Clinical Research

PH Javara

Our Practice Participates in Clinical Trials in Partnership with Javara.
Discuss with your Physician Today.

We conduct clinical trials to help find new and better ways of preventing, diagnosing and treating disease.  Results from clinical trials help determine if a medicine or medical device is ready to go to market.

As a participant in a trial, you may receive access to treatments and diagnostics that may not otherwise be available and that could potentially lead to improved health outcomes.  Additionally, you may receive compensation for study time and/or travel.    

If you are potentially eligible for a study, you may be contacted by a Javara research team member on our behalf to see if you are interested.  Privia’s Notice of Privacy Practices  describes how your data may be shared with our trusted partners for research purposes.  Participation in a clinical trial is always 100% optional and your access to medical care will not be impacted if you choose not to participate. 

We offer clinical trials that we believe will allow us to improve the quality of care of our patients.  Read our letter to patients about clinical research here.

Thyroid Radio Frequency Ablation

Radiofrequency Ablation

Radiofrequency ablation is a nonsurgical, minimally invasive procedure that uses heat generated from a medium-frequency alternating current to cauterize thyroid nodules and cysts. It will shrink nodules without compromising thyroid function, which is a distinct advantage over the more traditional surgical treatment.

Performed under local anesthesia, radiofrequency ablation is a relatively painless procedure performed in our office at the Thyroid and RFA Center for Excellence in Houston. We use a guided ultrasound to insert a thermal probe into the thyroid nodule. Through selective heating of the probe tip, the nodule is destroyed. The cauterized tissue is then broken down by the body.

RFA is highly effective and, depending on the type of nodule, after one year patients can expect to see nodules shrink an average of 80%. 

Benefits of RFA

In addition to being a less invasive procedure, RFA has many other advantages:

  • preservation of thyroid function
  • fewer complications than surgery
  • shorter recovery time than surgery with a quicker return to normal activities
  • the entire procedure lasts anywhere from 15 minutes to one hour
  • NO general anesthesia
  • NO scarring
  • minimal risk of permanent damage to the vocal cord nerve
  • NO risk to the parathyroid glands
  • NO need for lifelong thyroid medication

How RFA Works

Internally cooled electrodes with different active tip lengths are connected to a generator that creates an electric circuit. Approved by the Food and Drug Administration, these tools are designed specifically for a thyroid radiofrequency ablation (RFA).

​The probe is inserted into the thyroid nodules and the generator creates a high frequency wave that it sends directly to the tip of the needle, which, in turn, heats a few millimeters of the nodule’s tissue and treats it point by point.

​An alternating electric current creates frictional heat around the electrode to immediately damage the nodule tissue in significant amounts in areas very close to the electrode. Nodule tissue farther removed from the electrode is heated slowly. When temperatures reach 46°C, irreversible cellular damage on the nodule occurs and when temperatures are increased to 60-100°C, the nodule tissue immediately coagulates.

​A normal occurrence during the procedure is to hear the sounds of popcorn being popped, which means the generator and water pump each are doing their jobs.

Thyroid Cancer

Thyroid cancer is an abnormal growth of the cells of the thyroid gland, a butterfly-shaped gland located in front of your neck just below the voice box (larynx). Thyroid gland secretes hormones that help regulate the body’s metabolism and levels of calcium. Thyroid cancer is more common in women than men. People who are exposed to high levels of radiation to the neck and have a family history of thyroid cancer and goiter (enlargement of thyroid gland) are at a higher risk of developing thyroid cancer.

There are four types of thyroid cancer:

  • Papillary thyroid cancer: Cancer that begins in the follicular cells and usually spreads slowly. It is the most common type of thyroid cancer and can be cured especially if early diagnosis is made
  • Follicular thyroid cancer: Cancer that develops in the follicular cells and usually spreads slowly. Like papillary thyroid cancer, it can be cured with early diagnosis
  • Medullary thyroid cancer: Cancer that arises from C cells of the thyroid gland. It produces abnormally high amounts of the hormone, calcitonin. It tends to grow solely and can be treated before spreading to the other parts of the body
  • Anaplastic thyroid cancer: Cancer that starts in the follicular cells of the thyroid and grows and spreads quickly to other parts of the body. It is the least common type but the most aggressive form of thyroid cancer

As the cancer develops, you may notice a lump or swelling in front of your neck, pain in the neck or throat, difficulty in swallowing or breathing, cough, and changes or hoarseness in your voice. Your doctor will recommend a treatment plan based on the results of diagnostic tests such as blood tests, thyroid biopsy, thyroid scan, laryngoscopy, and ultrasound of the thyroid gland.

