expert type icon EXPERT

Dr. Richard A. Guthrie, M.D.

Endocrinology-Diabetes

Dr. Richard Guthrie practices Endocrinology in Wichita, KS. Dr. Guthrie specializes in preventing, diagnosing, and treating diseases related to hormone imbalance, and the bodys glands in the endocrine system. Endocrinologists are trained and certified to treat a variety of conditions, including menopause, diabetes, infertility, and thyroid disorders, among many others. Dr. Guthrie examines patients, determines means of testing, diagnoses, and decides the best treatment methods.
61 years Experience
Dr. Richard A. Guthrie, M.D.
  • Mount Hope, 20
  • Univ of Mo, Columbia Sch of Med, Columbia Mo
  • Accepting new patients

How do you feel when your sugar is high?

AWFULL!! I have diabetes & have had it for 27 Yrs. & I have experienced high & low BS. Both make you feel bad but it has to do with the degree of high or low. Also different people READ MORE
AWFULL!! I have diabetes & have had it for 27 Yrs. & I have experienced high & low BS. Both make you feel bad but it has to do with the degree of high or low. Also different people have different tolerance for high & low. Some people can feel low & bad at 70 while others can go below 30 or so & not feel it. The same is true of high BS. I begin to feel bad above 300. Others may feel bad above 250 & some not until above 4-500. So it's hard to answer your ? specifically. You have to find your level at which you feel bad. The feeling is hard to describe & is different in different individuals. I feel weak & Nauseated & irritable & "out of sorts". You may feel tired, thirsty & urinating a lot. Just try keeping your BS in a good range (Fasting <110 & after meals <150) & you won't have to have any of the feelings of high & low.

Am I guaranteed to have diabetes if my mom does?

NO. Diabetes is inherited as a recessive trait, i.e. it takes 2 genes (one from each parent) to inherit it. That doesn't mean you may not get it. Your father could have a recessive READ MORE
NO. Diabetes is inherited as a recessive trait, i.e. it takes 2 genes (one from each parent) to inherit it. That doesn't mean you may not get it. Your father could have a recessive gene & give that to you. Your mother has 2 genes for diabetes & when the chromosome divides between the forming egg, one gene goes to each egg. The father's sperm do the same. So you get one gene from each. From your mother, you will always get a gene for diabetes. But it takes 2 to tango, so if dad has no diabetes genes, you will be a carrier but not have the disease. If dad is a carrier of one gene, you have a 50/50 chance of getting that gene & thus a 50/50 chance of diabetes. You should also know that there are environmental factors that trigger the genes. Some people who have 2 genes still will not get the disease if they do not encounter the env. factors. The triggering factors for type 1 diabetes are little understood but the ones for type 2 diabetes are known. They are factors of life style such as overeating & obesity, under activity & sedentary life style. So if your mother has Type 2 diabetes, then you should not be inactive, overeat & get fat. Good luck!!!

Are these signs of diabetes?

They could be. You didn't mention frequent urination. Usually dry mouth associated with diabetes is a result of excessive urination causing dehydration. The dry mouth is your body READ MORE
They could be. You didn't mention frequent urination. Usually dry mouth associated with diabetes is a result of excessive urination causing dehydration. The dry mouth is your body telling that you are urinating more out than you are taking in . This is often associated with a large intake of food but losing weight in spite of the large intake. Since you didn't mention urination or wt. loss or the other symptom, rapid breathing (polyuria, polydipsia, & polyphagia) & a normal BP I would doubt that your dry mouth or overeating is due to diabetes. But it wouldn't hurt to see a Dr. & get tested or buy an over-the-counter urine test kit for sugar & ketones & test yourself. If positive please see a DR. right away. Good luck!

How young can a child get diabetes?

