Diabetes Mellitus and the Thyroid Gland
Hormones are chemical signals that enable glands to coordinate and regulate other organs in critical functions such as energy production, blood sugar level, growth, bone density, reproduction, blood pressure, and a defense against stress. This widespread influence can affect mood, cognitive ability, weight, sleep, strength, and appetite. When a gland fails to produce the required amount of a hormone, body systems are widely affected resulting in illness. Adjusting or balancing hormone dosages to an optimal range can improve health and overall performance.
The Thyroid Gland
The thyroid gland secretes hormones to normalize growth and development, body temperature, and energy levels. Follicular cells in the gland secrete thyroid hormone, which actually consist of two different hormones: thyroxine (T4) and tri-iodothyronine (T3). The thyroid secretes sufficient amounts of thyroid hormones to maintain the basal metabolic rate which insures normal growth and development. An underactive thyroid gland can cause a person to feel tired, have increased weight gain, have cold sensitivity, and constipation. Thyroid Function testing and autoimmune laboratory analysis should be completed to determine appropriate hormone replacement therapy. An ultrasound of the neck may be recommended for better visualization of the gland. Symptoms of hyperthyroidism or an overactive gland may include unexplained weight loss, sweating, intolerance to heat, irregular heartbeat, and/or irritability. Thyroid function test and sometimes a radioactive iodine study may be needed to determine if anti-thyroid agents are necessary.
Our clinic specializes on the care of patients with diabetes and lipid disorders. We help patients with diabetes, pre-diabetes, and those with low blood sugars (hypoglycemia). Optimizing blood glucose control is imperative to prevent long-term complications of the disease on the cardiovascular system, kidneys, and even brain. Our first line therapy includes a focus on nutritional modifications, diet, and lifestyle changes. This facility treats diabetes in all age groups and has specialized laboratory testing for diagnosing type 1 diabetes in the pediatric population. Our type 2 diabetic patients are started on oral anti-glycemic agents as first line according to the American diabetic association guidelines. There are six classes of antidiabetic drugs to treat diabetes mellitus type 2 including biguanides, sulfonylureas, thiazolidinediones, incretin enhancers, meglitinides, and alpha-glucosidase inhibitors. Incretins are hormones released in the small intestines in response to meals. Incretin hormones increase the amount of insulin secreted by the pancreas, delay gastric emptying to slow glucose absorption, reduce glucagon secretion from the pancreas and improve feelings of satiety with decreased food intake. The two classes of drugs that increase the action of incretin hormones are dipeptidyl peptidase 4 (DPP-4) inhibitors and GLP-1 receptor agonist. These medications are available as oral therapy or weekly dosed injectables. We provide care for advanced disease process that need initiation or titration of insulin therapy.