EXPERT
Dr. Marvin A. Leder
Endocrinology-Diabetes
Dr. Marvin Leder practices Endocrinology in Forest Hills, NY. Dr. Leder 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. Leder examines patients, determines means of testing, diagnoses, and decides the best treatment methods.
Dr. Marvin A. Leder
- Rego Park, NY
- State University of New York Upstate College of Medicine
- Accepting new patients
Cardiovascular Outcomes in Type 2 Diabetes
It is known that strokes and heart attacks occur 2 to 4 times as frequently in diabetics than in non diabetics. An article that appeared in an August 8, 2018 edition of the New...
Sweetener Situation?
Dear Patient,
Erithritol is a sugar alcohol and causes bloating: I could not find any study that would support increasing doses to avoid complications and therefore unable READ MORE
Dear Patient,
Erithritol is a sugar alcohol and causes bloating: I could not find any study that would support increasing doses to avoid complications and therefore unable to support your desire to slowly desensitize yourself to side effects. I would avoid sweeteners in general as they may lead to an increase in sugar intake as well as syrupy sugar drinks, which can cause obesity, elevated triglycerides as well as fatty liver.
Respectfully,
Marvin A. Leder, MD FACP FACE
Erithritol is a sugar alcohol and causes bloating: I could not find any study that would support increasing doses to avoid complications and therefore unable to support your desire to slowly desensitize yourself to side effects. I would avoid sweeteners in general as they may lead to an increase in sugar intake as well as syrupy sugar drinks, which can cause obesity, elevated triglycerides as well as fatty liver.
Respectfully,
Marvin A. Leder, MD FACP FACE
Am I pre-diabetic?
Dear patient,
Based upon the classification of normal sugar 70 to 99, pre-diabetes fasting sugar 100 to 125, diabetes fasting sugar 126 or higher you are pre diabetic. I don't READ MORE
Dear patient,
Based upon the classification of normal sugar 70 to 99, pre-diabetes fasting sugar 100 to 125, diabetes fasting sugar 126 or higher you are pre diabetic. I don't know your body mass index, family history or meds for MS. These should be reviewed. Pre-diabetes should be treated with weight loss as needed and sometimes meds. Special attention to blood pressure and lipids should be paid.Many diabetic complications occur during this.
Respectfully,
Marvin A. Leder, MD FACP FACE
Based upon the classification of normal sugar 70 to 99, pre-diabetes fasting sugar 100 to 125, diabetes fasting sugar 126 or higher you are pre diabetic. I don't know your body mass index, family history or meds for MS. These should be reviewed. Pre-diabetes should be treated with weight loss as needed and sometimes meds. Special attention to blood pressure and lipids should be paid.Many diabetic complications occur during this.
Respectfully,
Marvin A. Leder, MD FACP FACE
How many units can I take of insulin?
Dear patient,
Lantus and Lispro insulins are not interchangeable. Lantus is long acting over a period of 16 to 24 hours depending on dosage, and Lispro is short acting and READ MORE
Dear patient,
Lantus and Lispro insulins are not interchangeable. Lantus is long acting over a period of 16 to 24 hours depending on dosage, and Lispro is short acting and usually used 30 minutes before meals. You should speak to your physician as he will be best able to help you as he knows your condition and other meds.
Respectfully,
Marvin A. Leder, MD FACP FACE
Lantus and Lispro insulins are not interchangeable. Lantus is long acting over a period of 16 to 24 hours depending on dosage, and Lispro is short acting and usually used 30 minutes before meals. You should speak to your physician as he will be best able to help you as he knows your condition and other meds.
Respectfully,
Marvin A. Leder, MD FACP FACE
My child is 5'4.2" and he's 14, what can I do?
Dear patient,
I believe nutrition affects height in childhood as protein intake is most important. At this age, if there are no other medical or endocrine factors, he may be READ MORE
Dear patient,
I believe nutrition affects height in childhood as protein intake is most important. At this age, if there are no other medical or endocrine factors, he may be a candidate for Human Growth Hormone treatment. Please discuss with your physician.
