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.
59 years Experience
Dr. Richard A. Guthrie, M.D.
  • MOUNT HOPE, KS
  • Univ of Mo, Columbia Sch of Med, Columbia Mo
  • Accepting new patients

I am gaining a lot of weight even when I exercise?

I doubt that this is the effect of the metformin. This drug usually dulls appetite by leaving a small metallic taste in your mouth. I have used the drug on thousands of patients READ MORE
I doubt that this is the effect of the metformin. This drug usually dulls appetite by leaving a small metallic taste in your mouth. I have used the drug on thousands of patients over the years and have not seen wt. gain. It is considered a "wt. neutral" drug. What else are you taking? Many drugs not necessarily associated with diabetes can cause wt. gain. Check with your doctor about this problem. It is important.

Can diabetes cause erectile dysfunction?

Yes, it could. Decrease in libido (desire) & ED (erectile dysfunction) is very common in diabetes and can be due to many factors. Poor diabetes control can affect male hormone READ MORE
Yes, it could. Decrease in libido (desire) & ED (erectile dysfunction) is very common in diabetes and can be due to many factors. Poor diabetes control can affect male hormone secretion, lessening desire. High blood sugar can damage the nerves to the penis that control erections.

Can diabetes be fatal??

Yes diabetes can be fatal. You did not tell me whether you have Type 1 or 2. Possibility of fatality is different for each of the. Acute fatality is more likely i Type 1 from a READ MORE
Yes diabetes can be fatal. You did not tell me whether you have Type 1 or 2. Possibility of fatality is different for each of the. Acute fatality is more likely i Type 1 from a condition known as diabetic ketoacidosis. I suspect you have type 2 and acute problems are rare. CHRONIC problems do occur in Type 2 from long term poor control of blood glucose. These problems occur because high blood sugar damages the blood vessels & nerves causing blindness, kidney failure, heart & stroke problems, lower limb amputation, etc. So control your blood sugar to prevent these problems (this means you should be testing your blood sugar frequently) & making changes to keep the your blood sugar normal or near normal & you should be fine.

I am feeling very thirsty lately. Could it be a sign of diabetes? Should I get myself checked?

Yes, it could be diabetes and you should get it checked. There are other causes of polydipsia (thirst) & polyuria (urination), not all are SERIOUS & need treatment. Please see READ MORE
Yes, it could be diabetes and you should get it checked. There are other causes of polydipsia (thirst) & polyuria (urination), not all are SERIOUS & need treatment. Please see your Dr. right away & get it checked.

If I avoid medicines and concentrate on lifestyle, can I win over diabetes?

The answer to your question is Yes & No. Diabetes is an inherited disease and we can't change our genetics. So that part (genetic susceptibility) you will always have. But there READ MORE
The answer to your question is Yes & No. Diabetes is an inherited disease and we can't change our genetics. So that part (genetic susceptibility) you will always have. But there are environmental factors that impact he manifestations & seriousness of the diabetes & these you can impact. Overwt., bad diet, lack of exercise, etc. are factors you can control. So diet & exercise & healthy lietingving will help you a lot. There is loss of function of the insulin secreting mechanism in every one, just as we loss function of other organs-knees, mental etc as we age so life style change may not keep you off medications forever, but will help. Remember though that it is vital to maintain your blood sugar in or near thew normal range to prevent damage to the blood vessels & nerves that can cause blindness, kidney failure, heart problems & strokes and lower limb problems. So keep your blood sugar normal & take medicine when life style will no longer control it.

Can one be diagnosed with both type 2 and type 1 diabetes?

