Endocrinology Center: Diabetes
The Diabetes Center at Mercy, a division of The Center for Endocrinology at Mercy, provides comprehensive diabetes management services including diagnosis, treatment, education and support for diabetes and related disorders. The Center offers patients on-site, point of care A1C testing, seven-day continuous glucose monitoring, and a nationally recognized education program. It is important to have the tools, skills, and information necessary to make the best choices for managing diabetes. At The Diabetes Center at Mercy, a team of physicians, nurse educators, and nutritionists is dedicated to providing patients with the most current information and compassionate care.
Although there is no cure, diabetes is treatable and able to be controlled. The Diabetes Center at Mercy specializes in personal, team-oriented treatment plans that focus on helping patients and their families manage diabetes. When patients understand how blood sugar, medication, diet, and exercise interact, they can better understand how to care for themselves.
It is important to diagnose diabetes early and properly treat all types of diabetes. The Diabetes Center helps patients control their blood glucose levels to reduce the chance of chronic complications. By providing individualized nutrition information, patients learn how to choose the right foods at the right time. The Diabetes Educators work with patients to:
- Identify any needed lifestyle and behavior changes
- Identify food likes and dislikes and design a meal plan
- Understand pattern management of blood sugar
- Help patients manage special occasions while still maintaining good blood sugar control
- Implement changes gradually and successfully
Research has shown that diabetes complications can be prevented. Working with Mercy's Diabetes Team, patients can have the benefits of:
- Near normal blood glucose levels
- Blood pressure and lipid control
- Education in self management skills
- Frequent screening for complications
- Access to the most cutting-edge technology and new treatments
Through teamwork, education, and commitment to community awareness, The Diabetes Center can significantly reduce the burden of diabetes in patients' lives.
The following external links are provided for your convenience:
Continuous Glucose Monitoring System
The Diabetes Center at Mercy offers the Continuous Glucose Monitoring System (CGMS), an FDA approved device that continuously records glucose levels throughout the day. The data collected is downloaded to an external computer for analysis at The Diabetes Center at Mercy.
The process works in four simple steps:
- A tiny sensor is inserted just beneath the skin of the abdomen.
- A wire connects the sensor to a monitor, which is the size of a regular pager, that can be worn up to 72 hours. The system can record a glucose measurement every five minutes. Fingerstick blood glucose readings are entered into the monitor for calibration. A diary of food eaten and medication taken is also entered as data.
- While wearing the sensor, people with diabetes push simple buttons on the monitor to mark the time of meals, exercise, or any other events that should be remembered.
- After three days, the sensor is removed and the data is downloaded to obtain a graph that shows a complete look at where glucose levels have been and identify areas of improvement needed.
The CGMS can, for the first time, show a person with diabetes exactly what is happening between fingersticks. The detailed computer graph shows what really happens during sleep, exercise, or when taking medication. The CGMS can take 288 blood sugar readings a day by monitoring levels every 11 seconds and averaging them every five minutes.
The Diabetes Center at Mercy provides Diabetes Self-Management Skills and Education and Training based on National Standards for Diabetes Self-Management Education Programs.
The team at The Diabetes Center provides:
- Assessments of the knowledge, understanding, and skills of diabetes management
- Assessments of health beliefs, cultural influences, learning styles, and lifestyles
- Individualized education plans based on principles of teaching-learning theory
- Documentation of the process
- Evaluations based on outcome criteria
- Plans for follow-up and ongoing education
The dedicated Diabetes Educators provide:
- Basic diabetes pathophysiology and management (what the condition is and how it is treated)
- Nutritional management and meal planning
- Pharmacological interventions (medications for treatment)
- Benefit of exercise and activity plans
- Self-monitoring of glycemic control
- Prevention and management of complications, both acute and chronic
- Psychosocial adjustment (dealing with diabetes in a patient's life)
- Problem-solving skills and management of behavioral changes
- Stress management
The earlier diabetes is detected, the more likely a patient is to successfully manage the disease and lead a normal, healthy life. Patients should be tested for diabetes if they:
- Are overweight
- Don't exercise regularly
- Have a family history of diabetes
- Have high blood pressure
- Feel overly tired
- Are always thirsty
- Are losing weight without trying
- Are age 45 or older
- Are a woman who has given birth to a baby weighing more than 9 pounds
Causes that amount for only a very small percentage of all diabetes include:
- Traumas (for example - an auto accident severely injuring the pancreas)
- Cancer necessitating the removal of the pancreas
- Certain medications such as steroids and chemotherapy medications
- Other endocrine diseases
Take the American Diabetes Association Type 2 Diabetes Risk Test to find out if you are at risk.