Respectfully,
Marvin A. Leder, MD FACP FACE
I believe nutrition affects height in childhood as protein intake is most important. At this age, if there are no other medical or endocrine factors, he may be a candidate for Human Growth Hormone treatment. Please discuss with your physician.
Respectfully,
Marvin A. Leder, MD FACP FACE
Can too much sugar cause problems?
Dear Patient,
If you do not have diabetes, or a family history of diabetes or cardiovascular disease and are not obese, then the sugar and sugar drinks can only cause overweight READ MORE
Dear Patient,
If you do not have diabetes, or a family history of diabetes or cardiovascular disease and are not obese, then the sugar and sugar drinks can only cause overweight and fatty liver. If you are diabetic or overweight, then the excess sugar and sugary syrup drinks can cause more overweight, insulin resistance, fatty liver and increased blood fat, and cardiovascular disease. In general, it is best to avoid sugary drinks and large amounts of table sugar as they contain fructose, which can cause fat to accumulate in the liver as well as blood fat abnormalities.
Respectfully,
Marvin A. Leder, MD FACP FACE
If you do not have diabetes, or a family history of diabetes or cardiovascular disease and are not obese, then the sugar and sugar drinks can only cause overweight and fatty liver. If you are diabetic or overweight, then the excess sugar and sugary syrup drinks can cause more overweight, insulin resistance, fatty liver and increased blood fat, and cardiovascular disease. In general, it is best to avoid sugary drinks and large amounts of table sugar as they contain fructose, which can cause fat to accumulate in the liver as well as blood fat abnormalities.
Respectfully,
Marvin A. Leder, MD FACP FACE
Is it safe to now take Pfizer or Moderna vaccinations after taking Novavax?
Dear patient,
Novavax had excellent efficacy in its studies. You took it over 8 months ago. The Pfizer vaccine showed loss of effectiveness after 6 months. I don’t know about READ MORE
Dear patient,
Novavax had excellent efficacy in its studies. You took it over 8 months ago. The Pfizer vaccine showed loss of effectiveness after 6 months. I don’t know about effectiveness of Novavax at that time. I would call the CDC directly as they have a hot line. I suspect that you should get Pfizer or Moderna prior to travel, considering comorbidities.
Respectfully,
Marvin A. Leder, MD FACP FACE
Novavax had excellent efficacy in its studies. You took it over 8 months ago. The Pfizer vaccine showed loss of effectiveness after 6 months. I don’t know about effectiveness of Novavax at that time. I would call the CDC directly as they have a hot line. I suspect that you should get Pfizer or Moderna prior to travel, considering comorbidities.
Respectfully,
Marvin A. Leder, MD FACP FACE
Blood test shows Low Deoxycorticosterone?
Deoxycorticosterone is a precursor in adrenal steroid metabolism, which leads to production of aldosterone which are in normal range in you. This reaction may be blocked by specific READ MORE
Deoxycorticosterone is a precursor in adrenal steroid metabolism, which leads to production of aldosterone which are in normal range in you. This reaction may be blocked by specific enzyme deficiencies, however, normal cortisol and aldosterone do not support that diagnosis. Excess male hormone can occur with adrenal enzyme defects. I don’t think fatigue is part of this clinal entity and I would not do any further evaluation if vital signs and physical exam are normal. Depending on clinical picture I would probably repeat the aldosterone, cortisol and androgens (male hormones) in six months. Further study would be by endocrinologist.
Marvin A. Leder, MD FACP FACE
Marvin A. Leder, MD FACP FACE
Is anesthesia safe for diabetics?
Yes anesthesia is safe but as diabetics may have cardiovascular or kidney issues these must be stabilized pre op. Also glucose control must be good to prevent swings in blood sugar READ MORE
Yes anesthesia is safe but as diabetics may have cardiovascular or kidney issues these must be stabilized pre op. Also glucose control must be good to prevent swings in blood sugar and problems associated with that issue.
