Diabetes Management: Personalized Care from a Type 2 Diabetes Doctor in Lewisville

At Health Express Clinics in Lewisville, we take a comprehensive, evidence-based, and patient-centered approach to diabetes management. As a board-certified family physician, I’ve managed hundreds of patients with Type 2 diabetes, prediabetes, and early complications, helping them regain control of their health and avoid long-term damage.

While endocrinologists offer advanced diabetes care for complex cases, most people with Type 2 diabetes can be effectively managed in a primary care setting. Our clinic focuses on education, medication, lifestyle guidance, and close follow-up to ensure lasting results.

Understanding Diabetes: The Basics

Diabetes is a chronic condition that affects the way your body uses insulin—a hormone that helps move sugar (glucose) from your bloodstream into your cells for energy.

Types of Diabetes:

  • Type 1 Diabetes: Autoimmune destruction of insulin-producing cells; usually diagnosed in children or young adults. Requires insulin for life.
  • Type 2 Diabetes: The body becomes resistant to insulin or doesn’t produce enough. Often associated with obesity, aging, and lifestyle factors.
  • Gestational Diabetes: Temporary insulin resistance during pregnancy.
  • Prediabetes: Elevated blood sugar not yet in the diabetic range, but with high risk for progression.
  • “Diabetes doesn’t happen overnight. It often starts years before symptoms appear—which is why early detection in primary care is so important.”— Dr. Harveer Parmar, MD

Top 5 Questions Patients Ask About Diabetes Management

1. Should I see an endocrinologist near me or a primary care doctor?

Many patients ask whether they need to see an endocrinologist near me or a diabetes specialist doctor. The answer depends on:

  • Type of diabetes: Type 1 typically requires endocrinology care. Type 2 is usually managed in primary care.
  • Complexity: If blood sugar remains uncontrolled despite multiple medications, or if you develop complications (kidney disease, severe neuropathy), we refer you to an endocrinologist.
  • Patient preference: We collaborate with local endocrinologists throughout the DFW area when needed.

At Health Express Clinics, we successfully manage most cases of Type 2 diabetes with a proactive and holistic plan.

2. What’s included in a diabetic management plan?

A comprehensive plan includes:

  • Lab work: A1C, fasting glucose, lipid panel, kidney function, microalbumin, vitamin D, B12
  • Lifestyle counseling: Weight loss, activity, sleep, alcohol moderation
  • Medication review: Metformin, GLP-1 agonists, SGLT2 inhibitors, insulin (when needed)
  • Monitoring: Home glucose logs, CGM data, blood pressure
  • Specialist referrals: Podiatry, ophthalmology, nutrition
  • Mental health support: Addressing diabetes-related burnout

We adjust this plan every 3–6 months based on labs, symptoms, and patient feedback.

3. What does a healthy diabetic diet look like?

We help patients build realistic, sustainable dietary plans—not extreme or unsustainable diets. Key elements:

  • High in fiber: Vegetables, beans, whole grains
  • Moderate in healthy fats: Avocado, nuts, olive oil
  • Controlled carbohydrates: Focus on low glycemic index
  • Minimize added sugars and processed food
  • Avoid high-fructose corn syrup, sugary drinks, and white bread

“When evaluating diabetic diets, I consider culture, lifestyle, and food preferences. Cookie-cutter plans don’t work—customization does.”
Dr. Harveer Parmar, MD

4. Can Type 2 diabetes be reversed?

In early stages—yes. Remission is possible through:

  • Weight loss (5–10% of body weight)
  • Regular physical activity
  • Carbohydrate moderation
  • Certain medications like GLP-1 receptor agonists

While we don’t promise “cures,” we’ve helped many patients normalize their A1C and reduce or discontinue medications under supervision.

5. What are the risks of poor diabetes control?

Uncontrolled diabetes can lead to:

  • Heart disease & stroke
  • Kidney failure (nephropathy)
  • Nerve damage (neuropathy)
  • Vision loss (retinopathy)
  • Amputation from foot ulcers
  • Increased risk of dementia and infections

“Diabetes complications are preventable. The earlier we intervene, the less risk there is for life-altering damage.”
Dr. Harveer Parmar, MD

Our Approach to Diabetes at Health

Express Clinics

Step 1: Accurate Diagnosis

We use ADA and AAFP criteria to diagnose:

  • A1C ≥ 6.5%
  • Fasting glucose ≥ 126 mg/dL
  • 2-hour OGTT ≥ 200 mg/dL
  • Random glucose ≥ 200 mg/dL with symptoms

Step 2: Individualized Treatment Plan

  • Newly diagnosed? We focus on education, goal setting, and lifestyle change.
  • On meds already? We evaluate medication efficacy, side effects, and insurance coverage.
  • High A1C or complications? We discuss intensification or specialist referral.

