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July 28, 2002

Other Social Issues

Question from West Dundee, Illinois, USA:

Our son is only four, so I know the future holds many dreams for him, but I'm still curious to know what types of jobs are unavailable to people with diabetes?

Answer:

At the present time, I believe that the only irreconcilable problems relate to the military, to being a commercial pilot and in some instances to being a long distance truck driver — hardly major strictures on ambition. In order to make sure that what your son does eventually hope for is not compromised by early complications, you need to work with a clinical team that can help you keep up with advances in clinical care. At the same time you need to become an expert at keeping his blood sugars as near to normal as possible without significant hypoglycemia.

Later on, as he nears the teen years, you are going to be challenged to pass these skills on to him. However, before he goes to college, I really believe that if the tempo of present research is maintained that the two major problems with transplantation will be solved. These are the lack of donors and the need for lifetime immunosuppression if you do get transplanted.

Only recently, there have been reports from a group in Minneapolis who have shown that it is possible to grow totipotential stem cells from an adult and to use these to regenerate tissue within that same adult. If these and other surrogate cells can be engineered to produce a glucose sensitive insulin response, that will solve the first difficulty. On the second issue, there are now studies starting in humans that promise graft tolerance after minimal immunomodulation. In short, I don’t think that it is now fanciful to look for a cure, even though it may still be a decade or more away.

DOB