Bayfront Health Medical Group is focused on preventative medicine, educating their patients and treating diseases and disorders with a patient-centric approach to personalize their treatment options. They recently recruited Dr. Herschdorfer Rodriguez for her dedication and commitment to patient care. We caught up with Dr. Herschdorfer Rodriguez to find out about her thoughts on the diabetes epidemic in our country.
Over 30 million people in the U.S. have diabetes, and 84 million are considered prediabetic. There are two primary forms of the disease, known as type I and II; while both of these are equally dangerous, type II is, however, the most common. Glucose is the byproduct of the breakdown of the sugar and carbohydrates that we eat. Glucose is an essential nutrient that powers the cells in your body. However, a hormone in the blood called insulin is also critical to our body’s cells, as insulin is needed to absorb the glucose and use it for energy. With diabetes, the body doesn’t make enough insulin, or the body can’t use the produced insulin (insulin resistance), and in some cases, both happen simultaneously.
Q: First, please tell us why you decided to go into medicine.
A: Since I was a child I always knew I wanted to go into medicine. My grandmother was a dentist, and I loved how she treated her patients with passion and dedication. She never retired, she worked up until two weeks before her passing, and I always wanted to be like her from a very young age.
I loved overall health and wellness and decided to go into primary care to make a difference in the healthcare industry by paying attention to my patient’s specific needs. I am the first line of defense when it comes to disease and wellness management. I act as a manager in the sense that sometimes one patient is being seen by multiple specialists, each of them with knowledge of one piece of the “puzzle”, and it is my job to put all the puzzle pieces together and coordinate their care with those specialists in order to achieve the best possible results for my patient. I often tell my patients that we work as a team: the patient and I devise a plan together tailored to their specific needs and preferences, which gives the patient more control about her/his health; this tends to make them more compliant and overall happier than if I just “tell” them what to do or not do.
Q: What should patients know about Type II Diabetes?
A: Diabetes is a “silent disease” sometimes there are no symptoms at all. Patients may even feel completely healthy, that is why routine testing is critical. High blood pressure can often be one of the first symptoms. You can have diabetes for years and not know about it because the symptoms are either ignored, overlooked, or very minute.
Common signs/symptoms of diabetes are increased thirst, blurry vision, frequent urination, unintentional weight loss or weight gain, fatigue, neuropathy (numbness and tingling), high blood pressure, high cholesterol, and obesity. The earlier the person is diagnosed, the better their chances are of reversing the disease and damage. It is important for patients to be aware of what their daily glucose level is and of their hemoglobin A1c is. Hemoglobin A1c is basically a 3-month average of their sugar, including fasting and after meals, and it gives us a better picture (compared to a one-time fasting glucose test) of how they are doing. Patients at risk need to have blood work regularly to diagnose diabetes and also to monitor their diabetic state once they have the disease.
Q: Why is diabetes so dangerous?
A: In my opinion, diabetes is more challenging to treat than HIV. The reason I say that is because with HIV, patients can often take 1 pill once a day that pretty much treats the disease (around 75% of the time), but with diabetes, patients tend to become resistant to one drug, so we have to add more drugs to the regimen to keep the sugar controlled, many times needing insulin. Also with HIV, you don’t have to do fingersticks every day to see how you are doing, you just do a test every few months; with diabetes, you do have to do fingersticks every day, often multiple times a day, and ALSO do bloodwork every few months. Diabetes is dangerous also because multiple illnesses are often present, like heart disease, eye disease, nerve damage, kidney disease; it also increases risks for infections, heart attack, strokes, and cancer just to name a few. All this means that when we are treating diabetes, the treatment is multifocal to prevent and/or address all of these complications.
Neuropathy, which is nerve damage, is extremely dangerous. Patients basically do not feel much when they get a cut or small bruise, especially on their feet. Individuals with diabetes are at a higher risk of developing non-healing ulcers in the feet because glucose dampens the healing process, so it takes longer for a cut or wound to heal. So diabetics have a dangerous combination of problems: 1) they don’t feel it when they get a cut, and 2) it takes them longer to heal.
If foot ulcers are left untreated in diabetic patients, they can develop into gangrene. Unfortunately, in these cases, it is not uncommon for patients to need amputation of their toes, foot, or leg due to progressive infection. I tell my patients to do self-checks on their feet and hands daily, and if they are experiencing any sores, cuts or excessive cracks, they should schedule an appointment with me immediately.
Kidney damage is also common and can be debilitating if patients end up needing dialysis to flush the toxins out of their systems. Little by little, diabetes can quickly become a very advanced and life-threatening disease if not properly treated.
Q: What dietary or health & wellness advice do you give patients?
A: First, I would like to point out that there are excellent medications to control diabetes like metformin, but diet and exercise are the first steps to preventing and reversing diabetes. Eating the right foods at the right time in the right portion size is the most important aspect in treating their diabetes. I tell all of my patients to eat a substantial breakfast because fasting for too long can be unfavorable with insulin levels. A good protein like hardboiled eggs, as well as vegetables, fruits, and a complex carb like whole wheat toast are ideal. Cheese (in moderation) is also acceptable. Breakfast should be the largest meal of your day.
Lunch should be a medium to large size meal that should include a protein like fish, chicken or lean beef; vegetables such as a nice salad of greens, tomatoes, etc. Maybe a little quinoa, or brown rice for the complex carbohydrates, and healthy fats like avocado or olive oil are great. Beans are also one of the best foods to incorporate in your diet because they are made up of fiber, complex carbs, and protein.
Dinner should be the smallest meal of the day. Fill your plate with mostly vegetables, ¼ with protein and ¼ with the complex carbs. If you’d like a little dessert, I recommend fresh fruit or dark chocolate (at least 60% cocoa) as it causes the least amount of sugar spikes.
I know things can be confusing, so that’s why I always go over with my patients about what they are currently eating and how we can incorporate healthier choices.
I tell them to imagine they are on a deserted island. There is no fast food, no ice cream, no alcohol, no cakes, and no chips on an island. If they imagine they have to forage for their food, they get a better idea about eating fresh produce, good lean proteins like eggs and fish and drinking water. I give them quality options and ideas that taste great. Once you change your diet, your health will improve on many different levels.
Q: Why should patients see you for their primary care needs?
A: I firmly believe that patients should like and feel completely comfortable with their physician. They need to know that they are understood and have a good fit personally with their PCP. This connection allows for better overall care. It’s important to search for a doctor that understands your needs and works with you one on one to get you to a healthier state and to keep you there.
I take pride in making those critical connections with my patients, just like I saw my grandmother do growing up. It’s better for the patient and myself to have genuine communication and goals.
By maintaining an ideal body weight, losing weight if necessary, exercising regularly, and avoiding sugar and simple carbohydrates, you can reverse or significantly improve your diabetes. Also taking your medications and visiting your doctor on a regular basis is an important and often ignored part of your care.
If you or someone you know is concerned about your diabetic risk factors or are experiencing symptoms of diabetes or related issues, call today. Most calls will result in a same-day appointment. Just call 941-575-1514.
Bayfront Health Medical Group