Warren L. Butler, MD

Dr. Warren L. Butler would choose no specialty other than family medicine because “meeting an entire family’s needs brings tremendous challenge and reward,” he says.

Dr. Butler is based at Tanner Clinic Syracuse, where he sees patients of all ages. His emphasis is on diabetes and effective and long-term management of the disease.

A native of Kaysville, Utah, Dr. Butler earned a B.A. from the University of Utah, majoring in French with plenty of pre-med classes. He was accepted at the Saint Louis University School of Medicine in St. Louis, Mo., where he earned his M.D.

Dr. Butler completed his family-medicine residency at the University of Utah Affiliated McKay-Dee Hospital Family Practice Residency Program. He joined Tanner Clinic in 1997.

The board-certified family physician is married and the father of five children and grandfather of two. Any spare time he has is spent with family enjoying horseback riding, vintage car restoration, good books and wood projects. He can also be found sitting at a piano or in the yard doing gardening.

What patients are saying about Dr. Butler

“Dr. Butler is always honest and blunt, which is how I like it. He is very professional and quick. He always has good advice. I will continue to see him for years!” -Anonymous, in-clinic review card, February 2016

“Tuesday evening I experienced a severe allergic reaction – to what we unfortunately do not know. So grateful urgent care was available at Syracuse Tanner Clinic! Dr. Butler and his nurse on duty were so attentive and the care I received was excellent and most appreciated. Thank you, thank you!” – Linda on Facebook, November 2015

Keep Your Diabetes Manageable with Regular Doctor Visits

Dr. Warren Butler handles all the broken arms and sore throats of a family-medicine practice, but he particularly emphasizes diabetes and how to best manage the disease.

That’s because, he says, diabetes encompasses many other disorders that affect his patients’ quality of life.

The goal, he said, is to keep the kidney healthy. “I always tell my patients that the kidney is the pivotal organ,” he said. “If you keep it healthy, chances are you’ll do much better down the road.”

When patients are diagnosed with diabetes — types 1 and 2, but usually type 2 — Dr. Butler sets them up on a quarterly appointment schedule. In these regular visits to the doctor’s office, the first order of business is to check the patient’s A1C level.

Dr. Butler said the A1C test is used to diagnose diabetes and, once diagnosed, to guide the management of the disease.

This test, which measures the glucose in the blood and averages it over the previous three months, is the yardstick by which a diabetic’s health is determined. A person without diabetes would expect to be at a level of 4 to 6, he said. Prediabetes occurs at about 5.7, and insulin would be required at levels above 8, he said.

Dr. Butler explains what patients with diabetes can expect at each regular appointment:

Every three months

▸ A1C test to determine glucose readings for the previous three months

▸ Physical foot checks for damage caused by neuropathy

▸ Blood pressure

▸ Weight

Diabetes doesn’t necessarily raise blood pressure and cholesterol levels, but “they often go hand in hand,” said Dr. Butler. Again, the goal is a healthy kidney. He adds, “There are some tricks and things to know about diabetes that are unique and different from a population that only has hypertension or high cholesterol.”

Every six months

▸ Cholesterol

▸ Blood work to measure kidney function

▸ Microalbumin (urine) test to measure kidney function. The test measures the amount of protein in the blood and is one of the first indicators of kidney damage

▸ Liver function tests

Every 12 months

▸ An eye exam by an ophthalmologist

A dilated-pupil exam allows detection of retinal damage, a side effect of diabetes. The test is important because there are no other early signs of eye damage. “Eye damage is not symptomatic early on,” he said. “If it is? symptomatic, it’s probably too late to reverse the damage.”

Dr. Butler said that among patients with uncontrolled diabetes the A1C level tends to seesaw by as much as several points. “A well-controlled patient may stay in the 6 level range for years,” he said. “But we also have patients who may fluctuate by two or three points based on their motivation and their interest.”

The goal is to keep that number from climbing too high, he said. “The higher a number gets, the more aggressive the physician needs to be to control the diabetes to avoid the complications,” he added.

Many tools to help with healthy lifestyle

Dr. Butler notes that the older we get, the more difficult it is to maintain a lifestyle that’s focused positively on diet, exercise, weight and attitude.

However, he adds, “the options available to patients keep expanding all the time.” Among the tools he uses to control diabetes are medications that use different mechanisms, insulin and injections of hormone-like substances that help control sugars.

When patients do have a hard time maintaining their weight, exercise and diet, “we have the tools to help them,” he said.

“I always tell people that I like to use the least amount of medication as possible,” he said. “So if they work with me and work with their diet and exercise, that allows me as a physician to use less of the pills and shots.”

Next Best Thing to a Foot Massage Is a Foot Check

Neuropathy (nerve damage) remains one of the biggest concerns for diabetic patients because the onset of numbness prevents patients from knowing that damage — especially to their feet — is taking place.

That’s why Dr. Warren Butler, a family-medicine physician at Tanner Clinic Syracuse, makes it a point to do a regular foot check on patients with diabetes.

He checks their feet for sensitivity to touch; he takes a look between the toes and determines if the foot is showing any inflammation or bone and joint abnormalities; and he inspects the skin for sores, cracked skin, calluses and blisters.

He encourages his patients to do the same at home on a daily basis.

With nerve damage to the feet, patients may not be aware of injuries that occur. He recommends patients do not go barefoot in the house or particularly in public settings like on the beach.

Diabetic patients “can’t feel things as well,” Dr. Butler said, “and they may have injuries to their feet they’re not aware of. If they get a fever and don’t know where the fever is coming from, it could be a cut or foreign body in the foot.”

If he sees foot problems that he can’t address, he’ll refer the patient to a podiatrist.

— Tanner Clinic staff