June 15, 2001
Research: Causes and Prevention
Question from Salt Lake City, Utah, USA:
My mother died as a result of a myriad of complications from type 2 diabetes. She was diagnosed with the disease and placed on insulin after only a month or so. When she got the disease, she was not very overweight, ate a diet that consisted of high fiber and lots of vegetables. She did smoke, but never drank alcohol.
My mother was diagnosed when she was in her early thirties and now I am in my early thirties. I have been checking my blood sugars, which have been 150-200 mg/dl [8.3 -11.1 mmol/L], and I am sure that I will develop the disease. I am just like my mom, no serious weight problem, no other health problems, normal blood pressure, normal cholesterol, and I don’t smoke. If I start taking low doses of insulin now, would that stave off the development of the disease? I am not afraid of insulin — I am afraid of gangrene, and all the other horrors I have seen that come from this illness. I know that heredity plays a big role, but does it play a role in the severity of type 2, or even type 1?
Answer:
Diabetes by itself doesn’t mean complications. Complications are due to a poor metabolic control over a long period of time and having given genetic susceptibility for them.
I think your mom may have had Late-onset Autoimmune Diabetes of Adulthood (LADA) that was probably in poor metabolic control, despite insulin therapy (In those days, we knew much less about intensified insulin treatment for type 1 diabetes at diagnosis and smoking surely accelerated the progression of chronic complications).
Your concern and fear of complications (gangrene) is valid, but if you understand this concept and don’t ignore the high blood sugars you report (already diagnostic of a diabetes state similar to your mom’s), they can be avoided. Please see an endocrinologist, or better a diabetes team, as soon as you can. Ask for further testing and the most appropriate therapy (I say insulin) to restore the best metabolic control. That’s the best way to fight complications.
MS
