Dr. Marvin A. Leder

Yes, diabetes may cause erectile dysfunction due to vascular and neurological involvement of male genitalia. Good control of diabetes, weight, blood pressure, and lipids are essential in preventing or limiting this complication. It is also important to review medications being taken for other diseases to make sure they are not contributing to the impotence. Loss of desire (libido) can be caused by low testosterone levels, chronic disease, anxiety, or depression, which should be addressed. Testosterone levels are done at labs. Usually, a combination of testosterone and viagra are helpful in restoring potency. It is a difficult problem.

Marvin A. Leder, MD, FACP, FACE

Yes, people who had gestational diabetes are at greater risk of developing type 2 diabetes following their pregnancy. To avoid that consequence, weight control is most important using a plant-based, low-carb, low-fat diet. Exercise is also helpful in weight control.

Marvin A. Leder, MD, FACP, FACE

No, natural remedies do not reverse type 1diabetes.

Respectfully,

Marvin A. Leder, MD

Dear Patient,

Very good question, asked many times. Bottom line is, brown rice has fiber surrounding grain (not processed), which is different than white rice. This causes a slower rate of digestion and absorption of the carbohydrate in it and can lead to lower levels of blood sugar after eating. This is known as a lower glycemic index food. It is important to note that each 1/2 cup rice (brown or white) is 20 grams of carbohydrates and this must be integrated into daily total carb intake of about 130 grams per day for good control of diabetes and weight. Dietary fiber has many health benefits involving cardiovascular system and gastrointestinal tract.

Respectfully,

M. Leder, MD, FACP, FACE

Yes, Yoga is good. Any exercise that increases muscle activity will improve the uptake of glucose from the blood stream and lower the sugar, but also make sure you are following a plant-based diet low in carbs and saturated fat.

Respectfully,

Marvin A. Leder, MD, FACP, FACE

Dear wife,

It is not possible to answer this question without knowing patient, exam, labs, and meds. He should be seen by his physician and be evaluated; this would include good history, physical exa , review of labs, and meds. I am not a believer in supplements except as replacement for deficiencies. If he is on metformin, checking b12 is important; I use vitamin d to be sure bones are strong in diabetics. If nutrition is a problem, Glucerna may be helpful. Only your physician can answer these questions.

Best wishes,

Marvin A. Leder, MD, FACP, FACE

Seems as if you have a regular workout routine that probably includes weightlifting, which will build muscle as a normal consequence and is not an endocrine problem. However, weight loss is a manifestation of many endocrine problems including uncontrolled diabetes, hyperthyroidism, adrenal insufficiency, and many non-endocrine diseases. A medical evaluation should be done if you are concerned that there is more going on than exercise-related muscle changes.

Respectfully,

Marvin A. Leder, MD, FACP, FACE

Type 1 diabetes is an autoimmune disease; the body produces a protein called an antibody, which then can destroy the insulin producing Beta Cells of the pancreas. There is in people with type 1 diabetes chromosomal gene changes, which increase the ability of the antibodies produced in the auto immune process to destroy the insulin producing Beta Cells. Type 2 diabetes is not due to an auto immune process. Type 2 diabetes is usually related to the effect of obesity in bringing out the genetic tendencies inherited such as insulin tissue resistance in the presence of a reduction in the ability of the Beta Cells of the pancreas to produce insulin raising the blood sugar. It is very complicated.

Marvin A Leder, MD FACP FACE

Dear Patient:

Best of luck with your pregnancy.
It is very important for you to keep your sugar levels under good control. High sugars cross the placenta and the fetal pancreas responds by producing more insulin which causes the baby to gain weight. In the overweight baby this can lead to insulin resistance, high sugars and eventually diabetes.
Future development of diabetes in the child is also affected by the genetic contribution of the parents.
So, gestational diabetes is very complex when it comes to fetal growth and development. Bottomline, for your infant's good your sugars should be well controlled.

Respectfully,
Marvin A. Leder, MD, FACP, FACE

Type 1 diabetes is insulin dependent diabetes which means that due to an autoimmune process in the body the pancreatic beta cells which produce insulin is destroyed and no longer can produce insulin. These people present with excess urination, thirst, weight loss, nausea, vomiting and are quite ill. They may present with diabetic ketoacidosis, which is a severe illness requiring hospitalization. Most of time, type 1 presents in childhood or adolescence but may occur at any age. their blood work can show antibodies to the beta cell and to insulin. This is a biomarker that may be used to discover these folks early prior to the eruption of the full disease.

Type 2 diabetes is due to insulin resistance and eventual beta cell failure. These people have high insulin levels on presentation and are generally obese. Their tissues are insensitive to their insulin and the beta cells must produce insulin at a high rate to prevent the development of diabetes. They are mostly obese, may have high blood pressure, high waist to hip ratio, elevated triglycerides, low HDL and urine protein. Prior to the development of diabetes in theses people their fasting sugars may be between 100 and 125; normal fasting is below 100. Two hours after eating their sugars may range from above 140 to 199. Diabetes is diagnosed when fasting sugar is 126 or over or the two hour after eating sugar aboive 200.
As the diabetes in type 2 disease progresses the beta cell stops producing insulin and these people require insulin for treatment. Prior to that time oral agents are used to treat as well as lifestyle changes which includes low carb, low-fat diets for weight loss and exercise to at least 150 minutes a week. In pre-diabetes, these lifestyle changes may delay the onset of diabetes and the eventual development of the many complications of the disease.

It is very important to treat both type 1 and 2 early in the disease to reduce the rate of complications. As part of treatment program attention is paid not only to the blood sugar but to treatment of high blood pressure, cholesterol, overweight or obesity and to cessation of smoking.

Small amounts of Stevia are safe to use in diabetes; they can assist in sugar metabolism; however, it is safest to limit its use and avoid the sweet tooth feeling which can lead to excess use and weight gain

It means that the diabetes is well-controlled by either lifestyle changes such as diet and exercise or medications.

AM sugars reflect overnight production of sugar by the liver, which is dependent on the degree of insulin resistance present in the patient. AM sugars also reflect the quantity of carbs eaten for dinner as well as the time dinner was eaten, and it also reflects medications taken to control sugars. It is a complex problem that requires careful analysis and treatment.