CONDITIONS WE TREATObesity, diabetes, and more
We use a team approach to care for diabetes, obesity, and other metabolic conditions.
We provide expertise to meet the unique needs of each patient and family. Our treatment plans include the four pillars of care: food, movement, sleep, and stress reduction.
What is obesity?
When a person has accumulated an excess amount of weight on the body, this condition is referred to as obesity. Excess fat can be measured in several ways, but one of the more common ways is to look at a person’s weight in association with his or her height. This calculation, which is slightly different for males and females, is called body mass index (BMI).
Visit the Centers for Disease Control and Prevention website to calculate BMI:
An adult is considered overweight if his or her BMI is between 25 and 29.9. Class 1 (low-risk) obesity is between 30 and 34.9. Class 2 (moderate-risk) obesity is a BMI between 35 and 39.9, and Class 3 (high-risk) obesity is a BMI of 40 or higher. Children are diagnosed with obesity if their BMI is above the 95th percentile for age. Unfortunately, in the past 30 years, people in the US have become more obese; nearly one in three people in West Virginia is considered obese.
What impact does being obese have on our health?
The accumulation of excess fat on a person’s body takes its toll on many organs in the body, from our head to our toes. Carrying too much weight around for our frame makes us age faster and increases the risk for many unhealthy conditions. It can increase our risk for stroke; make us short of breath with exertion; cause us to have difficulty breathing while sleeping (sleep apnea); and increase our risk for high blood pressure, heart disease, certain cancers, liver disease, diabetes, osteoarthritis of our knees and hips, and gout, to name a few. Healthy wholesome eating and an active lifestyle can help us reduce our accumulation of excess fat to reduce these health risks.
How are being overweight and obesity treated?
There are four pillars that can help people achieve a healthier weight. They include: making healthy food choices most of the time (what you eat on a daily basis); getting daily physical activity, such as working out regularly or working in your garden; getting enough hours of good quality sleep each night; and keeping your life stressors managed in a good way, while enjoying each day to the fullest.
Treatment for obesity begins with a medical evaluation to determine if any medical complications of obesity are already happening or if a medical cause of obesity is present. Our team works with you to create a plan for any lifestyle changes that may be needed. We work together with your family, nutritionists, physical therapists, and your primary care provider to make sure you are supported.
Some patients may benefit from medications or surgery for weight loss if an earnest trial of lifestyle changes does not cause adequate weight loss. For most of our patients, we would like to achieve better health with the four pillars.
What is pre-diabetes?
Pre-diabetes is a condition in which your blood sugar is higher than normal but not considered high enough to have type 2 diabetes. Pre-diabetes is usually associated with an excess of accumulated fat, especially around the abdominal organs. The body has developed insulin resistance in pre-diabetes. A physical sign that can appears in pre-diabetes is acanthosis nigricans (a dark rash around the back of the neck). About half of people with pre-diabetes go on to develop diabetes if no lifestyle intervention is accomplished. Obesity, a diet high in sugars and processed foods, and a family history of type 2 diabetes increase the risk of progression to diabetes.
How is pre-diabetes treated?
Lifestyle intervention with healthy nutrition and an active lifestyle can help reduce insulin resistance, stabilize blood sugars, and prevent the progression from pre-diabetes to diabetes. A diet lower in refined carbohydrates than the average American diet has been shown to be helpful in people with pre-diabetes, as it specifically reduces insulin resistance. Weight loss of even five to eight percent of a person’s excess body weight reduces risk.
TYPE 1 DIABETES
What is type 1 diabetes?
Type 1 diabetes is a chronic condition that involves the body’s immune system attacking and destroying insulin-producing cells in the pancreas. In type 1 diabetes, this immune destruction of pancreatic cells leads to an absolute insulin deficiency, and when there is no naturally-produced insulin for the body to control blood sugar, the glucose levels become very high. Only a small number of people with diabetes have type I diabetes. Type 1 diabetes is not usually associated with excess fat accumulation. It represents a different kind of diabetes than type 2 diabetes.
How is type 1 diabetes treated?
If you have type 1 diabetes, you will require daily injections of insulin. You will also need to follow a healthy diet, get plenty of exercise, enjoy good sleep, and apply stress management coping skills in your life.
TYPE 2 DIABETES
What is type 2 diabetes?
Type 2 diabetes is a chronic condition that affects the way your body controls sugar. There are multiple risk factors for developing type 2 diabetes: obesity, a family history of diabetes, previous diagnosis of gestational diabetes (diabetes that arises during pregnancy), and polycystic ovary syndrome, to name a few. These conditions have in common a state of insulin resistance. Insulin is a key hormone that directs movement of sugar into your cells. When your body does not make enough insulin or is resistant to the insulin it makes, the result can be a buildup of insulin outside the cells, in the bloodstream, and this is called type 2 diabetes. Type 2 diabetes is diagnosed by measuring glucose in your blood stream.
The following tests can be used:
- Hemoglobin A1c: The A1c test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically live for about three months. The A1c test reflects the average of a person’s blood glucose level over the past three months. A person has pre-diabetes if their A1c measurement is between 5.8 and 6.4 percent. Diabetes is diagnosed if A1c is 6.5 percent or higher.
