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, 20
  • Univ of Mo, Columbia Sch of Med, Columbia Mo
  • Accepting new patients

Will my blood sugar levels reduce if I exercise and reduce weight?

Yes you can reduce your blood sugar (BS) with diet, wt. loss & exercise. I do not have enough information to completely answer your question. How old are you, what is your Ht. READ MORE
Yes you can reduce your blood sugar (BS) with diet, wt. loss & exercise. I do not have enough information to completely answer your question. How old are you, what is your Ht. & Wt (BMI) and what was your BS? Also was a Hemoglobin A1c done & what was it? If I had this info. I could better answer your ? about medication. There are degrees of loss of insulin production and this governments BS & HbA1c. The more loss of insulin production you have in your pancreas cells the more medication. If your diabetes is early & you still have a lot in insulin production the taking the strain off the insulin production by diet, exercise & losing wt. may prevent medication for now. If you have lost a lot of insulin production you may need medication. Also remember that insulin production is lost with time and even if medication is not needed now, it may be in the future so good followup with your Dr. will be needed.

glycemic index in foods

Glycemic index was developed in Canada a number of years ago & can be helpful in planning diet. It compares a measured amount of food to a base # of 100. So a potato may have a READ MORE
Glycemic index was developed in Canada a number of years ago & can be helpful in planning diet. It compares a measured amount of food to a base # of 100. So a potato may have a high index (say 98), while some other food may be low (say 56). The low index will give a lessor amount of carbohydrate (though not less calories) than a high index food & slower absorbtion. The index can be helpful in planning diets but there are some caveats. For example: Potatoes have a high index but put gravy on them & calories go up but the index goes down because the gravy slows absorption. Surprisingly ice cream has a low index though high calorie for the same reason. The index may be helpful in planning & controlling BS but does not tell you about calories so is not useful for weight loss. The best for weigh for wt. control is control portion size but not so much what you eat-the exception being not to binge & watch junk foods.

I am a diabetic since 8 years. Will me being diabetic affect my baby?

Yes it will. Not knowing what your treatment & level of control is now, I cannot give you specific advice-only general. In the past, we had few tools to control diabetes & the READ MORE
Yes it will. Not knowing what your treatment & level of control is now, I cannot give you specific advice-only general. In the past, we had few tools to control diabetes & the toll on the baby was very bad. Miscarriage was high as was big babies that had multiple problems after delivery such as breathing problems, prematurity, low BS, low calcium, etc. They also had a high incidence of congenital anomalies such as spina bifida, heart defects, etc. We have learned though, that these problems are associated with high BS in the mother and can be prevented. I have now cared for hundreds of pregnant women that have had normal babies. BUT BS has to be controlled. For pregnancy I try to keep Fasting BS less than 90-95, and post meals BS <120. HbA1c should be checked frequently and be <6.5%. Since some oral drugs will cross the placenta and may effect the baby, for gestational diabetes & certainly for diabetes I would always use insulin & give it as basal-bolus (4x/day) with careful BS monitoring Fasting & 1-2 hr post meal daily. With this kind I therapy you chances of having a good baby are great. Get you BS under good control before pregnancy & keep it in control. I can't guarentee you a good baby but The above will increase your chances for a good healthy baby to the same as a woman who does not have diabetes. Good luck. Have a healthy baby and enjoy the experience.

My 8 year old son weighs 30 kg, and he is always thirsty. Is he diabetic?

Not necessarily. Increased thirst & urination (called polydipsia & polyuria) are signs of diabetes and are easily checked with a urine test. But there are many other causes of READ MORE
Not necessarily. Increased thirst & urination (called polydipsia & polyuria) are signs of diabetes and are easily checked with a urine test. But there are many other causes of persistent thirst. The is a disease of the pituitary gland in the brain called diabetes incipidous that can cause thirst. (Diabetes is an old Greek word that means "to siphon" & thus to the water loss.) The disease you are thinking of is diabetes mellitus (mellitus is a Latin word that means sweet like honey-Yes they discovered that the urine was sweet by tasting it). Diabetes incipidous is unrelated to diabetes mellitus. Incipidous is a Latin word from which we get our word incipid (tasteless or blah). The most common cause of thirst in a child you childs age though is habit. There are some simple tests that can differentiate these & other causes of constant thirst. See you Dr. & get tested as some of these problems are benign & some can become life threatening.

My premature baby has high sugar levels. I am worried. Please help.

Relax & don't worry. These problems can be corrected. Although diabetes can occur in a newborn it is very unlikely. Transient hyperglycemia of the premature (THP). is common & READ MORE
Relax & don't worry. These problems can be corrected. Although diabetes can occur in a newborn it is very unlikely. Transient hyperglycemia of the premature (THP). is common & frequently occurs in the first 4 mo. of life. It usually disappears then & the baby is fine. There were some new guidelines for this published recently. Check with a perinatologist or a neonatologist about this. There are some test that can be done & some treatments recommended. Have them review these new guidelines with you. For now relax & enjoy your baby.

