Lifestyle Recommendations for Prediabetic Patients

Primary care physician Dr. Rex Mahnensmith has provided patient-centered treatment and preventative care at hospitals and medical centers in North Carolina, Oregon, Rhode Island, and Connecticut. In his current role as an internal medicine physician at StayWell Health Center in Waterbury, Connecticut, Dr. Rex Mahnensmith administers diagnostic tests for common metabolic conditions such as prediabetes. 

Patients with elevated baseline blood sugar levels are categorized as prediabetic. However, they are also at increased risk of developing heart disease, organ failure, and other chronic conditions. Blood sugar can often be reduced to normal levels through the following lifestyle changes:

- Lose weight. Prediabetic patients who are overweight or obese can reduce their likelihood of developing diabetes by losing as little as 5 percent of their body weight. This type of weight loss is achievable by starting a regular exercise routine and limiting high-fat foods.

- Schedule follow-ups. Developing healthy habits can take a lot of willpower and guidance. Patients should work closely with their physicians to monitor their progress through quarterly or bi-annual check-ups. 

- Get rest. Poor sleep quality is often associated with health conditions that exacerbate prediabetes, including obesity and impaired insulin production. In addition to establishing a healthy sleep routine and limiting caffeine before bedtime, patients should be screened for disorders such as sleep apnea.

About the Shortage of Primary Care Physicians

Certified by the American Board of Internal Medicine, Dr. Rex Mahnensmith serves StayWell Health Center as an internal medicine physician. Over the past 30 years, the majority of Dr. Rex Mahnensmith’s career has been in primary care.

One of the most pressing barriers to Americans’ access to improved health is the shortage of primary care physicians. As the population grows and ages, the crisis is expected to grow direr over the next decade. Primary care physicians are in demand particularly because their services help to decrease the incidence of heart failure and coronary heart disease, improve rates of early detection of cancers, and prevent certain diseases through vaccination.

Primary care physicians will account for 40 percent of physician vacancies in the coming years. As reported in 2017 by the Association of American Medical Colleges, by 2030 the US will experience a deficit of close to 105,00 physicians, 43,000 of which are primary care physicians.

Several factors contribute to the shortage of primary care physicians. One is the coming retirement wave of older primary care physicians. Other factors include the increasing number of medical residents seeking specialties other than primary care, the growing number of older Americans who use more health care services, and the expanding population.

The Relationship Between Glucose Intolerance and Prediabetes

Since 2015, Dr. Rex Mahnensmith has treated patients as an internal medicine physician at StayWell Health Center in Waterbury, Connecticut. Dr. Rex Mahnensmith previously served as a full-time geriatric physician from 2014 to 2015 with Genesis Physician Services and was the clinical director of nephrology at the Yale School of Medicine from 1992 to 2014. Dr. Mahnensmith has received numerous awards as a professor and researcher and is the author of more than 20 original articles, many of which focus on kidney disease.

One of the common causes of kidney disease is diabetes mellitus, a condition involving poor blood glucose control. However, before diabetes develops patients may experience glucose intolerance.

Glucose intolerance occurs when the blood sugar remains above 100 mg/dL for more than two hours after eating or drinking or if it rises above 140 mg/dL. It occurs when the cells and tissues are unable to use ingested glucose to produce energy due to insulin resistance or insufficient insulin production within the body. People with diabetes mellitus also experience insulin resistance and reduced insulin production, but to a much greater extent than people with glucose intolerance.

Glucose intolerance is considered a prediabetic condition, since 25 to 50 percent of people with the condition will eventually develop diabetes. Prediabetes has been associated with reduced life span and health complications including organ dysfunction, eye disease, and cardiovascular problems.

How Obesity Impacts the Body

Dr. Rex Mahnensmith is an internal medicine physician with Stay Well Health Center in Waterbury, Connecticut. A graduate of the Yale School of Medicine, Dr. Rex Mahnensmith is familiar with common health conditions and their impact on the body, including obesity.

Obesity is a medical condition defined by a body mass index (BMI) that equates to more than 30 kilograms of body weight per square meter of height. A person with a BMI of between 25 and 30 kilograms, meanwhile, is considered overweight. An individual's BMI can be calculated by dividing his or her weight in pounds by height in inches squared, then multiplying that number by 703. Medical professionals believe a person’s optimal body weight should fall between 19 and 24 kilograms per square meter of height.

