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Conquering type 2 diabetes

Endocrinology experts weigh in

Dr. Mark Borchelt
Dr. Ellen Caswell

November is American Diabetes Month, and Mississippi continues to be at the top of the list in overall diabetes prevalence, according to the Centers for Disease Control and Prevention. Diabetes has serious health consequences, but it also can be controlled and prevented with the proper treatment. 

Dr. Mark Borchelt and Dr. Ellen Caswell specialize in endocrinology and help patients with both type 1 and type 2 diabetes. Here, they share their expertise on the condition and answer frequently asked questions. 

WHAT ARE SIGNS AND SYMPTOMS OF DIABETES? 

Dr. Borchelt: “Most patients, unfortunately, have no symptoms of diabetes unless their blood sugar is quite elevated. When this occurs, the symptoms include excessive thirst, urination, fatigue and weight loss. Many patients will note that have to wake up during the night to urinate as well.” 

WHAT ARE TREATMENT OPTIONS FOR THOSE WITH DIABETES? WHAT’S ON THE HORIZON? 

Dr. Borchelt: “Treatment options depend of the type of diabetes and can include oral agents or injectable options. Newer agents include GLP – 1 receptor agonists that are given by injection either once daily or once weekly (although there is also an oral option available). The SGLT2 inhibitors allow the kidney to spill sugar into the urine. Both options help with weight loss and protect against the decline of kidney function, which accompanies diabetes. On the horizon, a once-weekly insulin option may soon be available. 

Additionally, a new medication, Tirzepatide, promises improved blood glucose control, as well as dramatic weight loss similar to that seen with weight loss (metabolic) surgery. There are also exciting developments for insulin pumps and beta cell technology.” 

HOW SHOULD PATIENTS BEST MANAGE THEIR DIET? 

Dr. Caswell: “The power of eating healthy is underestimated. I have seen many of my Type 2 diabetics come off of medical therapy with weight loss and changing their diet. Sitting down with a nutritionist or diabetic counselor at the time of diagnosis can be very beneficial.” 

HOW IMPORTANT IS EXERCISE? 

Dr. Borchelt: “Of course, exercise is important for diabetes management. Trying to find an exercise that people can do, especially if they have physical limitations (such as arthritis or orthopedic procedures) is sometimes a challenge. Walking, bike riding, swimming or other aerobic activities are recommended for a total of 2.5 hours per week.” 

WHY IS DIABETES PREVENTION ESPECIALLY IMPORTANT IN MISSISSIPPI? 

Dr. Caswell: “The complications of diabetes are serious and very detrimental to quality of life. These include vision loss, kidney damage and even loss of limbs. Some types of diabetes are purely genetic, but type 2 diabetes can be unmasked by obesity and worsening insulin resistance. Maintaining a healthy weight and avoiding poor eating habits early can be the difference in developing insulin resistance and ultimately diabetes. The health of our state is greatly affected by the increasing numbers of diabetes cases. Early prevention and treatment help Mississippians live longer, healthier and with less medical burden.” 


Dr. Mark Borchelt, F.A.C.E., is board certified in endocrinology at Memorial. Dr. Ellen Caswell is board certified in internal medicine and board eligible in endocrinology at Memorial. Memorial offers a Diabetes Education Wellness Program, available by physician referral, for people with diabetes. Speak with your primary care provider or call (228) 867-4000 to learn more. 

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