  • Calcitonin blood test: This test measures the amount of the hormone calcitonin in the blood. This test can help diagnose medullary thyroid cancer as there is a high level of this hormone in the blood in this disease
  • Laryngoscopy: It is an examination of the larynx (voice box) performed by holding a small mirror at the back of your palate or by placing a laryngoscope (a thin tube with a light and a lens on the end) in the mouth
  • Thyroid scan: A thyroid scan is a nuclear medicine test that allows your doctor to check how well the thyroid gland is functioning. It uses a radioactive tracer and a scanner to measure how much tracer the thyroid gland absorbs from the blood
  • Ultrasound of the thyroid: It uses sound waves to create images of your body. This test uses a lubricating gel and a transducer rubbed over the neck to look at the size and texture of the thyroid gland. This test can tell whether a nodule is a fluid-filled cyst, or a mass of solid tissue

Depending upon the type of thyroid cancer present, your doctor may choose one or more of the following thyroid cancer treatment options:

  • Radiation therapy: This method uses high beam of radiations to destroy the cancer cells. The patient may also take a dose of radioactive iodine to kill thyroid cells
  • Surgery: Generally, surgery is the most common treatment of thyroid cancer. Total thyroidectomy is a surgical procedure to remove all of the thyroid gland. Subtotal or partial thyroidectomy is a surgery to remove part of the thyroid gland. Your doctor may also remove the lymph nodes if the cancer has spread to the lymph nodes
  • Chemotherapy: It is a type of cancer treatment that uses drugs to destroy cancer cells. Chemotherapy may be used to cure the cancer, slow its growth and spread, and lessen the pain. Chemotherapy is used in patients with cancer that cannot be treated with surgery or is unresponsive to radioactive iodine, as well as for patients with cancer that has spread to other parts of body

Diabetes Insipidus

Diabetes Insipidus (DI) is a hormonal disorder characterized by an inability of the kidneys to conserve water due to insufficient production of antidiuretic hormone (ADH). Based on the underlying etiology DI can be categorized into central diabetes insipidus and nephrogenic diabetes insipidus. The primary symptoms of DI include excessive thirst and excessive urination. The management of DI based on the underlying cause. Vasopressin (desmopressin, DDAVP) can be used for the management of central diabetes insipidus.

Pituitary Diseases

Pituitary Tumor

Pituitary tumor is an abnormal cellular growth in the pituitary gland located in the brain. Pituitary gland releases hormones that act directly on the body tissues and also regulates the production of hormones from other glands such as thyroid and adrenal gland. Thus pituitary tumors lead to overproduction of one or more hormones causing conditions such as hyperthyroidism, gigantism, Cushing’s syndrome and abnormal discharge from the nipples of the breasts. As they grow they may put pressure on the optic nerve affecting vision. Their diagnosis is thus made on the basis of endocrine function test for cortisol, follicle stimulating hormone, insulin growth factor-1, luteinizing hormone, serum prolactin, and testosterone and thyroid hormone levels. The diagnosis is further confirmed by MRI of the head.

Most of these tumors are non-cancerous and do not spread to other areas of the body. The treatment involves radiation, medications and surgery as monotherapy or combination therapy. The surgery is essential when the tumor is pressing the optic nerve and may cause blindness. Most of these tumors are removed through nose and sinus without external incision using endoscopic transnasal transsphenoidal approach. However, in case the tumor is big it is removed through the incision in the skull (transcranial approach).