Step 3: Ongoing Monitoring

  • A1C every 3–6 months
  • Blood pressure and foot checks at each visit
  • Yearly referrals to retinal exam, urine microalbumin, podiatry.

    Case Examples from Practice

    (Anonymized)

    • A 52-year-old man with an A1C of 10.2% and poor energy. We started metformin and a GLP-1 agonist, modified his diet, and added walking after dinner. After 6 months, his A1C dropped to 6.8%—no insulin required.
    • A 40-year-old woman with prediabetes and PCOS. We focused on weight loss and dietary coaching, and she was able to bring her fasting sugar from 115 mg/dL to 92 mg/dL within 4 months.
    • A 65-year-old on insulin who was experiencing frequent lows. We switched her to a SGLT2 inhibitor and CGM monitoring. Her quality of life improved significantly.

      First-Line, Second-Line & Alternative Treatment Options

      Treatment Goal

      First-Line

      Second-Line

      Alternatives

      Lower A1C

      Metformin

      GLP-1 agonists, SGLT2 inhibitors

      Insulin (when needed)

      Weight Loss

      Lifestyle changes

      GLP-1 agonists

      Bariatric surgery (for BMI > 35)

      Glucose Monitoring

      Fingerstick logs

      CGM devices (Freestyle Libre, Dexcom)

      Smart glucose meters

      Diet

      Balanced diabetic plate

      Nutritionist-guided plan

      Plant-based or Mediterranean diet

      Sources: ADA Standards of Medical Care (2023), JAMA Internal Medicine (2022), Annals of Family Medicine (2023)

      Misconceptions About Diabetes

      ❌ “Only overweight people get Type 2 diabetes.”
      ✔️ Genetics, ethnicity, and insulin resistance play roles even in people with normal BMI.

      ❌ “Once you start insulin, there’s no going back.”
      ✔️ Many patients reduce or stop insulin with improved diet and meds like GLP-1s.

      ❌ “All carbs are bad.”
      ✔️ Quality matters more than quantity. Fiber-rich, whole carbs are essential to a balanced diet.

      When to Refer to a Diabetes Specialist Doctor or Endocrinologist

      We refer when:

      • A1C remains >9% despite multiple meds
      • Severe hypoglycemia or insulin resistance
      • Type 1 diabetes or adult-onset autoimmune diabetes
      • Diabetes in pregnancy
      • Diabetic ketoacidosis (DKA)
      • Complex medication regimens requiring endocrinology expertise

      We maintain referral relationships with endocrinologists across Lewisville, Denton, Plano, and Dallas-Fort Worth for cases requiring specialist input.

      Local Relevance in Lewisville and DFW

      In the Dallas-Fort Worth metroplex, we see higher than average rates of:

      • Obesity-related Type 2 diabetes
      • Hispanic and South Asian populations with genetic risk factors
      • Limited access to nutrition and activity resources in underserved areas

      That’s why at Health Express Clinics, we offer:

      • Accessible, same-day appointments
      • Diabetes screening at all annual wellness visits
      • Culturally sensitive dietary planning
      • Medication selection based on affordability and insurance coverage

      Why Choose Health Express Clinics for Diabetes Management?

      ✅ Experienced Type 2 Diabetes Doctor
      ✅ On-site lab testing
      ✅ Personalized medication plans
      ✅ Lifestyle-focused diabetic care
      ✅ Coordination with diabetes educators, dietitians, and specialists

      “You don’t need a specialist to start healing. You need a provider who listens, tracks your numbers, adjusts your plan, and walks the journey with you.”
      Dr. Harveer Parmar, MD

       

       

      Take the First Step Toward Better Diabetes Control

      Whether you’ve just been diagnosed or have struggled with blood sugar control for years, Health Express Clinics can help you take control of your health—without judgment and without delay.

      📍 Serving Lewisville, Denton, Carrollton, and the surrounding DFW area
      📅 Call or schedule your appointment online
      🩺 Ask about A1C testing, diabetic diet plans, and CGM options