Yes it can happen. Both type 1 & type 2 are genetic diseases, but different genes. They are 2 different pathways to the same end. It is rare to inherit both sets of genes at the READ MORE
Yes it can happen. Both type 1 & type 2 are genetic diseases, but different genes. They are 2 different pathways to the same end. It is rare to inherit both sets of genes at the same time but it is possible. You should begin by testing for pancreatic antibodies that are markers for Type 1. If you don't have antibodies, then you probably do not have Type1 (though there is a small chance you could. a few people with type 1 do not have antibodies). If you have antibodies, you have Type 1. To find out about Type 2 you would need further genetic testing. There is no specific test for Type 2. We rely on signs & symptoms but if you really want to know you could have gene testing that could tell you if you have can dilate genes for type 2. That would be expensive & I wouldn't recommend it since you have to treat the Type 1 & that will treat the Type 2 at the same time.

Can honey worsen my diabetes?

This depends on how much honey you are using. Yes honey is basically sugar & can raise your blood sugar. But honey is no different from any other sugar. It does do miracles like READ MORE
This depends on how much honey you are using. Yes honey is basically sugar & can raise your blood sugar. But honey is no different from any other sugar. It does do miracles like some ads will tell you but neither is it any more harmful that any other source of sugar. Used sparingly, it can be compensated for by adjusting you medications or exercise to burn it off. Remember that honey is a concentrated sugar so it has a lot of calories & can contribute to weight gain which can effect your blood sugar control & you medication needs. Small amounts of honey in your tea once a day will probably not cause you much trouble but go easy on it.

My husband feels anxious due to his diabetes medication. What should we do to manage it?

I can't really answer this ? without knowing what he is taking or the doses he is taking. I would also need to know what his level of control is. If his blood sugar is in poor READ MORE
I can't really answer this ? without knowing what he is taking or the doses he is taking. I would also need to know what his level of control is. If his blood sugar is in poor control either too high or too low, it could be the level of control causing the fatigue not the medicines, There are now many medicines available to treat diabetes so a change in medicines might be needed. Check this out with you Dr. & it should be solvable if good control is established with proper meds,

How can we fight diabetes naturally?

"Natural methods" of diabetes control have been tried for centuries will poor results. Metformin was once a "natural" treatment. Centuries ago medical people dried a plant called READ MORE
"Natural methods" of diabetes control have been tried for centuries will poor results. Metformin was once a "natural" treatment. Centuries ago medical people dried a plant called Goat's Root grown in France & gave it to people with diabetes. It worked. We now know that the active factor in it was metformin. The problem though, with these "natural" substances is that there is no standardization. You don't know what all is in it & in what doses. Usually there is more fiber that meds in it. Contaminants are also possible since they are not controlled by standards of purity. Some of these can be toxic. You did not say what he is taking now for his diabetes.

The skin on my feet is so dry. Could this be because of my diabetes?

Yes it could. Dry skin, especially on the feet, is very common. This should be treated. There are now on the market many skin creams formulated for people with diabetes. Get some READ MORE
Yes it could. Dry skin, especially on the feet, is very common. This should be treated. There are now on the market many skin creams formulated for people with diabetes. Get some and use it regularly. One of the best I have used over the years is called UDDER BUDDER. It's what farmers use on cows to keep the tips soft. You can get it in any store that sells animal supplies or medicines.

Do I need to take insulin forever?

Yes, it's possible to stop the insulin. I can't get too specific about it since I have too little information. If you have type 2 diabetes & remain in good control of your blood READ MORE
Yes, it's possible to stop the insulin. I can't get too specific about it since I have too little information. If you have type 2 diabetes & remain in good control of your blood glucose, some of your beta cells that make insulin can rejuvenate and you could stop taking the insulin injections. To answer your question in more detail, I would need to have more information like your age, how long you have had diabetes, whether your diabetes is type 1 or 2, your HbA1c, and ,most importantly, what your weight & BMI are. Advising you to take insulin at night probably means you have an elevated fasting blood glucose. You should also test some after meal BS to see if your post-prandial glucose levels are also high & need to change daytime meds or take insulin with meals as well as at nighttime. The most important thing is to GET & KEEP YOUR BS IN CONTROL TO PREVENT COMPLICATIONS.

If I had diabetes during pregnancy, are there chances I will get the disease later in life?