Thyroid Ultrasound

Ultrasound Examination

Ultrasound examination is the most accurate and useful imaging test to detect nodules or lumps within the thyroid gland. Ultrasound procedure uses sound waves to produce images of the thyroid gland and the images can be captured to assess the size, shape, structure and any abnormalities of the thyroid gland. Accurate measurement of the size of the thyroid nodules can be made using ultrasound imaging. It also assists in evaluation of the variations in the thyroid tissue such as enlargement caused by goiter and decrease in size caused by inflammation, and can differentiate between solid, fluid filled or complex type of thyroid nodules.

Thyroid ultrasound is recommended by your doctor in following conditions:

  • If a thyroid nodule can be felt on physical examination
  • In suspicion of hormonal disorder of the thyroid gland
  • In swallowing disorders
  • If you are at a high risk for thyroid cancer with family history of thyroid malignancy and radiation therapy to the neck during childhood
  • To evaluate changes in the size of thyroid nodule during follow-up
  • To monitor your condition after surgery for removal of thyroid gland

The role of ultrasound in diagnosis of thyroid conditions is complex and involves detection of the thyroid and neck masses, distinguishing between benign and malignant nodules, and guidance during fine needle aspiration (FNA) biopsy and percutaneous treatment.


You will be made to lie down on your back on the examination table. Your neck should be in extended position so that ultrasound transducer can be placed properly. A gel will be applied to the skin to facilitate conduction of sound waves. The sound waves directed from the transducer are reflected back by thyroid gland structures and these reflected sound waves or echoes are received again by the transducer. The computer analyzes this information and creates several images each second that get displayed on the monitor. The entire procedure may last for about 10 minutes.

Ultrasound of thyroid is a very safe procedure and there is no exposure to radiation as no X-rays or other harmful radiations are not employed in the procedure.

Thyroid Ultrasound

Thyroid Diseases

Graves’ Disease

Graves’ disease is a condition in which the thyroid gland produces excessive hormones (hyperthyroidism). It is the most common cause of hyperthyroidism. It is an autoimmune disorder, meaning the body’s immune system acts against its own healthy cells and tissues. The disorder may occur at any age, but women over age 20 are most commonly affected.

The thyroid gland, located in front of your neck just below the voice box (larynx) produces two hormones thyroxine (T4) and triiodothyronine (T3) that regulate body metabolism. With Graves’ disease, the immune system makes antibodies that attack to the thyroid cells and stimulate the thyroid to make more amount of thyroid hormone than your body needs. This results in hyperthyroidism.

Patients with Graves’ disease may have some of the common symptoms such as anxiety, difficulty in sleeping, fatigue, muscle weakness, nervousness, hand tremors, frequent bowel movements, increased appetite, rapid and irregular heartbeat, weight loss, goiter (enlarged thyroid gland), and change in menstrual cycles, and breast enlargement in men. Graves’ disease can also cause eye changes such as inflammation, swelling of the tissues around the eyes, and bulging of one or both eyeballs. This condition is called Graves’ ophthalmopathy. Rarely, there may be thickening and reddening of the skin over the shins known as pretibial myxedema. This skin problem is not serious and is usually painless.

Your doctor will diagnose hyperthyroidism based on the findings of a physical examination of neck, medical history, and by laboratory tests. Laboratory tests include blood tests to measure levels of thyroxine, or T4, and triiodothyronine, or T3 and thyroid-stimulating hormone (TSH) in your blood. Your doctor may conduct a radioactive iodine uptake test, to measure the amount of iodine the thyroid collects from the bloodstream.

The goal of treatment is to control the excessive activity of the thyroid gland. Treatment options include:

Antithyroid drugs: Anti-thyroid medications may be prescribed to interfere with the production of hormones by the thyroid gland.

Beta blockers: Your doctor may prescribe beta blockers to relieve symptoms such as rapid heartbeat, sweating, and anxiety.

Sometimes a steroid drug that suppresses the immune system may be prescribed to reduce eye irritation and swelling.

Radioiodine therapy: The thyroid gland uses iodine to produce thyroid hormone. With this treatment, you swallow a pill that contains radioactive iodine that destroys thyroid cells so that less thyroid hormone is made. The thyroid gland shrinks and the symptoms reduce gradually over time. Radioiodine therapy is not used in pregnant women or women who are breastfeeding.

Thyroid surgery: You may need to have surgery to remove your thyroid (thyroidectomy).
After removal of the gland, you will need treatment to provide normal amounts of thyroid hormone to your body for the rest of your life.

