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December 25, 2007

Research: Causes and Prevention, Type 2

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Question from New Jersey, USA:

I have been thin my entire life, but type 2 diabetes runs in my father’s side of the family. My father is also thin and has had type 2 for 35 years. He is now 86 and very healthy except for the fact that he has had several cardiac stents.

I have had pre-diabetes for the past four to five years with fasting blood sugars ranging from 101 mg/dl [5.6 mmol/L] to 108 mg/dl [6.0 mmol/L]. My most recent one was 101 mg/dl [5.6 mmol/L]. My doctor also monitors my A1c with the last being 6%. It has ranged from 5.8 to 6.1. My cholesterol levels have always been normal but, now that I am in menopause, they have been creeping up. My last total cholesterol was 229, with LDL of 124, triglycerides of 63 and HDL of 92. I exercise like a maniac and my HDL reflects this. Will I be able to avoid getting full blown diabetes if I keep up my exercise? My doctor told me to watch my diet and will consider medication if my LDL doesn’t go down in three to six months.

My son developed type 1 diabetes two years ago at the age of 17. There is no type 1 diabetes in the family, only type 2. Is the development of his diabetes related to the strong incidence of type 2 in my family?

Answer:

From: DTeam Staff

It sounds like a strong familial/genetic component to the high lipids and the glucose intolerance. Anything that you do to exercise a lot will help, but still may not be sufficient. So, it would not surprise me that you need some medication help with the lipids. You can try some over-the-counter sterols such as CholestOff. If this does not work, then medications like Zetia or one of the statins would likely work very well. These are mild abnormalities but why not treat them?

It is the same with the high sugars. Avoiding carbohydrates or cutting way down may also help a lot. A version of the Atkins diet may allow your pancreas to not need as much insulin since you have some compromise genetically – that is why you are always hovering on the wrong side of 100 mg/dl [5.6 mmol/L] and the A1c is in the higher range. With your description of exercising and not being overweight, this would likely be worth a try to see how you feel, how you function and then what happens to the actual blood sugars and A1c levels after several months.

However, don’t be too hard on yourself. It sounds like you are doing all the correct things food and exercise-wise. They may not be enough for the biology/physiology of your pancreas and liver, but you will know this by the excellent monitoring you report.

SB