Yes! The decompensation rate for persons with gestational diabetes to full blown diabetes is about 5%/yr. So, in 10 years, 50% of the ladies will have diabetes. You can influence READ MORE
Yes! The decompensation rate for persons with gestational diabetes to full blown diabetes is about 5%/yr. So, in 10 years, 50% of the ladies will have diabetes. You can influence this. A study done a few years ago called the Diabetes Prevention Trial (DPT) showed that lifestyle changes (diet, wt. loss, & exercise) would reduce the rate of progression to full blown diabetes over the course of the study by 60%. If you have a YMCA near by, they now have this program & can help you for a very low price. I can't answer your question of your chances beyond this without knowing more about you, such as your wt & ht (BMI) & how severe your gestational diabetes was. Just based on national figures, though, the chances are as above, about 5%/yr. Age, body wt., family history of diabetes, etc., can modify this rate both ways. Get a good diet & exercise program, continue to check your blood sugar levels both fasting & after meals on occasion, & get a HbA1c test whenever your physician does other blood testing. Work at it and you can put it off.

Good luck!

Why is diabetes causing weight loss in my husband?

If he was overweight before, then the weight loss is good. Overweight causes insulin resistance and high blood sugar. Weight loss improves this. If he was not overweight before, READ MORE
If he was overweight before, then the weight loss is good. Overweight causes insulin resistance and high blood sugar. Weight loss improves this. If he was not overweight before, then the weight loss could be due to many things and needs to receive a work up for proper diagnosis. As to his diabetes, though, an HbA1c of 8.5 is much too high. It should be less than 7 or even 6.4%. That needs working on. See your physician and get a thorough exam of these problems that are probably related. Don't delay and get the diabetes under control NOW!

My husband is a diabetic and has been experiencing premature ejaculation. Are the two related?

Yes, the two could be related. However, there are many causes of PJ, so your husband and you need a complete evaluation by a qualified person trained in sex therapy. Start with READ MORE
Yes, the two could be related. However, there are many causes of PJ, so your husband and you need a complete evaluation by a qualified person trained in sex therapy. Start with a urologist & proceed from there. You did not tell me what medication he is taking for his diabetes, so I cannot give you specific answers. Most diabetes and blood pressure meds tend to cause delayed ejaculation rather than premature, but some can cause premature as can the diabetes itself. Both of you need to see the Dr. to get to the root of the problem. There are many causes of the problem to look for that may or may not be related to the diabetes or the medication. Get a good evaluation by a urologist & perhaps a gyn. for you. Then see a licensed sex therapist if needed. Your problem is important to your life and marriage & nothing to be shy about (it is common) and can be controlled with good diabetes control, perhaps a change in meds., & perhaps a qualified sex therapist. Please tell the Dr.'s your problem & get help. Your sex life is important to your life & marriage, so don't be shy & get the help you need. Good luck!

Can gestational diabetes continue after delivery?

Yes it can continue after pregnancy but it is not likely to continue. With gestational diabetes we know you have the genetics for diabetes so pre- diabetes or diabetes could persist READ MORE
Yes it can continue after pregnancy but it is not likely to continue. With gestational diabetes we know you have the genetics for diabetes so pre- diabetes or diabetes could persist after pregnancy. You cannot change your genetics so the possibility of diabetes will always be with you. That's the bad news. Now for the good news! the decompensation from gestational diabetes to diabetes is about 5% so this could be years away. Remember also that there are factors over which you have control. The development of diabetes is influenced be factors you can control. Life style is an important factor. Over-weight, lack of exercise, etc are factors you can control. A study done several years ago called the Diabetes Prevention Program showed that while we can't change our genetics we can prevent diabetes by life style change. In the study, they found that people with pre-diabetes, or gestational diabetes, that they could prevent full blown diabetes by 60% for the course of the study by life style alone. So you can help yourself to prevent going on to diabetes by altering the factors over which you have control & maybe put off diabetes or even prevent in for life. Good Luck

Do natural remedies help in reversing diabetes type 1?