You can get it at any age. I have a child as young as 3 mo. old develop Type 1 diabetes (T1D) & 4 yrs. old with Type 2 diabetes (T2D). There several forms of a disease called "Monogenetic READ MORE
You can get it at any age. I have a child as young as 3 mo. old develop Type 1 diabetes (T1D) & 4 yrs. old with Type 2 diabetes (T2D). There several forms of a disease called "Monogenetic Diabetes" that can appear in newborns. Since your sons problem is wt. gain, if he has diabetes it would be T2D since people with T1D usually lose wt. I doubt though that your son has diabetes since you didn't mention any of the other symptoms. Children who are home schooled do frequently have wt. gain due to overeating & under exercising (no recess or gym classes) just as adults quarenteened at home with the Corono-virus have gained an average of 8-10 # in just a month or so at home. For the wt. gain please see a Dr. for a test for diabetes or get a urine test kit at the pharmacy & test his urine for sugar & ketones. If positive see a Dr. right away. If negative you may still want to see a Dr. as the wt. gain can lead to insulin resistance that can lead to T2D. I don't think he has diabetes but see a Dr. anyway about his wt. gain & correct that since obesity can lead to a variety of other complications (heart & others).

What are the common symptoms of people with undiagnosed diabetes?

The classic symptoms of diabetes are Polyuria (excess urination) , Polyuria (excess urination) & Polyphagia (excess hunger). The latter is often associated with weight loss in READ MORE
The classic symptoms of diabetes are Polyuria (excess urination) , Polyuria (excess urination) & Polyphagia (excess hunger). The latter is often associated with weight loss in spite of overeating since the body cannot metabolize food without insulin. The above + rapid breathing are associated with Type 1 diabetes (T1D). The most common type of diabetes is Type 2 (T2D). With this type of diabetes there may, T2D, there may be no symptoms until late because the problem here is insulin resistance associated with over-weight. This disease can exist for many years before symptoms appear. The bad part is that even the mild elevations of blood sugar of early T2D that are asymptomatic can cause damage to the blood vessels & nerves. This damage can lead to heart attacks, foot ulcers with amputations, blindness, kidney failure and more if not corrected. So whether you have symptoms or not, get your blood sugar checked at least once a year by your Dr. and if you are over-weight, have relatives with diabetes, have had babies over 9# at birth or are non-white get checked more often as you are in a high risk group.

What happens when a diabetic eats sugar?

Table sugar is made up of 2 sugars-glucose & fructose. These 2 sugars are broken apart in the gut & absorbed separately and metabolized slightly differently. It is the glucose READ MORE
Table sugar is made up of 2 sugars-glucose & fructose. These 2 sugars are broken apart in the gut & absorbed separately and metabolized slightly differently. It is the glucose part that will elevate the blood sugar level (BS). The BS level in the blood is controlled very close to prevent several problems. First if the BS gets too low (under about 70 mg/dl) the brain begins to act "funny". If it goes below 50 the person may begin to act funny & lose control and lower the person may become unconscious & have a convulsion. This can be fatal so always know your BS level. If BS goes too high it can damage blood vessels and the organ the serve & the nerves. This can cause blindness, kidney failure, foot ulcers with often amputation, and heart disease. Normal BS levels Fasting is 70-120 mg/ml & after a meal is 80-125 depending on what & how much you eat. Since the breaking point above which the damage occurs is between 140 & 150 we try to keep the fasting below 120 & the post meal below 140. The other test we use is the Hemoglobin A1c (HBA1c) . This is a measure of sugar stuck to red blood cells. The more glucose in the blood the more there is to stich to the cells. The American Diabetes Association says keep the HbA1c less than 7%. Other organizations such as the AACE say keep it less that 6.5%. So what does eating sugar do- it raises your blood sugar damaging your blood vessels & nerves and the organs they serve. This must be controlled by 1)not eating sugar & simple carbohydrates or 2) taking a bigger dose of the diabetes meds you are taking to get the sugar out of the blood. CAUTION: it is much easier by not eating simple sugars to control BS (also they are empty calories & contribute to weight gain & tooth decay) than it to try to calculate medicine doses based on you intake of sugar. It too easy to miscalculate & overdose that will cause the problems of low BS. Be moderate in all things. You'll find that in the Bible & it is still good advice, Good Luck.

