Diabetes Archive

Ask the doctors

Q. My doctor recently told me I have prediabetes. Is this condition reversible?

A. Yes, it is possible to reverse prediabetes. Prediabetes is a condition that affects millions of Americans. The CDC estimates that as many as one in every three American adults has the condition, which is defined as having blood sugar that is elevated, but not high enough to meet the threshold for diabetes. Left untreated, prediabetes can progress to diabetes, a condition in which your body is not able to absorb glucose for energy properly, causing blood sugar to rise. If it's not managed properly, diabetes can lead to a number of health problems, from heart attack and stroke to blindness, kidney problems, and infections, among others. But making some lifestyle changes can reduce the risk that your prediabetes will develop into diabetes.

PrEP (pre-exposure prophylaxis) is a daily medication taken to prevent HIV infection. While multiple studies show PrEP is effective, relatively few of those who might benefit are taking it. Will a 10-year initiative to reduce rates of HIV and a new formulation of PrEP help?

Doctors say three recently approved migraine prevention drugs are helping people have fewer headaches.

For people with frequent, debilitating migraine headaches, 2018 brought encouraging news. The FDA approved three new medications — erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) — the first drugs designed specifically to prevent migraines and reduce their frequency, intensity, and duration.

It was a big development, since other medications used to stop migraines were created to control other conditions, such as seizures, depression, high blood pressure, or an irregular heartbeat. But their side effects (such as weight gain, dizziness, or fuzzy thinking) often cause people to skip treatment.

Technology may help to provide more supportive, efficient, and effective care for diabetes, a leading contributor to heart disease.

About one of every 11 adults in this country has diabetes — a chronic, costly condition that's closely connected to heart disease. Lifestyle changes that encourage eating healthy foods, exercising, and losing weight are the cornerstone of managing both problems. But making those changes can often feel overwhelming and frustrating, especially for people with diabetes. They also need to keep tabs on their blood sugar levels, which are influenced by what and when they eat and exercise.

And getting effective support for managing diabetes with lifestyle changes isn't easy. "The current system for managing diabetes is broken," says Dr. Osama Hamdy, medical director of the Obesity Clinical Program at Harvard-affiliated Joslin Diabetes Center. For starters, there aren't nearly enough endocrinologists for the millions of people with diabetes in this country. Appointments with these specialists are often too short and too infrequent for people to make meaningful progress, he explains.

Ask the doctors

Q. I've had endometriosis since I was in my 30s. I'm now approaching menopause. Will my symptoms get better or even go away after menopause?

A. Possibly, but not always. Endometriosis is a condition in which tissue that resembles the tissue that lines the uterus, called endometrial tissue, grows in other locations inside the body. Typically, it grows on structures and organs in the pelvis, such as the ovaries, fallopian tubes, bladder, or bowels. When a woman menstruates, this tissue behaves like the lining of the uterus and bleeds. But because this blood has no way to exit the body, it pools inside. This leads to pain, inflammation, and scarring.

Trying to make up for not getting enough sleep during the week by sleeping longer on weekends has been found to have negative effects such as weight gain, expending less energy, and increased calorie intake during evenings.

A recent 15-year follow-up to the Veterans Affairs Diabetes Trial found that short-term intensive blood sugar control did not lead to significant reduction of risk of cardiovascular events in the long term.