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August 17, 2000

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Question from Utah, USA:

I am 31 years old, 6 feet 0 inches tall, and weigh 200 pounds. I was diagnosed about a month ago with type 2 diabetes, but only found out this past week that I was "anti-ica512 positive" (0.57), but GAD negative. I had been on a sulfonylurea diabetes pill, in combination with three miles per day of jogging, and a 2000 calorie diet. I read that sulfonylureas can be destructive to the pancreas in type 1 diabetes and stopped taking the pill. My pre-meal tests are still in the 80 to 90s mg/dl (4.4 to 5s mmol/L) and my post-meal readings get as high as 140 to 150 mg/dl (7.8 to 8.3 mmol/L). I am very motivated and not afraid of insulin. I am obviously in the honeymoon stage. What do you feel my treatment should consist of to best preserve my pancreas. Or, is that not possible?

Answer:

We don’t know if it is possible in folks with type 1 diabetes. In the The United Kingdom Prospective Diabetes Study, the islet cell “poop-out” occurred at the same rate in all the participants, whether on diet/exercise, sulfonylureas or a non-sulfonylurea pilled called metformin. If there were any one thing that seems to help pancreatic poop-out, it would be to maintain normal glucose control by keeping your blood glucose levels in the goal range, which sounds like what you are doing. By the way, being ICA-positive makes you a type 1 in the making.

VV