DURHAM, N.C. — The Centers for Disease Control and Prevention reports more than 37 million people across America have diabetes.


What You Need To Know

Dr. Stef Alexopoulos is an endocrinologist at Duke

She said the biggest issue is people not knowing what benefits them

The reversal of diabetic symptoms is possible


A diagnosis can mean prolonged health changes for a patient.

A Duke doctor said from her experience, there are many times when the issue is a gap between knowing how to take proactive measures and make sure the people who most need that information receive it.

It’s no secret the nation’s premier governmental health agency rates the south as having one of the largest percentages of diagnosed diabetes in America. 

Dr. Stef Alexopoulos said what isn’t talked about enough are the people who are at risk.

“I can't tell you how many times I have seen people who either have prediabetes and don't know about it, because no one told them it's on their blood test,” she said. “Or someone who comes to me for (a) new diabetes (diagnosis) and have had prediabetes for years, and when I ask them, they say that no one had told them that they had prediabetes for years."

Alexopoulos has been working in the southeast for nearly 10 years.

“If you don’t give people that opportunity then they will just progress down that path,” Alexopoulos said. 

Before becoming an endocrinologist for Duke Medicine, Alexopoulos completed her clinical training through an Emory University Residency at Grady Memorial Hospital in Atlanta, which is a safety net medical center. By legal definition, a medical safety net admits patients regardless of their ability to pay.

It was during this time when Alexopoulos made a startling discovery influencing her career path forever.

“Seeing firsthand the amount of patients who had completely preventable complications and especially those of socio-economic disadvantage. It felt crazy to me like it really ignited a passion in me to really try to do something to improve the health of people with diabetes,” she said. 

The CDC describes prediabates as a serious health condition where blood sugar levels are higher than normal but not high enough yet to be diagnosed as type 2 diabetes. Alexopoulos said too often her patients are unaware.

“We just see too much of these things when we know they can be prevented,” Alexopoulos said.

She said what has struck her the most are the number of potential complications tied to diabetes after the diagnosis.

“Limb loss, people being on dialysis, having neuropathy from diabetes, having really bad liver disease,” she described.

The endocrinologist said step No. 1 is meeting people where they are in life.

“We’re trying to work with what we have and make sure that we improve the lives of people with diabetes,” she said.

The second step may be improving quality of life by developing strong health habits. The continual monitoring of glucose levels by finger pricking, remembering to take oral pills and checking blood pressure can be part of that. 

“A big focus of what diabetes management is all about is trying to prevent the complications,” she said. 

Many people with diabetes need insulin to stay healthy, and being consistent with your their medication management is key.

“There’s also the positive that you can get yourself out of it if you catch your symptoms early on,” she said.

Many of her patients suffer from type 2 diabetes which is a progressively worsening condition.

“I would reassure that person that they can turn things around, and things can get better,” she said.

To avoid dire health outcomes, Alexopoulos said coordinated care is pivotal to improving health outcomes. She said medical teams at Duke trade information. Doing so allows for more room to give the best medical patient advice about dietary maintenance, avoiding processed foods and incorporating daily exercise.

“People are best managed in a team format,” she said.

She said current guidelines suggest anyone 35 and older should be screened for diabetes, and those who have family members who have type 2 diabetes are at a risk for developing the disease themselves.