Respectfully
Marvin A Leder MD FACP FACE
Respectfully
Marvin A Leder MD FACP FACE
Hormonal imbalance?
Dear Patient,
Respiridone can cause increased appetite and weight gain, but not acne or arrhythmia. Please discuss these symptoms with your physician.
Respectfully,
Marvin READ MORE
Dear Patient,
Respiridone can cause increased appetite and weight gain, but not acne or arrhythmia. Please discuss these symptoms with your physician.
Respectfully,
Marvin A. Leder, MD FACP FACE
Respiridone can cause increased appetite and weight gain, but not acne or arrhythmia. Please discuss these symptoms with your physician.
Respectfully,
Marvin A. Leder, MD FACP FACE
Why a massive rise in blood sugar level?
Dear Patient,
A sugar level of 94 is perfectly normal, although I do not know meaning of shielding in your question. The level of 36 was low and dangerous and was done in Oct READ MORE
Dear Patient,
A sugar level of 94 is perfectly normal, although I do not know meaning of shielding in your question. The level of 36 was low and dangerous and was done in Oct 2020. Your question is being responded to August 26, 2021. I don't know if that was a fasting sugar or post-eating, but if you did not miss a meal, do strenuous exercise, or take extra diabetic meds, you need to be reevaluated as to diet and medications to prevent low sugars. High sugars can be caused by overeating carbs, overweight, onset of acute stress illness, and inadequate meds.
Respectfully,
Marvin A. Leder, MD FACP FACE
A sugar level of 94 is perfectly normal, although I do not know meaning of shielding in your question. The level of 36 was low and dangerous and was done in Oct 2020. Your question is being responded to August 26, 2021. I don't know if that was a fasting sugar or post-eating, but if you did not miss a meal, do strenuous exercise, or take extra diabetic meds, you need to be reevaluated as to diet and medications to prevent low sugars. High sugars can be caused by overeating carbs, overweight, onset of acute stress illness, and inadequate meds.
Respectfully,
Marvin A. Leder, MD FACP FACE
My daughter takes insulin daily?
Dear Patient,
Only side effect of todays insulin preparations is low sugar (hypoglycemia). Insulin is the key to managing type 1 diabetes, which I assume your daughter has. READ MORE
Dear Patient,
Only side effect of todays insulin preparations is low sugar (hypoglycemia). Insulin is the key to managing type 1 diabetes, which I assume your daughter has. Good sugar management will prevent or slow down the major complications of diabetes including kidney disease, visual problems, neuropathies as well as cardiovascular defects. It is the treatment of choice and has helped many children achieve a normal adulthood including pregnancies. Learn the keys to preventing low sugar such not as missing meals, preventing exercise induced hypoglycemia and proper insulin dosage.
Respectfully,
Marvin A. Leder, MD FACP FACE
Only side effect of todays insulin preparations is low sugar (hypoglycemia). Insulin is the key to managing type 1 diabetes, which I assume your daughter has. Good sugar management will prevent or slow down the major complications of diabetes including kidney disease, visual problems, neuropathies as well as cardiovascular defects. It is the treatment of choice and has helped many children achieve a normal adulthood including pregnancies. Learn the keys to preventing low sugar such not as missing meals, preventing exercise induced hypoglycemia and proper insulin dosage.
Respectfully,
Marvin A. Leder, MD FACP FACE
Experiencing tightness and heaviness on the left side of my body?
Dear Patent,
Left-sided chest pain can be a serious condition associated with heart disease as well as less serious illnesses associated with gastrointestinal disorders, lung READ MORE
Dear Patent,
Left-sided chest pain can be a serious condition associated with heart disease as well as less serious illnesses associated with gastrointestinal disorders, lung diseases and musculoskeletal disorder. Its occurrence after eating is suggestive of an esophageal disorder. Being diabetic and having high blood pressure are risk factors for cardiovascular disease. Please see your doctor as soon as possible for a proper evaluation of these symptoms.