Can diabetes in men affect their fertility?

Yes diabetes can effect fertility in both sexes. Get the diabetes under control. The problems that diabetes causes including erectile dysfunction & fertility are due to poor control READ MORE
Yes diabetes can effect fertility in both sexes. Get the diabetes under control. The problems that diabetes causes including erectile dysfunction & fertility are due to poor control of the blood sugar & the metabolic abnormalities that go with that. So be sure he is checking BS levels, reporting them to the DR. so the DR can get his BS under tight control. Can it effect the baby? That is a hard on. We know that diabetes in the mother can effect the baby unless the diabetes is kept in good control. The fathers diabetes will have no effect on the pregnancy or the newborn but statistics show that there is a higher incidence of children later in life developing diabetes when the father has diabetes than when the mother has it. Why we do not know. In any event the incidence is low & not much higher than the general population. SO get his diabetes under control & GO FOR IT!

My sugar levels are high. What to do next?

I can't answer this question without knowing what your BS was. The present criteria are: Normal=Fasting BS of 100 or less, 101-126=prediabetes and >126 is diabetes. If a Hemoglobin READ MORE
I can't answer this question without knowing what your BS was. The present criteria are: Normal=Fasting BS of 100 or less, 101-126=prediabetes and >126 is diabetes. If a Hemoglobin A1c test was done <5.6%=normal, 5.6-6.5%=prediabetes & >6.5%=diabetes. So where do you fall. If your values are close to any of these, get retested to varify & get both tests-Fasting BS & HbA1c. If you values are higher than these then talk to a physician knowledgable in diabetes and start treatment, The earlier treatment is started, the better you will do.

Why are my blood sugar levels fluctuating so much?

There can be many reasons for this fluctuation and you need to take your blood sugar tests to the Dr. to look for patterns. We all (I have had diabetes for 25 yrs) have fluctuations. READ MORE
There can be many reasons for this fluctuation and you need to take your blood sugar tests to the Dr. to look for patterns. We all (I have had diabetes for 25 yrs) have fluctuations. The more we have the more this tells us that we have fewer & fewer insulin producing cells and are depending on external medicine that can never duplicate what a few little beta cells in the pancreas can do. Some of this we can fix, some we cannot with present tools though we are getting better. Here are a few of the causes of fluctuation: medication not matching the food intake & exercise, wrong medicine, timing of the medication, mood changes, hormonal changes (like menstrual cycle). Not knowing what medication you are on or what type of diabetes you have, I can't give you specific help. If you are taking insulin a couple of things that can be helpful: an insulin pump can smooth out some of these, continuous glucose monitor can also, the new ultra-long acting insulins (Tresiba & Trajeo) will smooth out fluctuations as well. You need to see a Dr. who knows how to read BS records, and understand patterns of fluctuations to help you with this problem. It can get better so good luck.

As I am a diabetic, what to do for my leg injury?

Yes it can. If your diabetes is well controlled, it should heal OK but if your BS is not well controlled, even the smallest injury can become very serious. Get & Keep your diabetes READ MORE
Yes it can. If your diabetes is well controlled, it should heal OK but if your BS is not well controlled, even the smallest injury can become very serious. Get & Keep your diabetes in good control (HbA1c <7%) and you should heal the same as a person without diabetes. But above that & trouble can occur. So get & keep sugar in control & Good Luck

Thyroid Function Tests

Low FT4 with normal TSH is seen though not frequently. Several things may do this but medication is most common. The Abilify and/or Effexor could be causing. A failing pituitary READ MORE
Low FT4 with normal TSH is seen though not frequently. Several things may do this but medication is most common. The Abilify and/or Effexor could be causing. A failing pituitary or thyroid antibodies binding the FT4 could also be the cause. Have your Dr check thyroid antibodies to see if your are developing thyroid antibodies as evidence of developing sub-clinical thyroiditis to which TS has not responded. You didn't say how low the FT4 was so I can go further with diagnosis or recommend treatment without numbers.

I am a diabetic and my gums have been bleeding. Is there something to be concerned about?

Paridontal disease is very common in diabetes and you should be concerned about it. Unless treated you could lose all your teeth & even develop serious or even fatal septicemia. READ MORE
Paridontal disease is very common in diabetes and you should be concerned about it. Unless treated you could lose all your teeth & even develop serious or even fatal septicemia. You need to do 2 things: 1) get your diabetes under strict control and 2) see a dentist specializing in this disease right away.

Should I be checked for thyroid cancer?