- Fasting blood glucose: This is a blood glucose measurement taken after fasting (not eating) for at least eight hours. Diabetes is diagnosed if the value is greater than 126 mg/dL.
- Oral glucose tolerance test: A fasting blood sugar is taken and then the patient drinks a sugary drink containing 75mg of glucose. Blood sugar values are taken at 30 minutes, one hour, two hours, and three hours after the sugar load. In a person without diabetes, the blood sugar will rise and fall rapidly, but in a person with diabetes, the number will take longer to fall back to a normal value. If the two-hour value is greater than or equal to 200mg/dl, diabetes is diagnosed.
- Random glucose test: Type 2 diabetes can be diagnosed if you have symptoms of high blood sugar and a glucose reading greater than 200 mg/dL on two occasions when you are not sick or in a particularly stressed state.
How is type 2 diabetes treated?
Depending on the level of glucose when a patient is diagnosed with diabetes, treatment can consist of diet alone or diet along with specific medications. The mainstay of treatment for diabetes is a healthy diet, usually one low in refined carbohydrates. The standard American diet based on 2,000 calories usually consists of 200 grams of carbohydrate per day. For a person with diabetes, this amount of carbohydrate really strains the system. A combination of eating a lower carbohydrate diet and increased physical activity can help people treat and even reverse type 2 diabetes to the point that they do not need to take any medication. The goal of treatment is to keep blood sugars as close to normal range as possible without getting too low. If our patients need medication for glucose control, our team uses evidence-based medicine to tailor a plan for each patient. In some cases, we refer our patients for bariatric surgery. For our patients who have complications of diabetes, including difficulty controlling blood sugars and kidney, eye, or nerve damage, our endocrinologists provide expert care. After speaking with the patient to evaluate their eating habits and preferences, the patient and team will agree on a program specific to the patient’s needs.
DIABETES IN PREGNANCY
What is gestational diabetes (or diabetes in pregnancy)?
Gestational diabetes occurs when a mother’s blood sugar is higher than normal during pregnancy. This occurs in a women who did not have diabetes prior to the pregnancy, and usually is diagnosed in the second or third trimester of pregnancy. Most of the time, the blood sugar returns to normal after the pregnancy, but the onset of diabetes during pregnancy does increase a mother’s risk of diabetes later in life, as well as her infant’s risk of obesity and diabetes later on. During the pregnancy, higher blood sugar levels can affect the baby’s development, so it is important to follow a doctor’s recommendations about diet or medication to keep blood sugar in the normal range. Our specialists in endocrinology are experts in this area. They will help your delivering physician or nurse midwife manage your blood sugars in pregnancy.
POLYCYSTIC OVARY SYNDROME
What is polycystic ovary syndrome?
Polycystic ovary syndrome (PCOS) is a common hormone imbalance that affects around one out of 10 to 15 women. Girls as young as 11 can get PCOS. The most common signs and symptoms of PCOS include weight gain, irregular periods, and infertility. PCOS is associated with an insulin-resistant state and/or pre-diabetes. Oftentimes, these women can progress to type 2 diabetes if their condition goes untreated with diet, activity, or medication. PCOS also results from increased androgen levels and, thus, is associated with hirsutism, which is the development of dark, thick hairs on the face and body. Other skin changes include acne and dark patches called “acanthosis nigricans,” usually found around areas of friction, such as the neck or underarm areas.
How is PCOS treated?
Treatment for this condition depends upon multiple factors. Symptom severity, age, plans to become pregnant, and overall health play a part in creating an individual plan. The central treatment of PCOS emphasizes a healthy diet and physical activity. Medications like metformin may be used to reduce insulin resistance, and hormonal therapies can help with symptoms of irregular periods and hirsutism. The long term goal is to reduce the long term risks of type 2 diabetes and infertility.
MAKE AN APPOINTMENT
WVU Medicine Center for Diabetes and Metabolic Health and Healthy for Life Clinic for Children and Adolescents
1001 Sushruta Drive
Martinsburg, WV 25401
Office: (304) 597-5038
Fax: (304) 596-0025
Harper’s Ferry Family Medicine
171 Taylor Street
Harper’s Ferry, WV 25425
Office: (304) 535-6343
Fax: (304) 535-6618
Women’s Health and Family Medicine
203 East 4th Street
Ranson, WV 25438
Office: (304) 728-6343
University Endocrinology Associates – Ranson
211 E. 5th Avenue
Ranson, WV 25348
Office: (304) 596-5038
Fax: (304) 596-5037
University Healthcare Physicians
WVU Health Science Center- Eastern Division
2500 Foundation Way
Martinsburg, WV 25401
Emma Morton-Eggleston, MD, MPH
Sarah Moerschel, MD, FAAP
Pediatrics, Obesity Medicine
James Field, MD
Rosemarie Cannarella Lorenzetti, MD, MPH
Mark Cucuzzella, MD
Jon Deiches, PhD
Madison Humerick, MD
Catherine Feaga, DO