Respectfully,
Marvin A. Leder, MD FACP FACE
Left-sided chest pain can be a serious condition associated with heart disease as well as less serious illnesses associated with gastrointestinal disorders, lung diseases and musculoskeletal disorder. Its occurrence after eating is suggestive of an esophageal disorder. Being diabetic and having high blood pressure are risk factors for cardiovascular disease. Please see your doctor as soon as possible for a proper evaluation of these symptoms.
Respectfully,
Marvin A. Leder, MD FACP FACE
Reactive Hypoglycemia and my period?
Dear Patient,
The treatment of reactive hypoglycemia requires the reduction at meals of sugary foods and starches such as white bread, pasta, juices and use between meals of READ MORE
Dear Patient,
The treatment of reactive hypoglycemia requires the reduction at meals of sugary foods and starches such as white bread, pasta, juices and use between meals of high protein snacks like cheeses to reduce insulin spikes. I like patients to reduce meal time carbs to 15 grams. Berberine has not been studied enough in the United States. A study I saw on the internet suggested it could lower sugars, so I would not use it.
Respectfully,
Marvin A. Leder, MD FACP FACE
The treatment of reactive hypoglycemia requires the reduction at meals of sugary foods and starches such as white bread, pasta, juices and use between meals of high protein snacks like cheeses to reduce insulin spikes. I like patients to reduce meal time carbs to 15 grams. Berberine has not been studied enough in the United States. A study I saw on the internet suggested it could lower sugars, so I would not use it.
Respectfully,
Marvin A. Leder, MD FACP FACE
I only want to lose belly fat, is there a way or solution?
Belly fat usually reflects insulin resistance or hypercortisolism. Both are metabolic disorders which require elimination from diet of sugary foods and starch. Exercise helps, READ MORE
Belly fat usually reflects insulin resistance or hypercortisolism. Both are metabolic disorders which require elimination from diet of sugary foods and starch. Exercise helps, but only with diet.
Respectfully,
Marvin A. Leder, MD FACP FACE
Respectfully,
Marvin A. Leder, MD FACP FACE
16 weeks pregnant TSH 23...next steps?
Dear Patient,
Absolutely see an endocrinologist as a tsh of 0.23 is consistent in the second trimester with hyperthyroidism. In the first trimester, the hormone Human Chorionic READ MORE
Dear Patient,
Absolutely see an endocrinologist as a tsh of 0.23 is consistent in the second trimester with hyperthyroidism. In the first trimester, the hormone Human Chorionic Gonadotropin can affect thyroid lowering tsh, but this should resolve by second trimester of pregnancy. Yes, hyperthyroidism can have adverse effects on both mother and baby such as causing high blood pressure, pre eclampsia, early delivery, as well as low birthweight babies. It is treated with antithyroid meds.
Respectfully,
Marvin A. Leder, MD FACP FACE
Absolutely see an endocrinologist as a tsh of 0.23 is consistent in the second trimester with hyperthyroidism. In the first trimester, the hormone Human Chorionic Gonadotropin can affect thyroid lowering tsh, but this should resolve by second trimester of pregnancy. Yes, hyperthyroidism can have adverse effects on both mother and baby such as causing high blood pressure, pre eclampsia, early delivery, as well as low birthweight babies. It is treated with antithyroid meds.
Respectfully,
Marvin A. Leder, MD FACP FACE
What does this rash (On back of neck) mean?
Dear Patient,
There is a rash associated with type 2 diabetes called Acanthosis Nigricans, which can present on the neck. You do not mention family history of diabetes, although READ MORE
Dear Patient,
There is a rash associated with type 2 diabetes called Acanthosis Nigricans, which can present on the neck. You do not mention family history of diabetes, although you mention weight gain. You should see a dermatologist as well as do blood work for diabetes.
