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February 1, 2002


Question from Cocoa Beach, Florida, USA:

My 47 year old brother, who has had type�1 diabetes since the age of 14, has been on dialysis three times a week for the past five years. He suffered two strokes by age 40, congestive heart failure at age 44, gastrointestinal problems, and has just been diagnosed with an enlarged liver, thickening of the esophagus, and as a "spur or sticker" on his lung. Would you please send any information concerning treatment, prognosis, or any available information you may find useful in helping me to care for him.


Your brother sounds like he has been a sick guy. It sounds like he has multiple complications from diabetes. These include the kidney, eye, and nerves. He also has cardiovascular disease which is much more frequent in patients with kidney failure and diabetes.

There is not one prediction for his prognosis. One of the things that may improve his prognosis may be a transplant, either a kidney/pancreas transplant or a kidney alone transplant. He needs to talk with his physicians about such treatments.