New Cleveland Clinic doc sheds light on managing diabetes


Dr. Alexander Williams is one of Cleveland Clinic’s newest hires, joining the Indian River Hospital team just last month after completing his endocrine and diabetes fellowship at Vanderbilt University Medical Center in Nashville. The young endocrinologist specializes in diagnosing and treating health conditions related to problems with the body’s hormones, or the endocrine system of the body – including diabetes, which is caused by problems with the hormone insulin.

“The whole endocrine field was always interesting to me,” Dr. Williams said. “There are so many different hormones that regulate different things in the body. If everything is working well, you don’t think about it.

“If there are any issues like diabetes, however, where there’s a problem with insulin either not being enough and the patient is insulin resistant, or with thyroid hormones being too high or too little, both can cause problems. I like the focus of endocrinology with all these hormones because it is really about keeping things as normal as possible to prevent illnesses or complications from illness down the road.”

Diabetes is the most common disease Dr. Williams treats. According to the Centers for Disease Control, Diabetes affects 34.2 million adults in the U.S. – and 1 in 5 of them don’t know they have it. It is also the seventh leading cause of death in the U.S. and the No. 1 cause of kidney failure, lower limb amputations and adult blindness. It’s also on the rise, with the number of adults diagnosed with diabetes more than doubling in the last 20 years.

“Generally speaking, diabetes refers to blood sugar that is too high,” Dr. Williams explained.

“There are two major types of diabetes. Type 1 diabetes is an autoimmune reaction that generally occurs in younger people, although it can appear at every age. The body attacks itself by making antibodies against the insulin producing cells in the pancreas. As a result you end up without enough insulin, which can be life-threatening.”

The CDC states that only 5 percent to 10 percent of the people who have diabetes have type 1.

Symptoms of type 1 diabetes develop quickly, usually in children, teens and young adults. If you have type 1, you will have to take insulin every day to survive. But with the help of insulin therapy and other treatments, this condition can be managed, and the patient can lead a long, healthy life.

“Type 2 diabetes is more of a mild lack of insulin or insulin resistance. Your body doesn’t use insulin well and can’t keep blood sugar at normal levels.” Dr. Williams continued. “Generally, we see it in older adults and overweight people. Oftentimes it can be treated without medication by changing their lifestyle, diet and other medications.

“If medication is needed, much of it is in pill form, but there is a new group of injectables that are not insulin that help people control blood sugar and lose weight. Of course, there is always insulin, but we try to reserve insulin for type 2 diabetics for those who didn’t do well on other therapies.”

About 90 percent to 95 percent of people with diabetes have type 2, according to the CDC. It develops over many years and is usually diagnosed in adults. Type 2 diabetes can be prevented or delayed with healthy lifestyle changes such as losing weight, eating healthy food and being active.

Alarmingly, more than 1 in 3 adults in the United States have prediabetes and more than 84 percent of that group doesn’t know they have it. The condition occurs when sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes.

Your primary care physician will be the first line of defense to the disease and will most likely be the one to diagnose and manage the condition. Only when the patient starts needing more medicine or needs to transition to different insulins will you be referred to an endocrinologist.

Some of the symptoms of diabetes are urinating often, feeling thirsty and hungry, extreme fatigue, blurry vision, cuts and bruises that are slow to heal, weight loss, and tingling, pain or numbness in the hands and feet.

Should you experience any of these warning signs, consult your primary care physician. Early detection and treatment of diabetes can decrease the risk of developing complications of the disease including neuropathy, eye complications, kidney disease, cardiovascular disease and foot problems.

The good news is that diabetes can be controlled and a person with diabetes can live a perfectly normal life.

“The only treatment for type 1 diabetes is insulin,” said Dr. Williams. “The best way for a patient to monitor their blood sugar level is to measure it at home. We recommend that the patient check their blood sugar once a day to four times a day.”

The traditional blood sugar meter, called a glucose meter, is the tried-and-true method of glucose monitoring for diabetes. The drop of blood that you get with a simple finger prick is enough to place on a test strip.

New methods of measuring blood sugar are now available, however. In recent years, technologies have come out to make the process less painful by not using finger pricks. These noninvasive monitors known as continuous glucose monitors (CGMs) can be worn on the arm or abdomen and can measure your blood sugar every five minutes. CGMs detect glucose through interstitial fluids in the skin. Some CGMs have the capability of connecting to and downloading blood glucose information to your smartwatch. CGMs are convenient and effective but may not be as accurate as traditional meters.

“Type 2 diabetes can be managed with diet and lifestyle if it’s a mild case,” Dr. Williams clarified. “You must always be mindful of it and be on top of it. While diet and exercise changes will help, there may still come a time when you need medication as it progresses. Your insulin-producing cells are not working as well as they used to. Even if you don’t require medication, your primary care doctor will want to check you once or twice a year.

“Diet is a huge factor. Some people drink 72 ounces of soda a day and have very high blood sugar. If they stop they can have normal blood sugar almost immediately. Eating a low-carb, vegetable- and protein-based diet is the best prevention.”

Dr. Williams attended medical school at Ross University School of Medicine in Portsmouth, Dominica, and completed his residency at Carilion Clinic, at Virginia Tech Carilion in Roanoke, Virginia, and his fellowship at Vanderbilt University Med Center in Nashville.

Having grown up on the west coast of Florida, he feels right at home in Vero Beach in his new position with Cleveland Clinic Indian River Hospital. Dr. Williams is now accepting new patients at his office located in the Health and Wellness Center at 3450 22nd Court, Vero Beach.

Call 877-463-2010 for an appointment.

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