Understanding Diabetes: Ohio State Endocrinologist Explains Key Differences, Risks and Treatment Advances

COLUMBUS — An Ohio State endocrinologist is urging people to take symptoms of diabetes seriously and seek medical care early, noting that delays in diagnosis can lead to severe and sometimes life-threatening complications.

Dr. Kathleen Wyne, MD, PhD, an endocrinologist specializing in diabetes, hypertension and lipid metabolism at The Ohio State University, said both type 1 and type 2 diabetes can occur at any age — a common misconception she hopes to dispel.

Wyne explained that type 1 diabetes is marked by a complete lack of insulin, requiring immediate insulin treatment to prevent dangerous complications. Type 2 diabetes, she said, occurs when the body still makes insulin but not enough to meet its needs. That form is far more common and can often be managed for years with medications that improve the body’s insulin use.

Regardless of the type, Wyne stressed that high blood sugar damages “every cell in the body,” raising risks for heart attack, stroke, kidney failure, vision loss and even amputations. She added that erectile dysfunction can develop earlier in men with uncontrolled diabetes.

She highlighted several warning signs that should prompt immediate medical attention: excessive thirst, frequent urination (especially at night), extreme fatigue, constant hunger, eating more without gaining weight and unexplained weight loss. Anyone with multiple symptoms — particularly alongside a family history of diabetes — should be evaluated quickly, even at urgent care.

Lifestyle changes remain key for prevention. Wyne said that losing just 15 pounds or about 10–15% of body weight can significantly slow or prevent the progression from pre-diabetes to diabetes. Physical activity also plays a vital role by improving insulin sensitivity.

For those newly diagnosed, treatment now often begins with once-weekly GLP-1 injections such as semaglutide, dulaglutide or tirzepatide — not metformin, which was traditionally the first step. Another class, SGLT-2 inhibitors, helps protect the kidneys and heart and is often paired with the weekly injections for stronger control.

Wyne said that with modern medications, many patients with type 2 diabetes may avoid insulin for years. Even so, she emphasized that diabetes has no cure, and long-term management is essential to preventing complications.

Insurance coverage can affect medication order, she noted, but patients can typically access the recommended combination therapies over time.