expert type icon EXPERT

Deirdre J. James

Endocrinology-Diabetes

Dr. Deirdre James practices Endocrinology in Memphis, TN. Dr. James 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. James examines patients, determines means of testing, diagnoses, and decides the best treatment methods.
Deirdre J. James
  • Memphis, TN
  • Accepting new patients

How can diabetes type 1 be controlled?

Type 1 diabetes can only be treated with insulin. The amount of insulin required changes from individual to individual based on carbohydrate intake, body mass index, and activity READ MORE
Type 1 diabetes can only be treated with insulin. The amount of insulin required changes from individual to individual based on carbohydrate intake, body mass index, and activity level. She should see a endocrinologist to help with her management

I need medical assistance?

Please go to see your primary care physician. Breast cancer is a major, but no the only concern. Lymphoma for instance can cause enlarged lymph nodes.

Can hypothyroidism hair loss be reversed?

Hypothyroidism usually causes hair to become drier and coarser. Because of this, it is definitely more prone to breakage. These effects should be reversed when thyroid function READ MORE
Hypothyroidism usually causes hair to become drier and coarser. Because of this, it is definitely more prone to breakage. These effects should be reversed when thyroid function returns to normal. However, if you are seeing bald spots, it makes me concerned that you may have hair loss due to a reason other than your thyroid. Especially if you have Hashimoto's thyroiditis. If you have one autoimmune condition, you will have a greater risk of another autoimmune condition. Some of which can cause hair loss like Lupus. Talk to a dermatologist.

How are thyroid evaluations performed?

Your primary care physician can draw your blood and test for thyroid function tests. Initial testing usually is a TSH +/- Free T4/Free T3 depending on symptoms.

Is maxillofacial surgery advisable for a diabetes patient?

Yes. If she needs surgery, she should proceed as long as her providers are all in agreement. Controlling her blood sugar with an A1c of 7 or less will give her the best chances READ MORE
Yes. If she needs surgery, she should proceed as long as her providers are all in agreement. Controlling her blood sugar with an A1c of 7 or less will give her the best chances of proper wound healing.

Hypothyroid condition?

Yes. You should not take any other medications or eat within 30min to 1 hour of levothyroxine. There is not a maximum time between these activities only a minimum of at least 30 READ MORE
Yes. You should not take any other medications or eat within 30min to 1 hour of levothyroxine. There is not a maximum time between these activities only a minimum of at least 30 minutes.

What should I do?

Hello, I would find an income based clinic in your area. I work at an institution like this now. For patients without insurance, they do not have to have for clinic visits or most READ MORE
Hello,
I would find an income based clinic in your area. I work at an institution like this now. For patients without insurance, they do not have to have for clinic visits or most medications. I am hoping for the best for you.

Should I be worried about unintentional weight loss?

Hello, Yes, I would see my primary care physician for a regular check-up. I would specifically ask for thyroid function tests. Because you have type 1 diabetes, you are at higher READ MORE
Hello,
Yes, I would see my primary care physician for a regular check-up. I would specifically ask for thyroid function tests. Because you have type 1 diabetes, you are at higher risk for thyroid disease. Hyperthyroidism can lead to weight loss and menstrual irregularities. Best of luck.

Diabetes and irregular periods?

Although is is true that some women with Diabetes have irregular menstrual cycles, diabetes is more likely to present with frequent urination, blurry vision, extreme thirst, UTIs READ MORE
Although is is true that some women with Diabetes have irregular menstrual cycles, diabetes is more likely to present with frequent urination, blurry vision, extreme thirst, UTIs or yeast infections. You are still young, so your menstrual cycle may still need to mature. Young women may have anovulatory cycles which cause irregularities. I would agree that you need to make sure you are routinely checked for diabetes because your risk of getting diabetes is about 60% greater than the general population because both of your parents have it.

Do I have diabetes?

I know that the medication that you are on may cause worsening glycemic control, so you are worried. The best way to determine if you have diabetes is a fasting plasma glucose, READ MORE
I know that the medication that you are on may cause worsening glycemic control, so you are worried. The best way to determine if you have diabetes is a fasting plasma glucose, oral glucose tolerance test, or A1c testing. Please visit your doctor for this.