Tests of the blood for thyroid cancer are not as yet as refined as we want so are not specific. See your Dr. at least yearly and be sure he or she does a palpation of your neck READ MORE
Tests of the blood for thyroid cancer are not as yet as refined as we want so are not specific. See your Dr. at least yearly and be sure he or she does a palpation of your neck for lumps in the thyroid. If they feel anything at all or there is any suspicion, have a thyroid sonogram. Any suspicious mass or lump should be biopsied. Watch closely but don't be afraid. Thyroid cancer picked up early is curable.

Can I get diabetes from eating sugar?

This is not true. Eating too much of anything, including sugar, may make you fat and that can c contribute to diabetes but sugar itself along is no worse than any other food. Too READ MORE
This is not true. Eating too much of anything, including sugar, may make you fat and that can c contribute to diabetes but sugar itself along is no worse than any other food. Too much sugar can rot your teeth & do other things but not of itself cause diabetes which is a disease of genetics & environment. How much? That depends on your age, body size, Body Mass Index (body weight proportioned to height-called BMI-Keep it less than 24). But remember what St. Paul said-Moderation in all things.

Can I keep my child from developing Type 1 diabetes?

We don't know the answer to that. DM1 is a combination of inheritance and environmental factors. You can get tests that will screen for the inheritance portion but even if you READ MORE
We don't know the answer to that. DM1 is a combination of inheritance and environmental factors. You can get tests that will screen for the inheritance portion but even if you have the genes only < 50% of the people get it. So there is an environmental factor but what it is we don't know. Certain viruses may trigger the genetic factor as may certain gut germs. We don't have a prevention at present. Just feed them right and keep them healthy for now.

Suddenly getting dark hair on my chin. Hormonal problem?

What you are seeing is a normal phenomenon with aging especially in females. What has happened is that with menopause, you have lost your estrogen secretion. This let the testosterone READ MORE
What you are seeing is a normal phenomenon with aging especially in females. What has happened is that with menopause, you have lost your estrogen secretion. This let the testosterone predominate & gives you some masculine characteristics. Men & women have both male & female hormones. Its a matter of balance. After menopause women can get an imbalance because of loss of estrogen. Men who take certain drugs for prostate enlargement that block testosterone can then have an imbalance with too much estrogen & get some female characteristics such as breast development. You probably have no disease but see your Dr and be sure.

Diabetes and eye health

I answered this question previously. Eye damage from diabetes is common and is the leading cause of adult blindness. Yes follow your Drs advice & get a dilated eye exam every year. READ MORE
I answered this question previously. Eye damage from diabetes is common and is the leading cause of adult blindness. Yes follow your Drs advice & get a dilated eye exam every year. Do not resist this extremely important exam since diabetic eye damage is reversible is picked up early & is treata ble today with modern medicine & equipment so blindness can be prevented

Using an EpiPen

I am not an allergists & have had little direct experience with EpiPens so I will answer this question with a little generality. Medical pens today have very small (called micro READ MORE
I am not an allergists & have had little direct experience with EpiPens so I will answer this question with a little generality. Medical pens today have very small (called micro or nano) needles that are virtually non-painful. I have had a lot of experience with these pens in people with diabetes and if inserted rapidly they are essentially painless. Epinephrine itself can cause some discomfort in the tissue but if you are having a severe allergic reaction a little discomfort is better than losing your life. The discomfort is not bad & doesn't last long. Don't be afraid. your life could be at risk if you hesitate.

Type 1 diabetes and general anethesia

Not knowing what his insulin regimen is, I find this Question hard to answer. He should be receiving a basal insulin at night and this dose should be given as previous. Then since READ MORE
Not knowing what his insulin regimen is, I find this Question hard to answer. He should be receiving a basal insulin at night and this dose should be given as previous. Then since he is NPO the day of the surgery give no insulin in AM as his basal from the night before is working. When he gets to the surgical center the Dr. will take it from there. After surgery gauge insulin by his ability to eat. Consult your endo who cares for him to help. This surgery is with little risk & modifications is his insulin regimen should be minimal.

Diabetes affecting my baby

if your diabetes has been well controlled and the baby is at term, I would not anticipate any problems. There are a lot of problems with the baby if the diabetes is not well controlled. READ MORE
if your diabetes has been well controlled and the baby is at term, I would not anticipate any problems. There are a lot of problems with the baby if the diabetes is not well controlled. Premature babies, large babies, breathing problems, blood sugar & blood calcium problems, jaundice etc are common & can be life threatening. If control has not been good, & sonogram indicates the baby is overweight for gestational age then a neonatologist should be consulted prior to delivery & be on standby to take the baby to NICU. But if your blood sugars have been good & the HbA1c has been good the baby should be fine. Good luck & congratulations