This Disaster Averted is not just about one patient but about many who take insulin. Most think high A1C means one needs to increase insulin. Not always! Remember, A1C is an average. Just because someone has an A1C of <7% doesn't actually mean glucose is managed.

I traveled to Europe, a continent with a lot of history and cobblestone streets. I was aware of the amount of walking I was going to do and reminded myself of what we teach, or should be teaching, our patients: Do not travel with new shoes only. Always bring a pair of tried and true. And when you do buy new shoes, buy them later in the day, make sure they fit well, and break them in before wearing for long periods at a time. Wear them about a half hour a day, then slowly increase the time you wear your shoes to avoid foot problems.

So many of my patients who have insulin resistance, type 1 or type 2 diabetes with hyperglycemia and/or obesity have vitamin D or vitamin B12 deficiency. Often they have never had their levels checked or, if they have, were diagnosed with either or both vitamin D deficiency and vitamin B12 deficiency and do not take their prescribed vitamins. Why?

Female, 67 years of age, type 2 diabetes, class 2 diabetes, depression, hyperlipidemia, vitamin D deficiency plus more. Her A1C is 6.8% and her lipids are within goal. Her random glucose 2 hours after eating cookies was 118 today. Her glucose lowering meds are Trulicity, metformin, and Jardiance. She takes them as prescribed. Her endocrinologist recommended she meet with me. She refused until he recommended she see me the same day she was coming in to see another health care provider for her monthly infusion for another disease process to make getting here easier.

Concerned about the extreme weather disasters we have had and those predicted, I reached out to Carol Atkinson, Director of Insulin for Life, a trusted organization, to see how we could help. She was so busy putting packages together for people who have diabetes, she quickly told me the story of Wharton, Texas. It was Labor Day weekend. Hurricane Harvey had just hit and it hit Wharton, Texas hard. They were in need of insulin.

Dr. Leigh Perreault is an associate professor of medicine, physician and clinical researcher at the University of Colorado Denver School of Medicine, Aurora, CO. Her overarching research interest lies in understanding the different pathways by which people develop type 2 diabetes, and developing tailored strategies for diabetes prevention. Complementing her independent research interests, Dr. Perreault works closely with collaborators examining emerging risk factors for diabetes such as sleep restriction, intramuscular lipids and the human microbiome.

In this Exclusive Interview, Dr. Leigh Perreault talks with Diabetes in Control Medical Editor Joy Pape during the ADA meeting in San Diego, California, about obesity and the effects of the human microbiome on this disease.

Dr. Leigh Perreault discusses the genetic and environmental aspects of obesity, and the role of the human microbiome in obesity.

In part 1 of this Exclusive Interview, Dr. Leigh Perreault talks with Diabetes in Control Medical Editor Joy Pape during the ADA meeting in San Diego, California, about the causes of obesity.

In part 3 of this Exclusive Interview, Dr. Leigh Perreault shares her recommendations for healthier eating in a conversation with Diabetes in Control Medical Editor Joy Pape during the ADA meeting in San Diego, California.