Endocrine Neoplasia

Multiple Endocrine Neoplasia

Multiple endocrine neoplasia (MEN) is a hereditary condition, where an individual may have developed tumors in one or more endocrine glands. Endocrine glands are the glands that secrete hormone into the blood directly rather than secreting into a duct. Tumors can be benign (noncancerous) or malignant (cancerous). The glands that are commonly affected include pituitary, thyroid, parathyroid, adrenal, and pancreas.

The major types of MEN syndromes are MEN type I and MEN type II.

Multiple endocrine neoplasia type I – It is caused by a defect in the gene coding for the protein menin, which is located on chromosome 11. The tumor commonly affects the parathyroid, pancreas, and pituitary glands. The common symptoms include abdominal pain, black stools, headache, burning sensation in upper abdomen, loss of appetite, weakness, loss of muscle coordination, and nausea and vomiting. The tumor can be diagnosed by tests such as abdominal CT and MRI scan, blood tests, and parathyroid biopsy.


  • If the tumor has affected the pituitary gland then anti-cancer drugs are given to prevent the tumor growth and to reduce the prolactin level. Prolactin is a peptide hormone produced by the pituitary gland
  • If the tumor has affected the parathyroid gland then the entire gland may be removed. Parathyroid gland controls the calcium production and if these glands are removed the body will not be able to produce calcium which may lead to formation of kidney stones, thinning of bone, and high blood pressure. Hence the total removal of the gland is not done initially. If the entire gland is removed during the surgery, your doctor may suggest for hormone replacement therapy
  • Your doctor may prescribe certain medicines to lower the production of gastric acid produced by some tumors and to reduce the risk of ulcers

Multiple Endocrine neoplasia (MEN) type II – It is caused by a defect in the RET gene. It commonly causes medullary carcinoma in the thyroid gland. Pheochromocytoma (adrenal gland tumor) may be seen in nearly half of the patients and some patients may also have hyperplasia of parathyroid gland.

Multiple endocrine neoplasia type II is subdivided into three types, MEN IIa, MEN IIb, and familial medullary thyroid carcinoma (FMTC). The MEN type IIa is most commonly occurring subtype where medullary carcinoma occurs in early stages of adulthood, some of the individuals develop pheochromocytoma and some develop hyperparathyroidism. In MEN type IIb the medullary carcinoma occurs in the early childhood and some individuals develop pheochromocytoma but hyperparathyroidism may not be observed. In FMTC, medullary carcinoma occurs in several members of the same family without the occurrence of pheochromocytoma and hyperparathyroidism.

The most common symptoms include tumor pressing on the nearby structures, breathing problems, cough, diarrhea, abdominal pain, chest pain, nervousness, palpitations, irritability and weight loss. Type II MEN disorder can be diagnosed by physical examination and diagnostic tests such as abdominal CT and MRI scan, thyroid scan, ultrasound scan, and biopsies of the glands.

Surgery is done to remove the tumor in the adrenal gland. Medullary carcinoma is treated by removal of the thyroid gland and the surrounding lymph nodes. Your doctor may suggest hormone replacement therapy if the entire thyroid gland is removed. Early diagnosis and surgery can cure the disease condition. If the child is a carrier of RET gene, then thyroid gland is surgically removed before it becomes cancerous.

The purpose of hormone replacement therapy is to compensate for the thyroid hormones that are lost when the thyroid glands are removed because of which the body will no longer be able to produce thyroid hormones, leading to hypothyroidism. Thyroid hormones help to control body metabolism, when the hormone level is reduced the metabolism rate will be impaired. Hormone replacement therapy can address the issue of hypothyroidism.

Metabolic Bone Disease

Metabolic bone disease or MBD refers to a large spectrum of bone disorders, usually caused by mineral abnormalities such as calcium, phosphorus, magnesium or vitamin D. The most common metabolic bone diseases include osteoporosis, osteomalacia, rickets, renal osteodystrophy and osteitis deformans (Paget’s disease of bone).

Metabolic bone disease can be caused by a number of factors including vitamin D deficiency, hereditary hypophosphatemia, and hyperparathyroidism (over-activation of the parathyroid gland).