Any individual classified as obese is at risk for a wide range of health conditions, including diabetes, high blood pressure, and progressive atherosclerosis. Furthermore, obesity puts constant pressure on a person’s heart and lungs. Existing health conditions, such as coronary heart disease and various arthritic conditions, can be exacerbated by obesity. 

An obese individual who decreases their weight by just 10 percent will notice measurable health benefits. To learn more about the impact of obesity on the body and how to address the situation, individuals should reach out to an experienced physician.

Annals of Vascular Surgery Publishes Telemedicine Study

A Yale-educated physician who completed a dual internship and residency in internal medicine at the Yale-New Haven Medical Center, Dr. Rex Mahnensmith has treated patients at Waterbury, Connecticut’s StayWell Health Center since 2015. One of Dr. Rex Mahnensmith’s areas of professional interest is telemedicine.

A recent study in the Annals of Vascular Surgery established a link between telemedicine access and overall patient satisfaction. Titled, "Results of Telehealth Electronic Monitoring for Post Discharge Complications and Surgical Site Infections Following Arterial Revascularization with Groin Incision," this study concentrated on patients in the Appalachia region in the wake of a specific form of cardiovascular surgery.

West Virginia University School of Medicine professor and leading researcher Albeir Mousa worked with 30 participants and supplied 16 of them with the telemedicine app Enform. When compared to the 14 participants who didn’t receive the app, the Enform app users experienced fewer limitations due to health problems and received higher scores when it came to overall physical function and mental health. Roughly 90 percent of patients also claimed that access to telemedicine boosted their overall quality of care.

The Prediabetic Health Impact of Glucose Intolerance

Dr. Rex Mahnensmith is a respected Waterbury, Connecticut, physician who treats chronic kidney disease cases at the StayWell Health Center. In a paper authored by Dr. Rex Mahnensmith, he examined glucose intolerance as a prediabetic condition.

Utilized by human tissues in generating energy, glucose is ready to absorb through the blood stream once it is broken down by the intestines from starches. Following absorption, glucose is transported to specific cells, tissues, and organs with the assistance of insulin, which is secreted by the pancreas. The secretion of the glucose ­transport hormone insulin is triggered by glucose surges in the bloodstream. 

Glucose intolerance arises when glucose levels rise above 140 mg/dL or stay at a level higher than 100 mg/dL for more than two hours following ingestion. With the body unable to tolerate the load of glucose placed on it within a specific timeframe, the glucose ingested is not utilized completely by tissues and cells for production of energy. 

Glucose intolerance is tied to the development of diabetes mellitus in many patients and has serious ramifications. The reason for this has to do with the way in which glucose molecules unused for energy production ultimately bind toxically with blood vessel walls and cell membranes, and result in adverse reactions and microscopic scarring.

Fructose, Glucose and the Danger of Glycation Reactions

Based in Waterbury, Connecticut, Dr. Rex Mahnensmith is an internist who practices with StayWell Health Center. Having lectured extensively on issues such as kidney disease, Dr. Rex Mahnensmith authored the article “Glucose Becomes A Toxic Molecule in Prediabetes and Diabetes.”

Focusing on an element of diet typically consumed in starchy plants such as corn, potatoes, yams, wheat, and rice, Dr. Mahnensmith describes chain-bound glucose as distinct from sucrose, which chemically combines fructose and glucose within a two ­molecule compound. Sucrose is found in numerous fruits, vegetables, and other plants, including beets and sugarcane. 

When ingested, sucrose is split into its fructose and glucose components. The glucose is rapidly absorbed through the intestinal tract to the bloodstream and provides a ready energy source for a variety of tissue and cell functions. This process takes less than a day and results in cells stocking up with energy that is either consumed through activity or stored for future use as glycogen starch.

By contrast, fructose is not absorbed readily. In cases where it is bonded with cellulose, it passes through the intestinal system and is finally eliminated. In cases of bloodstream absorption, it enters the liver and is turned into fat cells that serve as an “energy depot of last resort” when glycogen starch is used up by the body 

Where glucose becomes harmful - and often serves as an indicator of prediabetes - is when it is not transported to tissue cells efficiently. Oxygen and other circulating reactive molecules ultimately cause the glucose molecules to undergo a molecular structure change while still in the bloodstream, leading to random glycation reactions that impact tissue and organ structures adversely.