Does caffeine affect blood sugar?

This is a hard ? to answer since there are few good studies & they often contradict each other. In my own experience, I have experienced low blood sugar after I drank coffee & READ MORE
This is a hard ? to answer since there are few good studies & they often contradict each other. In my own experience, I have experienced low blood sugar after I drank coffee & at the same time ate a sweet such as a donut. When I became a diabetic 28 yrs. ago that problem stopped & I could drink coffee with a sweet or without & there was no effect on my blood sugar. I think it is important that you not put a lot of sugar in the coffee. If you do and are not diabetic, the combination may overstimulate insulin secretion & the BS will get low. If you are diabetic, the coffee will do nothing but the sugar in it will elevate your blood sugar. Experiment a little & record the effects & follow the course of least symptoms. By the way, there some studies now that have shown that 4 cups of coffee a day in women (but not in men) will slow the development of heart disease. Remember though that caffeine is a potent stimulator of constriction of the blood vessels and thus high blood pressure. So be moderate in intake. Don't over do it!!!

What causes high blood sugar in the morning?

Without knowing whether you have diabetes or not (I'm going to assume yo do and it is Type 2 Diabetes from your age), there can be several causes of high BS in this case. I will READ MORE
Without knowing whether you have diabetes or not (I'm going to assume yo do and it is Type 2 Diabetes from your age), there can be several causes of high BS in this case. I will list 3. 1) Your medicines may not be right. The doses may be too low, they may not be working, or they may not be lasting through the night. 2) The medicines may be too high at night & are causing low BS with rebound to higher values caused by the liver pouring out stored sugar to keep the brain functioning. 3) A common cause of this is known as the "Dawn phenomena". BS drops during the night & that is normal, but in some people, the insulin level must go up in order to keep the BS down. This is caused by the secretion of cortisol & human growth hormone that is the normal event that wakes us up & gets us going in the morning. Growth hormone & cortisol are "counter-regulatory hormones that raise BS so a peak can occur in these people in the morning. There are ways to check what the cause is so see your Dr. and set up these tests the correct it. It can often be corrected by a simple change in meds or the timing of taking the meds. It can be fixed.

Can you live a long life on blood thinners?

Yes you can with some precautions. But why at your age are you taking blood thinners? They are usually given to old codgers like me (I am on them for stent in my heart & I'm 84 READ MORE
Yes you can with some precautions. But why at your age are you taking blood thinners? They are usually given to old codgers like me (I am on them for stent in my heart & I'm 84 yrs old so I have lived long on them. You must be careful. These drugs are called blood thinners but they are really anti-coagulants. So you will bleed easier & take longer to clot. You must the avoid trauma like playing tackle football, etc. Watch for bleeding & tell your DR. I recently had an intestinal bleed, became very anemic, which put extra strain on my heart. I went into congestive heart failure & my lungs filled with fluid and went on to develop pneumonia. I had to be intubated & was on a respirator for 10 days-not fun. I am doing ok now but have some scaring in my lungs that may shorten my lifespan. I still take the meds but must watch it closely. at age 20 you have got a lot of years to watch & restrict your activities so be sure that the meds are really needed. "LIVE LONG & PROSPER" as Spock would say.

Will prediabetes go away?

The answer to this question is "YES AND NO". Most forms of diabetes or glucose abnormalities have a genetic component. That is we are born with it and we can't change our genetics READ MORE
The answer to this question is "YES AND NO". Most forms of diabetes or glucose abnormalities have a genetic component. That is we are born with it and we can't change our genetics so the inherited abnormality will not go away. But there is also an environmental component or trigger. For Type 1 diabetes we do not as yet know the trigger or triggers. For Type 2 diabetes & thus most prediabetes, we know that a sedentary life style, overeating, under exercising & the presence of overweight is associated with it. So if fits then, change food intake & type, increase exercise and lose weight and the blood sugar will improve & the day of developing full blown diabetes may be put off or prevented. Remember though that the abnormal gene is still there so if you let down your guard, it will come back.