The most common form of metabolic bone disorder is osteoporosis. Osteoporosis is a bone disease characterized by a decrease in bone mass and density resulting in brittle, fragile bones that are more susceptible to fractures. The condition most commonly affects elderly women. Osteoporosis related fractures are more common at the hips, wrists, or vertebral bodies of the spine. Osteoporosis is called a “silent disease,” because a majority of patients are unaware of their condition until they develop a bone fracture.

Metabolic bone disease in children can result in linear growth reduction, bone deformities, non-traumatic fractures, and impairment of motor development and function.


The diagnosis of MBD is usually made based upon a careful history, physical examination, radiographic (X-rays) examinations, appropriate lab tests, and bone biopsy if indicated.


Treatment for MBD depends on the underlying cause. Early detection and treatment of risk factors is essential to maintain the skeletal health of an individual. A balanced diet with adequate amounts of vitamin D and calcium and an adequate amount of physical activity are needed for normal bone metabolism. Your doctor may prescribe osteoporosis medications to help slow the rate of bone loss, and in some cases, to replace the lost bone structure.


Osteoporosis, often called “the silent disease”, is a bone disease characterized by decrease in bone mass and density resulting in brittle, fragile bones that are more susceptible to fractures, even without injury. The condition most commonly develops in elderly women.

The exact cause of osteoporosis is not known, however the factors that increases the risk of developing osteoporosis include:

  • Women are at a greater risk than men
  • Poor nutrition
  • Diet low in calcium
  • Lack of exercise
  • Asian people
  • People with thin and small body frame
  • Family history of osteoporosis
  • Women who are postmenopausal
  • Medical conditions, including hyperthyroidism, Cushing’s syndrome and hyperparathyroidism
  • Some medications such as corticosteroids, endometriosis medications, thyroid replacement medications, and antacids containing aluminum may contribute to bone thinning

Osteoporosis may cause no symptoms in the early stage of the disease. Later as the condition progresses it may cause the following symptoms:

  • Low back pain and neck pain due to fractures of the spinal bones
  • Dull pain in the bones accompanied by tenderness
  • Loss of the height of the spine giving a stooped posture (dowager hump)
  • Fractures from minimal trauma

Your doctor will make the diagnosis of osteoporosis based on the medical history, physical examination and a bone density test. Bone mineral density test is a painless, non invasive and safe method of measuring bone density.


The goal of the treatment is to control pain and to prevent bone fractures by reducing the bone loss. There are different treatment options for osteoporosis:

Diet: Consume a balanced diet rich in calcium and vitamin D

Exercise: Regular exercises can decrease the risk of developing bone fractures in people with osteoporosis. Your doctor may recommend exercises such as weight bearing exercises, riding stationary bicycles, using rowing machines, walking, and jogging.

Medications: Medications such as alendronate, risedronate, raloxifene, ibandronate, and calcitonin are used to strengthen bones and to stop bone loss.


The tips to prevent osteoporosis may include:

  • Consume a healthy balanced diet rich in calcium and vitamin D
  • Quit smoking and avoid excessive alcohol intake
  • Exercise regularly
  • Take medications to prevent osteoporosis

Diabetes Mellitus


Every cell in the human body needs energy in order to function. The body’s primary energy source is glucose; glucose from the digested food circulates in the blood as a ready energy source for any cells that need it. Insulin is a hormone produced by cells in the pancreas, an organ located behind the stomach.

Diabetes mellitus, commonly referred to as diabetes is a metabolic disorder characterized by high blood sugar levels that result from defects in insulin secretion or action or both. It is a chronic disorder that causes serious health complications such as kidney failure, heart disease, stroke and blindness.