Respectfully,
Marvin A. Leder, MD FACP FACE
There is a rash associated with type 2 diabetes called Acanthosis Nigricans, which can present on the neck. You do not mention family history of diabetes, although you mention weight gain. You should see a dermatologist as well as do blood work for diabetes.
Respectfully,
Marvin A. Leder, MD FACP FACE
I have sharp pain in my stomach?
You should be evaluated; if no response in several days or even now, see gastroenterologist. Abdominal pain can be due to multiple causes including ulcers, gastritis, gallstones, READ MORE
You should be evaluated; if no response in several days or even now, see gastroenterologist. Abdominal pain can be due to multiple causes including ulcers, gastritis, gallstones, kidney stones, diverticulitis, intestinal obstruction or disease of the genitourinary system. Gastropatrsis due to diabetes usually doesn’t cause acute, severe pain.
Respectfully,
Marvin A. Leder, MD FACP FACE
Respectfully,
Marvin A. Leder, MD FACP FACE
Diabetes blood test different meter answers?
Dear Patient,
There is a variability of 15 % of sugar values in each machine provided all proper supplies used as stated. The 109 and 123 value are a bit off the usual mark. READ MORE
Dear Patient,
There is a variability of 15 % of sugar values in each machine provided all proper supplies used as stated. The 109 and 123 value are a bit off the usual mark. I have asked patients to bring machine to office and test venous blood against glucometer value. This is usually a value of 15% or less and generally does not interfere with treatment choices.
Respectfully,
Marvin A. Leder, MD FACP FACE
There is a variability of 15 % of sugar values in each machine provided all proper supplies used as stated. The 109 and 123 value are a bit off the usual mark. I have asked patients to bring machine to office and test venous blood against glucometer value. This is usually a value of 15% or less and generally does not interfere with treatment choices.
Respectfully,
Marvin A. Leder, MD FACP FACE
Blood pressure vs low potassium problem?
Dear Patient,
The hydrochlorthiazide you are taking can lower potassium. If potassium supplements are not helping, then there are two classes of drugs that decrease blood pressure READ MORE
Dear Patient,
The hydrochlorthiazide you are taking can lower potassium. If potassium supplements are not helping, then there are two classes of drugs that decrease blood pressure and block the loss of potassium by blocking Aldosterone secretion and its receptors. There are the ACE InhIbitors and the angioTensin enzyme inhibitors and Angiotensin receptor blockers. They are monitored with blood work to make sure potassium is not elevated. The Amlodipine, while a good blood pressure lowering drug, can cause ankle edema.
Respectfully,
Marvin A. Leder, MDFACP FACE
The hydrochlorthiazide you are taking can lower potassium. If potassium supplements are not helping, then there are two classes of drugs that decrease blood pressure and block the loss of potassium by blocking Aldosterone secretion and its receptors. There are the ACE InhIbitors and the angioTensin enzyme inhibitors and Angiotensin receptor blockers. They are monitored with blood work to make sure potassium is not elevated. The Amlodipine, while a good blood pressure lowering drug, can cause ankle edema.
Respectfully,
Marvin A. Leder, MDFACP FACE
Is hyperthyroidism a genetic condition?
Dear Patient,
About 2% of hyperthyroidism is due to genetics. Graves disease an autoimmune disease is most common cause of hyperthyroidism. It may also occur as part of Hashimotos, READ MORE
Dear Patient,
About 2% of hyperthyroidism is due to genetics. Graves disease an autoimmune disease is most common cause of hyperthyroidism. It may also occur as part of Hashimotos, another autoimmune disorder. Other causes include excess iodine intake, use of meds such as Amiodarone, and, rarely, pituitary disorders.
Respectfully,
Marvin A. Leder, MD FACP FACE
About 2% of hyperthyroidism is due to genetics. Graves disease an autoimmune disease is most common cause of hyperthyroidism. It may also occur as part of Hashimotos, another autoimmune disorder. Other causes include excess iodine intake, use of meds such as Amiodarone, and, rarely, pituitary disorders.
Respectfully,
Marvin A. Leder, MD FACP FACE
