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February 8, 2008

Research: Causes and Prevention

Question from Portland, Oregon, USA:

I am a 50-year-old female with no family history of diabetes. I am about 10 to 15 pounds overweight, not enough to be (as I understand it) a risk factor. In fact, my family has a history of hypoglycemia, which I believe actually caused my grandmother's death. A year and a half ago, I was in a serious motorcycle accident in which I broke both wrists, my sacrum, and seven ribs. Puzzlingly, the hospital didn't check for internal injuries. A blood test about a year later discovered a wildly out-of-control blood sugar - a fasting sugar of 328 mg/dl [18.2 mmol/L] and an a1c of 12. A blood test the prior year showed no sign of problems. I am having difficulties finding literature on trauma-induced diabetes, but it seems only logical that if my pancreas were injured in the accident, it might explain the sudden onset of diabetes. Are there any studies or literature that you can recommend?

Answer:

The development of type 2 diabetes is not generally thought to occur unless structural damage to the pancreas is proven. Examples of pancreas damage where diabetes may occur include alcohol-induced pancreatitis, cystic fibrosis, pancreatic cancer, and any type of severe pancreatitis, to name just a few. However, in all of these, the disease did not just come up today after it was normal yesterday. These diseases are usually chronic and progressive in nature. As the primary disease develops, the likelihood of diabetes increases. I cannot quote you studies that have looked at trauma-induced diabetes. It is much more likely that diabetes may have developed as a result of prolonged omission from exercise with weight gain and then diabetes. If you have not been able to show organ damage to your pancreas, it would be hard to say the diabetes was a result. In addition, most patients experience diarrhea from the lack of digestive enzymes from the pancreas before they develop enough pancreas damage to have diabetes.

JTL