I wish it were and it was this easy. I would not say we will never have a natural product that will help since many meds originally came from plants. BUT we have no scientific READ MORE
I wish it were and it was this easy. I would not say we will never have a natural product that will help since many meds originally came from plants. BUT we have no scientific experimental evidence that fenugreek or any other of the "natural home remedies" work in people with type 1 diabetes. If you try one, PLEASE DO NOT STOP THE INSULIN. I have seen many people try this and get into serious trouble because the home remedy did not work and the lack of insulin caused them to go into DKA, and that can be fatal. Consult your Dr. before starting such an agent and have him or her follow the progress or lack thereof and be available to provide rescue if needed. Over the 55 yrs. I have provided diabetes care, I have seen a number of these supplements come about and just as quickly disappear. So be very careful.

Can my blood pressure be worsening my diabetes?

They can be. Why is your BP up? It could be due to adrenaline release that will also raise blood sugar. It's usually the other way around, i.e., a rise in BS damages blood vessels READ MORE
They can be. Why is your BP up? It could be due to adrenaline release that will also raise blood sugar. It's usually the other way around, i.e., a rise in BS damages blood vessels and thus raises BP, but it certainly can be the other way around. See your Dr. to get your BP under control and if your BS continues to be high, adjust diabetes meds. These two and other factors also such as blood lipids all interact, and it's hard to know which comes first, "the chicken or the egg." It doesn't matter - find out why and get all the factors under control.

What should be the ideal HbA1C for a diabetic patient?

This is a bit controversial right now. The American Diabetes Association has said for a long time (based on long-term outcomes studies) that HbA1c should be less than 7%. The International READ MORE
This is a bit controversial right now. The American Diabetes Association has said for a long time (based on long-term outcomes studies) that HbA1c should be less than 7%. The International Diabetes Federation says <6.5%, as does the American Association of Clinical Endocrinologist (AACE). Recently, a group representing internal medicine physicians said that the value should be between 7% and 8%. I believe, based on many outcome studies (including studies I have done), that the value should be 6.5% or less, but I would except 7% or less in some people. Some of this disagreement has to do with age and other factors. My father was 91 years old when he developed diabetes and I wasn't too concerned that he would develop blindness in 30 yrs. So age and social conditions must be taken into consideration, as do other factors. BUT 11% is much too high as is in a level that is almost certain to cause complications such as blindness, neuropathy, kidney damage, heart disease, stroke, etc. If I were treating you with a HbA1c of 11%, you would have started insulin right then. AACE says start insulin injections at HbA1c >9.5%. I start it at 9% as I want to prevent any dire complications.

Does insulin cause weight gain?

Yes insulin can cause wt. gain. Insulin increases appetite & thus a desire for more food. It does this by lowering the blood sugar which then tells the appetite center to eat. READ MORE
Yes insulin can cause wt. gain. Insulin increases appetite & thus a desire for more food. It does this by lowering the blood sugar which then tells the appetite center to eat. Most Type 1's are thin at diagnosis so we encourage the wt. gain problem. If you have reached your desired wt. or more, then cut back on your food intake and decrease your insulin accordingly. Less insulin and less appetite stimulation. Talk to your Dr. or a Diabetes Educator about this balance and make appropriate adjustments.

Bilateral medullary nephrocalcinosis and hyperthyroid.

Yes if you are high in calcium with kidney stones & hyperthyroidism you need treatment now! You didn't say where you live so I can't guide you to an endocrinologist. I can only READ MORE
Yes if you are high in calcium with kidney stones & hyperthyroidism you need treatment now! You didn't say where you live so I can't guide you to an endocrinologist. I can only give you general advise. If you live in or near a moderate or large city there should be an endo in the city. If not seek out a medical school nearest & get there right away. This is a serious problem and can destroy your kidneys and can also have a bad effect on your heart. If you have hyperparathyroidism as a cause of your calcium problem, this is usually due to a parathyroid tumor that can be removed. Get to a facility right away & get this fixed. It can be done then maybe your kidneys will improve.