What sweet things can diabetics eat?

Follow Saint Paul's advice "Be temperate in all things". Avoid completely "empty" calories & concentrated sweets such as sugar containing soft drinks, candy bars, very sweet pies READ MORE
Follow Saint Paul's advice "Be temperate in all things". Avoid completely "empty" calories & concentrated sweets such as sugar containing soft drinks, candy bars, very sweet pies & cakes, etc. Small pieces of candy that is low in sugar (such as some dark chock.) can be tolerated. I have diabetes & I do sometimes eat cake, like on birthdays, but I scrape off the icing. Remember that the empty calories will add to your weight & that will make the diabetes harder to control. So the advice is as above: Be moderate in all things. Choose low sugar or no sugar sweets & consume only small amounts.

What can cause growth disorders in children?

To know about growth, we need to know 2 things in addition to the child's age & Ht. We need to know his genetics ( how tall are his parents, siblings & some recent ancesters) and READ MORE
To know about growth, we need to know 2 things in addition to the child's age & Ht. We need to know his genetics ( how tall are his parents, siblings & some recent ancesters) and we need a growth chart to chart his rate of growth & predicted adult height. So low growth may be due to many factors such as genetics ( we would not expect a child of pygmy parents to be a 7 foot basketball player). There can be many causes of growth failure such as delayed puberty or delayed growth spurt but if he is well behind on growth & growth rate, he should have a work up for growth hormone deficiency. This can be genetic or not, and can be a problem of growth hormone secretion by the pituitary gland in the brain or a problem of the hormone not working because of a deficiency of a chemical called IGF1 in the blood. Growth hormone & IGF1 & some other things can be tested for and treated. So see a pediatric endocrinologist to evaluate growth, rate of growth, and hormone levels to be sure of cause.

Why do diabetics pee a lot at night?

This may have many causes but remember that polyuria (excess urination) is a key component of "Uncontrolled" diabetes. Much of the polyuria occurs at night because a laying posture READ MORE
This may have many causes but remember that polyuria (excess urination) is a key component of "Uncontrolled" diabetes. Much of the polyuria occurs at night because a laying posture changes the circulatory dynamics & more blood flows to the kidney. Check with your Dr. to be sure you don't have some problem with your bladder (such as infection or prolapse of the uterus, etc.) and above all get your diabetes in control with a HbA1c of less the 7% and preferably less than 6.5%. and the excess urination at night may go away.

How long does it take to go from prediabetes to diabetes?

Yes you should be worried. But the time to full blown diabetes is quite variable & depends a lot on what he is willing to do. The diabetes gene will never go away, so he is susceptible READ MORE
Yes you should be worried. But the time to full blown diabetes is quite variable & depends a lot on what he is willing to do. The diabetes gene will never go away, so he is susceptible the rest of his life. He needs to watch his diet, exercise (in other words change his life style-not easy) and lose wt. If he can accomplish this he can put off the diabetes indefinitely. But any time he slips & becomes overwt. again, the prediabetes will come back & progress toward diabetes again. So keep after him to change his habits & keep wt. down.

Can you eat sugar if you have type 2 diabetes?

Yes you can but be conservative & limit quantities. Remember that sugar & sugary foods are empty calories & will add wt. Since you are only 19 yr. old & have T2D, you are probably READ MORE
Yes you can but be conservative & limit quantities. Remember that sugar & sugary foods are empty calories & will add wt. Since you are only 19 yr. old & have T2D, you are probably overwt. so adding sugars will only increase your wt. problem. Also simple sugars require little digestion time so will rocket your blood sugar faster than other more complex foods. So you may have to adjust your medication to keep control. You don't need to completely eliminate sugar (indeed it's probably impossible since most processed foods have it added) but remember Saint Paul's advice "Be temperate in all things" & remember that while sugar tastes good, it is not necessarily needed since carbohydrate can better be gotten in more complex form with slower digestion.

