On Tuesday evening, February 9, the Navigating the Medical System Lecture Series featured a virtual lecture on diabetes and diabetes prevention. Dr. Mel Breite, Founder and Director of the Navigating the Medical System Lecture Series, introduced the speaker, Josef Tibaldi, MD, FACP, FACE, Chief of Endocrinology at NewYork-Presbyterian Hospital Queens. The lecture series is hosted by Congregation Etz Chaim of Kew Gardens Hills.

Dr. Tibaldi shared a detailed lecture. He began by explaining that diabetes is a metabolic disease, where the body has an inability to produce any or enough insulin, and this causes elevated levels of glucose in the bloodstream. He shared that there are four types of diabetes: Type 1, Type 2, gestational, and prediabetes. One person out of three will develop diabetes.

Type 1 diabetes usually occurs in children and young adults. Today, this is found to be occurring in older adults, too. Five percent of people have it. This is where the body doesn’t produce insulin. The causes are genetic or possibly a virus triggers it. The COVID-19 pandemic is increasing the cases of diabetes.

Type 2 is more common – 90 percent of all cases of diabetes are Type 2. In type 2 diabetes, the body doesn’t process insulin properly. Glucose doesn’t move into the cells and it piles up in the bloodstream. Symptoms include feeling very thirsty, urinating a lot, and eating a lot while still losing weight. This can develop at any age.

Today, many more young people are developing type 2 diabetes. Risk factors include: family history, polycystic ovary syndrome, obesity, race (more common in African Americans, Hispanics, and Asians), and age (over 45), and environmental factors like inactivity and weight gain.

Gestational diabetes occurs during pregnancy and disappears after childbirth. The baby is at risk for type 2 diabetes. Women take a glucose test at 24 weeks during pregnancy to test for this. Risk factors include prior gestational diabetes. It puts the baby at risk if it is not diagnosed and treated.

Complications for uncontrolled diabetes include kidney damage, damage to eyes, nerves, blood vessels, heart disease, stroke, and need for amputation. Dr. Tibaldi stated that patients age 40 and up with diabetes need to go on a statin to reduce the risk of heart disease, vascular disease, and stroke.

He shared that type 1 diabetes is not preventable. To maintain a healthy sugar level with type 1 diabetes, you need insulin, exercise, and a healthy diet. There is experimental work being done now with islet transplants.

In gestational diabetes, physical exercise and a high fiber diet reduces GDM (gestational diabetes mellitus). He shared a study on the prevention of type 2 diabetes. In the study of 4,000 people who were at high risk, five to seven percent walked briskly for 30 minutes, five times a week, and this reduced instances of diabetes by 58 percent.

Next, he taught that metformin works only on obese individuals. It reduces the risk of cancer and dementia. Also, it can lower your B12 levels and this can be rectified with vitamin supplements.

He shared that it is important to maintain a healthy lifestyle. Check A1C levels. Measure the percent of hemoglobin coated with sugar. You should screen for prediabetes. A1C 5.7%-6.4%. A higher number means a higher risk for diabetes. 6.5% and up is diabetes.

To prevent diabetes, he imparted that it’s important to exercise as much as possible. Treat hypertension and cholesterol. He said, “Everyone on diabetes medicine should be on cholesterol medicine. Also, they should have regular foot and eye exams. The foot exam is imperative to check for nerve damage and circulation problems. A yearly eye exam is necessary to prevent blindness. In the USA, 29 million people have diabetes, which is one out of 11. It is a very common disease; it affects 9.3% of the population. Many have it and go undiagnosed. We all have risk factors. The A1C test can help with this.

He noted that African American females have the highest incidence of diabetes. Dr. Tibaldi urged everyone to prevent weight gain. Every time you exercise you burn up fatty acids. The cost of diabetes is $245 billion.

He reviewed ways to prevent diabetes. Try to lose weight, eat healthfully, exercise. If you have diabetes, you should join the American Diabetes Association. With diabetes, there is a five percent higher chance of dying, so medical insurance is higher. Globally there is a 200 million person increase in diabetes. There is a need to educate people about it.

Dr. Breite then announced that Councilman Jim Gennaro was on the Zoom and that he had been instrumental in helping Dr. Breite found the Navigating the Medical System Lecture Series a decade ago.

Following this, newly re-elected Councilman Jim Gennaro spoke. He thanked Dr. Breite for the program. He shared that his wife died five years ago and he was her caretaker for eight years. He emphasized the importance of informative medical programs like this for the community. “Thank you for your good wishes and support. I look forward to serving the community in any way that I can.”

By Susie Garber