Diabetes - Donald Westbie, MD

Ask A Doctor
Donald Westbie, MD
Diabetes

Q: What is diabetes and what causes it?
A: Diabetes is a disease caused by multiple factors including genetics, lifestyle and environment. Diabetes patients cannot properly metabolize sugar because of an insulin-resistance or insulin deficiency that results in high blood sugar levels.

Type 1 diabetes is an autoimmune disorder affecting the pancreas, preventing the gland from producing insulin. Also known as juvenile diabetes, type 1 is truly an insulin deficiency. Patients require insulin treatment for life – both to live and for the rest of their lives. The cause for type 1 diabetes is not clear although excessively high or low birth weight and viral infection might play a role.

Patients with type 2 diabetes might produce insulin but insulin-resistant cells in the liver, skeletal muscle, and/or fat don’t respond well to the insulin and therefore don’t handle the sugars as they should, resulting in high blood sugar. Type 2 diabetes is most common in adults over 40 and contributing risk factors include heredity, obesity, and sedentary lifestyle.

Q: Can diabetes be prevented? Is there a cure?
A: Type 2 diabetes can be prevented to a very great extent by lifestyle changes – maintaining a healthy body weight, limiting carbohydrates, and getting regular exercise. There is no cure for diabetes, although bariatric weight loss surgery has shown to have an immediate and significant effect on lowering blood sugar. Diabetes can also be controlled with lifestyle changes and medication.

Q: How do I know if I have diabetes?
A: Commonly, patients do not know they have diabetes until their high blood sugar is picked up on a routine blood test. If symptoms do develop, they can include unexplained weight loss, frequent urination, and excessive thirst.

Q: If my diabetes symptoms are not bothersome, why do I need to manage my condition?
A: Diabetes is very controllable but it needs to be treated early and treated aggressively before complications develop. Complications of diabetes are devastating. Patients with uncontrolled diabetes have two to four-times greater risk for heart attack and also have increased risk for stroke, and peripheral arterial disease. Diabetes can also lead to problems with the kidneys and eyes and can also damage nerves.

Q: Have they made any progress in preventing or curing the sores I get on my legs and feet?
A: Diabetic ulcers can quickly develop from a combination of poor blood supply, which slows healing, and reduced sensation from nerve damage, which can make you unaware of the ulcer developing. Without treatment, diabetic ulcers can lead to severe infection that can even require amputation.

With treatment, the sores are highly curable. Successful treatment includes controlling blood sugar and improving blood flow, sometimes with surgery to open up the arteries.

Q: What do you think about the blood sugar tests that don’t need blood? How are they supposed to work?
A: I’ve seen the ad on television but I’m not sure these tests really exist. I’ve never seen them demonstrated.

Q: Does gestational diabetes create risk for developing type 2 diabetes after pregnancy?
A: There is definitely a greater risk for type 2 diabetes following gestational diabetes, a condition caused by changing hormone levels during pregnancy. There is a 50% incidence of type 2 diabetes for women who develop gestational diabetes. It is common for blood sugars to normalize after pregnancy and then five to ten years later increase again to diabetic levels.

Bio:
Donald Westbie, MD, grew up in Danville, Calif., and moved to Paradise when he was in high school. Dr. Westbie went to the California State University, Chico, and medical school at Tulane University in New Orleans. He became interested in metabolic processes and the endocrine system during postgraduate training.

Dr. Westbie completed his internal medicine residency and fellowship in endocrinology at the Naval Hospital in Oakland after an internship with the Naval Hospital in Philadelphia. He then served at the VA Clinic in Livermore as Chief of Medicine before going into private practice in Pleasanton. Dr. Westbie now practices with Sierra Internal Medicine, where he has worked for the last ten years.

Dr. Westbie’s interests away from work include cars, especially Corvettes. He has even spent some time on the racetrack. He also enjoys scuba diving. While he has dived in Monterey Bay, he much prefers the 80 degree waters off Belize and St. John. Dr. Westbie has been married 20 years; his wife is a retired CPA and was Dr. Westbie’s office manager in Pleasanton. Their son works in information technology with an online mortgage brokerage firm in Pleasanton.