What can cause thyroiditis?

I presume by thyroiditis you mean Hashimoto's thyroiditis that is an autoimmune disease in which the immune system goes off the tracks and attacks your normal tissue. You can blame READ MORE
I presume by thyroiditis you mean Hashimoto's thyroiditis that is an autoimmune disease in which the immune system goes off the tracks and attacks your normal tissue. You can blame this on your parents, especially your mother, since it is an inherited defect of the immune system & is much more common in women than in men. The immune system is there to kill viruses, bacteria, etc. but sometimes goes off & destroys normal tissue. Thyroiditis has a similar to many other auto-immune diseases such as rheumatoid arthritis, lupus, Bright's disease, certain intestinal diseases, etc. There is no cure (the body cannot make replacement tissue for that which is destroyed except in the liver) so we have to replace the hormone with a pill. This is no big deal as it is one pill a day. I've had this for 27 yrs. & take my pill each day & get the value checked 2x/yr. to see if I need to adjust the dose. It's simple & easy to treat, unlike some other autoimmune diseases such as diabetes, rheumatoid, lupus, etc. But Don't miss your pill.

What are the side effects of insulin injection?

There are few to no side effect to insulin injection. In the past there were a lot of problems since insulin was from animals & could cause a lot of problems. Also needles were READ MORE
There are few to no side effect to insulin injection. In the past there were a lot of problems since insulin was from animals & could cause a lot of problems. Also needles were big & not disposable so had to be sterilized. It is much better not. Current insulins are human insulin, identical to what the body normally makes so cause no allergy or tissue damage. Today also needles are so small you can hardly feel them & syringes & needles are disposable. The main side effect today from insulin injection is low blood sugar if you take too much, or don't eat or over exercise or too high a blood sugar if you do the opposite or skip a dose. Occasionally there can be a skin reaction from the insulin but this is usually caused by not getting the needle in all the way & giving part of the dose into rather than under the skin. Giving the dose in the same place over & over (as teenagers often do) can cause lumps to form in those areas. Rotating injections sites will prevent this. Other than the above I know of no side effect from modern insulin given with modern equipment. I have been taking insulin for 27 yrs & never had a problem. You can to.

Will insulin be difficult to get during the coronavirus?

It shouldn't be difficult to get. Pharmacies are open, though understaffed, and the cost has come down. Insulin now is made syntheticly so it should be produced continually. Unless READ MORE
It shouldn't be difficult to get. Pharmacies are open, though understaffed, and the cost has come down. Insulin now is made syntheticly so it should be produced continually. Unless the insulin companies (Eli Lilly, Novo, & Sanofi) shut down because of illness of their workers, they will continue to produce insulin. Lilly has now capped the co-pay price of their insulins at $35 so we should be able to afford it. I'm very optimistic regarding the continued supply of insulin.

What foods can diabetics eat freely?

Nothing is free. there is nothing you can eat "freely" Remember the words of Saint Paul "be temperate in all things" Still good advice today. Also remember that all calories count READ MORE
Nothing is free. there is nothing you can eat "freely" Remember the words of Saint Paul "be temperate in all things" Still good advice today. Also remember that all calories count and add up so be moderate in all foods. You do not want to get or maintain fat. What you shouldn't eat are concentrated sweets such as sugared soda, candy bars, etc. You should also avoid saturated fats as they cause heart disease. You can eat about anything else but control the quantity so you do n ot get fat as that will make your diabetes worse & the complications of diabetes more likely.

At what sugar level is insulin required?

At any sugar level. If your question means at what level of blood sugar should I change from oral meds to insulin then the answer is when the max doses of at least 3 oral agents READ MORE
At any sugar level. If your question means at what level of blood sugar should I change from oral meds to insulin then the answer is when the max doses of at least 3 oral agents will no longer control the BS (FBS 70-120, After meals 100-140 and Hb1c less than 7% or by some Drs. <6.5%).