Types of diabetes

There are 3 types of diabetes:

  • Type 1 diabetes: Type 1 diabetes is also called as insulin-dependent diabetes mellitus (IDDM). Type 1 diabetes is diagnosed in 5-10% of populations. Type 1 diabetes is caused when the body stops producing insulin or produces too little insulin to regulate blood glucose level. The body’s defense mechanism, immune system produce antibodies against insulin secreting cells in pancreas and destroy them
  • Type 2 diabetes: Type 2 diabetes is called as non-insulin dependent diabetes mellitus (NIDDM) and accounts for 90-95% of diagnosed diabetes. In type 2 diabetes the pancreas secretes enough insulin, but the body is partially or completely unable to use the insulin. The body develops resistance because of various factors including secretion more and more insulin
  • Gestational diabetes: It is a form of diabetes that occurs during the second half of pregnancy and blood glucose levels return to normal after delivering the baby. Women who develop gestational diabetes may develop type 2 diabetes in future

Pre-diabetes: It is a condition in which the blood sugar level is higher than normal but not high enough to be considered diabetic. The condition carries a high risk of type 2 diabetes as well as heart disease or stroke.


Causes of diabetes

Type 1 diabetes is caused due to an autoimmune disorder. Other causes include injury to the pancreas from disease, alcohol, trauma and surgery. Other causes including environmental factors, viral infection or nutritional factor in childhood may also contribute

Type 2 diabetes is associated with older age, overweight (obesity), physical inactivity, family history of diabetes and previous history of gestational diabetes

Other risk factors for developing type 2 diabetes include obesity, high blood pressure, sedentary life style, high alcohol intake, older age, high fat diet and pregnancy (gestational diabetes)

Symptoms of diabetes

  • Unexplained weight loss occurs due to loss of excessive calories in the urine
  • Polydypsia: As the kidneys produces excessive urine, it causes abnormal thirst, a condition called polydypsia
  • Polyuria: When the blood sugar level rises, the body tries to get rid of extra sugar in the blood by excreting it in the urine. The kidney excretes additional water to dilute the large amount of sugar
  • Delayed wound healing: White blood cells defend the body against bacteria. High blood sugar level prevents these cells from functioning normally and the wounds take much longer time to heal
  • Infections: Infections result from suppression of the immune system and by presence of glucose in the tissues which allow bacterial growth
  • Altered mental status: Irritation, inattention, and extreme lethargy or confusion are the signs of very high blood sugar
  • Dehydration: Excessive urination leads to dehydration as the sugar and large amount of water is excreted out of the body
  • Other symptoms include blurred vision, nausea, vomiting, and fatigue


  • Acute complications: Acute complications include the complications that occur quickly and usually last for a short time
    • Hypoglycemia: It is a condition characterized by an abnormally low level of glucose in the blood
    • Hyperglycemia: It is a condition of abnormally high level of glucose in the blood
    • Diabetic ketoacidosis: It is a condition resulting from a lack of sufficient insulin in the body, causing high blood glucose levels and ketone formation
  • Chronic complications: These include the complications that last long and are recurring
    • Eye complications: Diabetic retinopathy is the chronic complication of diabetes. Diabetes damages the tiny blood vessels inside the retina leading to diabetic retinopathy. It causes temporary or permanent loss of vision. It also increases the risk of developing cataracts and glaucoma
    • Kidney damage: High blood sugar level can damage the kidneys. When kidneys are damaged, wastes and fluids build up in the blood and are not excreted from your body causing diabetic nephropathy and leading to progressive renal failure
    • Nerve damage: Prolonged exposure to high blood glucose and longer duration of diabetes may cause nerve damage leading to diabetic neuropathy
    • Nerve damage can cause complete loss of sensation in the feet. Because of this minor foot injuries can lead to ulcers and infections and even gangrene. Diabetic foot is a term used for foot problems in patients with diabetes
    • Early coronary artery disease: High sugar levels causes narrowing of both the small and large blood vessels of the heart leading to coronary artery disease
    • Increased risk of infection: Bacterial and fungal infections develop when the blood sugar levels are high and the white cells cannot effectively fight infections


Your physician may diagnose the condition by performing various tests, which may include:

  • Fasting blood glucose test – It is often the preferred test done to diagnose prediabetes and diabetes. A single sample of blood is drawn after the person has fasted overnight. Fasting plasma glucose levels of more than 126 mg/dL on two or more occasions indicates diabetes
  • Random blood glucose test – A blood sample can be taken at any time of day. The blood glucose level of 200 mg/dL or higher indicates diabetes
  • Oral glucose tolerance test – It is commonly used for diagnosing gestational diabetes and in conditions of pre-diabetes. The test takes up to 3 hours, and in this test the person fasts overnight and then first sample of blood taken to determine fasting blood sugar level. After this test the person receives a large standard amount of glucose (75 to 100 grams) and blood samples are taken at every 30 to 60 minutes to measure the blood glucose. A person is said to have a normal response if fasting blood sugar level is less than 95 mg/dL, a 1 hour glucose level of less than 180 mg/dL, a 2 hour glucose level of less than 155 mg/dL, a 3 hour glucose level of less than 14o mg/dL
  • HbA1c test – It is a test used to measure the amount of glycated hemoglobin in the blood. Hemoglobin A 1c (HbA1c) is a minor component of hemoglobin. The blood sample is collected from the vein and the puncture site is covered with bandage to stop any bleeding. The normal level of HbA1c is 6 % or less and above 6.5 % may be considered as a condition of diabetes.


Treatment of diabetes involves diet, exercise, medications and other health habits. These will help to improve the blood sugar levels and prevent or minimize the complications of diabetes.

The goal of the treatment is to keep the blood sugar levels within normal range.

Diet – Eat a consistent well balanced diet that is high in fiber and low in saturated fat. Diabetic patients should not eat much sweet food. Meals should be taken on a regular schedule and long periods between meals should be avoided.

Exercise – Regular exercise in any form can also help people control their weight and maintain blood sugar levels within normal range. It can also reduce the risk of developing complications of diabetes.

Smoking and alcohol use – People with diabetes should stop smoking and consume only moderate or eliminate the consumption of alcohol.

Medical treatment – it depends on the type of diabetes, whether the patient has other medical problems, complications of diabetes, age and general health of patient.

Type 1 diabetes involves the daily injection of insulin, usually combination of short acting insulin and longer acting insulin. It is given in two or three injections per day generally around meal times.

Treatment for type 2 diabetes initially involves weight reduction, diabetic diet and appropriate amounts of exercise. If these measures fail, the oral medications are used. If oral medications do not help to control blood sugar level, insulin injections may be required. Your doctor may recommend taking a combination of oral medication and insulin injections to control blood sugar levels.

Anti diabetic agents used for treatment of insulin dependent and non insulin dependent diabetes mellitus include: Insulin detemir (Levemir),Insulin lispro (Humalog), Regular insulin (Humulin R, Novolin R) ,Insulin NPH(Humulin N, Novolin N), Insulin aspart( Novolog),Insulin glargine (Lantus),and Insulin glulisine (Apidra).

Oral Anti hyperglycemic Drugs: These drugs can often lower blood sugar levels and are usually prescribed for people with type 2 diabetes if diet and exercise fail to lower the blood sugar levels. Oral anti hyperglycemic drugs include Sulfonylureas (glyburide) and meglitinides (repaglinide) stimulate the pancreas to produce more insulin. Glyburide is an oral glucose lowering drug of the sulfonylurea’s group. It lowers the blood glucose by stimulating the release of insulin from the pancreas. Repaglinide improves the glycemic control in type 2 diabetes. Biguanides (metformin) and thaizolidinediones (rosiglitazone) do not affect the release of insulin but increase the body’s response to it. Both the drugs are used as adjunct to diet and exercise to improve glycemic control. Glucosidase inhibitors (acarbose), another class of drug, work by delaying absorption of glucose in the intestine.

Preventive tips

  • Keep your weight under control
  • Practice regular exercise
  • Reduce alcohol intake
  • Quit smoking
  • Adherence to medication and treatment of underlying complications or other disease conditions
  • Lifestyle modification
  • Skin care to prevent infections
  • Brush and floss the teeth regularly

Self care at home

The blood sugar level can be checked at home by pricking a fingertip with a lancing device and applying the blood to a glucose meter. The meter reads the value and the test results help patients to make adjustments in their diet, exercise and medications.


Dr Boccalandro and her team provide the highest quality of medical care with customized treatment plan for each of her patient. She evaluates and treats all types of hormonal disorders and other conditions such as osteoporosis, metabolic bone disease and Turner’s syndrome. To know more about the services click on the below mentioned tabs: