relieve complaints. There are also specific medications and creams to numb the pain in the feet. Likewise, certain medications can improve the circulation and allow the patient to walk more comfortably.

My husband feels extremely tired and drained out. How can I help him?

Poorly controlled diabetes reflects inefficient fuel processing by the body. Medications are used to restore balance between insulin delivery and body metabolism, but they are READ MORE
Poorly controlled diabetes reflects inefficient fuel processing by the body. Medications are used to restore balance between insulin delivery and body metabolism, but they are not able to do this without the help of proper nutrition and key vitamins and supplements. I use vitamins B, C and D as well as omega 3 and Coenzyme Q10, depending on circumstances, to correct deficiencies and to prevent complications. Your husband should meet with a diabetes specialist to review his situation and decide on the most effective management plan.

How should diabetes be treated in patients who have had it for a long time?

Medication alone will not restore blood glucose control absent lifestyle change. Your mother should speak with a nutritionist about balanced meals. She should also observe my READ MORE
Medication alone will not restore blood glucose control absent lifestyle change. Your mother should speak with a nutritionist about balanced meals. She should also observe my '4 AM - 4 PM' rule that recommends major meals be consumed early in the day when metabolism is most efficient. The evening meal should be very light (e.g., salad). Proper meal planning should permit your mother to have a blood glucose below 140 mg/dL before breakfast and that usually sets the standard for the rest of the day.
For meal planning and diet information, check my website and my book on:
www.mer-llc.com

I am losing muscle fat. Could this be because of an hormonal imbalance?

Body composition (proportion of fat and muscle in the body) is an important qualifier of body weight. Exercise coupled with a balanced diet promotes muscle growth and depletes READ MORE
Body composition (proportion of fat and muscle in the body) is an important qualifier of body weight. Exercise coupled with a balanced diet promotes muscle growth and depletes fat stores to meet energy requirements. It is important to have essential nutrients in the diet to grow muscle. Hormones such as insulin , steroids and thyroxine all play a role in metabolism and should be checked through special testing to ensure that they are adequate to promote muscle growth.

How does Glycomet SR help in losing weight?

Glycomet SR is a slow release form of metformin , a chemical used as medication that targets metabolic activity in the liver. The liver is responsible for processing nutrients READ MORE
Glycomet SR is a slow release form of metformin , a chemical used as medication that targets metabolic activity in the liver. The liver is responsible for processing nutrients absorbed from the intestine and producing fat and protein. It also stores glucose for future release to meet short-term energy requirements. The liver's pivotal role in energy balance in the body can be destabilized by hormonal deficiencies among other factors. It's cells can also become insensitive to hormonal messages. Metformin has the ability to restore the sensitivity of liver cells to hormonal messages and improve their function. This impacts energy balance in the body normalizing glucose levels and lipid levels among other benefits. When nutrients are used efficiently in energy production rather than being stored inappropriately, weight loss is realized.