Do I have diabetes?

Unfortunately, without lab tests, I can’t say if you have diabetes or not. It definitely sounds like it is a possibility.

What is the best spot in the body for insulin injections?

There is not a best stop per se. Many people use their lower abdomen. However, arms and legs are okay.

I have pain under my left breast?

Please go to the Emergency Department for evaluation if you are in active pain. If no active pain, go to your Primary Care Physician or Urgent care ASAP. I am worried you may have READ MORE
Please go to the Emergency Department for evaluation if you are in active pain. If no active pain, go to your Primary Care Physician or Urgent care ASAP. I am worried you may have heart disease or may be actively having a heart attack

Diabetes 2?

That is a difficult question to answer without knowing more information. To diagnose diabetes, we need two separate tests indicating that you indeed are diabetic. Most commonly READ MORE
That is a difficult question to answer without knowing more information. To diagnose diabetes, we need two separate tests indicating that you indeed are diabetic. Most commonly we use A1c, but fasting plasma glucose, 2hour oral glucose tolerance testing, and a random blood glucose greater than 200 with classic symptoms (frequent urination, etc) are used to diagnose diabetes. However, there are some circumstances in which your A1c is falsely elevated. For instance, did you get a blood transfusion around that time (90 days prior), was there medication interference (high dose steroids), etc. If your A1c was in the diabetic range 6.5 or greater, metformin has been known to decrease your A1c by one point. This combined with diet modification, I could reasonable see someone who was diagnosed with diabetes start metformin then result in these low A1c values. If the metformin is stopped, it is likely that the A1c will rise.

Weight loss issue?

Some people do not meet the “standard” weight range, but are still normal. I recommend that you to meet with a nutritionist and possibly a local endocrinologist. Make sure you READ MORE
Some people do not meet the “standard” weight range, but are still normal. I recommend that you to meet with a nutritionist and possibly a local endocrinologist. Make sure you are taking a daily multivitamin.

16 weeks pregnant TSH 23...next steps?

I think you do need to follow-up with an Endocrinologist. Do you have any prior thyroid issues? If not, it may be a normal finding in pregnancy. Additionally, if your prenatal READ MORE
I think you do need to follow-up with an Endocrinologist. Do you have any prior thyroid issues? If not, it may be a normal finding in pregnancy. Additionally, if your prenatal vitamin had biotin in it, it can cause a TSH of 0.23 if a biotin linked assay was used to measure your TSH. I wouldn’t worry about it but follow-up with your Endocrinologist

Is this serious or not?

If you have urine ketone strips, use them. If positive, it could indicate DKA, but may things can lead to ketones in the urine including starvation. My recommendation is that you READ MORE
If you have urine ketone strips, use them. If positive, it could indicate DKA, but may things can lead to ketones in the urine including starvation. My recommendation is that you go to the nearest emergency room for evaluation.

Can prediabetes numbers be managed with just diet alterations?

Lifestyle modification is the most effective way to manage prediabetes. Metformin has been used as an off-label treatment (not FDA approved for prediabetes), but it only lows READ MORE
Lifestyle modification is the most effective way to manage prediabetes. Metformin has been used as an off-label treatment (not FDA approved for prediabetes), but it only lows risk of developing diabetes by 30%. Lifestyle modification will lower by 60% if done properly.

Is it possible for a 34 year old to suffer from diabetic neuropathy?

Yes. Neuropathy is dependent on length and severity of disease. Therefore a person with long-standing and poorly controlled diabetes has a higher chance of developing neuropathy. READ MORE
Yes. Neuropathy is dependent on length and severity of disease. Therefore a person with long-standing and poorly controlled diabetes has a higher chance of developing neuropathy.

How can one prevent diabetes if it is hereditary?

When both parents have type 2 diabetes, the children have a 60% increased risk (as opposed to individuals without parental history of diabetes) of developing it themselves. Exercise READ MORE
When both parents have type 2 diabetes, the children have a 60% increased risk (as opposed to individuals without parental history of diabetes) of developing it themselves. Exercise and maintaining a normal weight will reduce your risk.

Deirdre James, MD