Types of Diabetes
The Diabetes Center at Mercy treats the different types of diabetes: Type 1, Type 2, and gestational diabetes.
Type 1 diabetes is when the auto-immune system causes the destruction of insulin producing cells (beta cells) in the pancreas. It is usually diagnosed under the age of 30 and its incidence rate is highest in ages 12-14, but it can happen at any age. People do not do anything to get the disease and it is not contagious. Although research points to hereditary factors being involved with developing this type of diabetes, frequently there is no known family history.
A person developing Type 1 diabetes will usually experience a sudden onset of classic diabetes symptoms:
- Frequent thirst (polydypsia)
- Frequent urination (polyuria)
- Excessive hunger (polyphagia)
- Unexpected weight loss
- Fruity smelling breath
These symptoms may lead to nausea, vomiting, and a serious condition called ketoacidosis.
Type 2 diabetes occurs in people who for a variety of reasons have experienced a decreased insulin sensitivity or decreased insulin production or both. With Type 2, a family history is usually present and African Americans, Hispanic, Pacific Islanders and Native Americans are at greatest risk. Type 2 diabetes is being found in children as young as 10 years of age due to the growing problems of obesity and sedentary lifestyle.
Frequently with Type 2 diabetes, symptoms do not appear for years. Risk factors that put some people at more risk are:
- Increased weight
- Family history of diabetes
- History of gestational diabetes or of a having a baby over 9 pounds at birth
- High blood pressure
- High risk ethnic groups
- Increased age
People with Type 2 diabetes are treated with diet, oral medications, and/or insulin.
Gestational diabetes is a special type of diabetes that develops during a pregnancy and usually disappears after the baby is born. However, these women are at a high risk for developing Type 2 diabetes later in life.
Risks for gestational diabetes include:
- Increased weight
- Family history of diabetes
- High risk ethnic groups (African American, Hispanic, Pacific Islander and Native American)
- Having had a previous child who weighed over 9 pounds at birth
- Increased age at time of pregnancy
The team at The Diabetes Center at Mercy works closely with Mercy's Department of Obstetrics and Gynecology to provide resources for mothers-to-be with gestational diabetes.
High Blood Glucose
High blood glucose, also called hyperglycemia, is toxic and can lead to the following:
- Heart disease - Increase in stickiness of blood clogs blood vessels leading to a predisposition to coronary heart disease and/or a fatal heart attack.
- Kidney failure - High blood glucose levels damage kidneys, which then can no longer process waste leading to kidney failure, dialysis, and possibly the need for a kidney transplant. Urine protein tests (urine microalbumin) should be taken each year. This test is an early marker for kidney damage while it still can be reversed.
- Neuropathy (nerve damage) - Patients could loose sensation in their extremities, like hands and feet, leading to injury, infection and even amputation. Physicians should examine patients' feet at every diabetes visit for pulses (circulation) and sensation. It is also possible to have nerve damage in other areas such as the urinary tract and stomach/gastrointestinal system.
- Erectile dysfunction (impotence) - Frequently caused by damage to the nerves and circulatory systems. Improved glucose control can sometimes help this condition resolve.
- Eye damage - Delicate blood vessels in the retina (the eye's back surface) can be damaged permanently causing blood or other fluids to leak which can cause blindness. Exerting aggressive control over blood sugar levels can reverse blurred vision that sometimes occurs with the onset of diabetes. When damage is done, laser treatments can help prevent blindness.
- Foot problems - A domino-like series of diabetes symptoms can lead to serious foot problems and even amputation. Nerve damage leads to decreased sensation in lower extremities and a weakened immune system makes it difficult to combat infections from cuts or wounds. This combination may lead to serious foot problems that may not be felt.
- Decreased circulation - Persons with diabetes can experience decreased circulation due to the damaging effects of high glucose levels on blood vessels and nerves.
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Tollfree: 1-800-MD-Mercy (1-800-636-3729)