TYPE 1 & TYPE 2 DIABETES TOGETHER

According to Professsor Francine Kaufman, Director of the Centre for Diabetes, Endocrinology and Metabolism at The Childrens Hospital, Los Angeles, California there now exists an increase in the onset of both T1DM and Type 2 Diabetes in children. What is unusal, is that both diseases exists together in the same child. Type 2 is for the most part obesity related and can be "prevented" with good and healthy Lifestyle habits. Here is a copy of the article which I hope you will find interesting.'Double diabetes' appearing in kids

[Posted: Mon 29/05/2006]

When a child or teenager develops diabetes, it is relatively easy for doctors to distinguish whether they have type 1 or type 2. However new research has found that some young people have elements of both kinds of the condition - a phenomenon known as 'double' or 'hybrid' diabetes.

Current figures show that both type 1 and type 2 diabetes are on the increase in children and teenagers. The overall prevalence of type 1 diabetes among children under 15 is increasing by over 3% every year, while in children under the age of four, it is increasing by more than 6% a year.

Meanwhile, over the last 10 - 15 years, there has been a increase in the incidence of type 2 diabetes in young people worldwide. This has largely been obesity-driven.

Writing in the International Diabetes Federation's magazine, Diabetes Voice, diabetes expert, Professor Francine Kaufman, said that while it is usually easy to determine what type of diabetes a young person has, 'in some instances, it is not quite so clear'.



While there are a number of differences between the two types of diabetes, Professor Kaufman pointed out that with type 1, the 'hallmark' is the presence of antibodies which attack the insulin-producing pancreatic beta cells.

The hallmark of type 2 meanwhile is the combination of insensitivity to insulin and the body's continuing ability to make the hormone, although not enough to overcome the body's insensitivity to the action of insulin.

"Double diabetes suggests that elements of both type 1 and type 2 diabetes co-exist in the same person...Blurring the issue further is the fact that people with type 1 have family members with type 2 and vice versa. This means that a considerable number of people may be at genetic risk for both kinds of diabetes", Professor Kaufman said.

She pointed out that at the time of diagnosis, the doctor should of course attempt to determine which type of diabetes is present. However if the type cannot be determined initially, 'the young person should be started on insulin therapy while waiting for test results that hopefully will clarify the situation'.

For people with double diabetes, it is likely that they will need both insulin and oral diabetes medication, she said.

"We need to learn more about this relatively newly recognised condition. Since the emergence of double diabetes seems to be linked to the epidemic of obesity in young people, our focus should be on how to prevent childhood obesity as a primary means of reducing the emergence of this potentially devastating condition", she added.

Professor Kaurfman is the head of the Centre for Diabetes, Endocrinology and Metabolism at the Childrens Hospital, Los Angeles, California.

THE HIDDEN SECRET THAT ISN'T ALWAYS REVEALED

All of us know that it is of prime importance to keep our HgbA1C's in great numbers as well as the day to day readings of our glucose levels. What is not (unfortunately) discussed is how to avoid the MANY complications that affect people with T1DM no matter how great the glucose numbers are. The problem is in the LONGEVITY of the Disease. That is the issue at hand. There was a time when mortality age levels were low in comparison to today. Hence the diseases and health problems that most people now encounter were never around before. One of the many many problems with T1DM is that (obviously) it is not just about SUGAR as the villain. T1DM also raises inflammatory levels in ALL of us(T1DM), which in turn makes for susceptibility towards things such as Coronary Artery Disease and various Neuropathies. These things most Physicians usually do not discuss with their Patients other than give them referrals and limit their time to Insulin/Glucose Maintenance. How unfortunate and another example of overspecialization, time constraint and the business of Medicine. The nature of the Beast is that it is not as simple as it appears. TRAGIC!!!!

ADDENDUM TO FAT PEOPLE=FAT PETS

This is pretty much an addendum to a previous posting about obesity in animals causing Diabetes. I have recently come across more information regarding this problem. The conclusions are self-evident. Another example whereby people do not take responsibility for the good health of themselves, their children and their pets. There always exits cause and effect relationships. Enjoy the read:PET DOCTOR
Middle-age thirsty cat tests positive for diabetes
Dr. Michael Fox

Dr. Michael Fox/PET DOCTOR

Q: My cat started drinking and urinating a lot more than usual. She seemed weak and walked differently, as if on her heels. I thought it was her kidneys giving out and was in shock when the veterinarian tested her positive for diabetes. She said this is common in middle-age cats and dogs. Please spread the word.

A: Your veterinarian is correct. Type 1 diabetes mellitus is common in middle-age and older dogs and cats. It is often associated with obesity. Complications include cataracts in dogs and fatty liver disease in cats. Acetone may cause the breath to smell sickly sweet. Cats develop a down-in-the-heels (plantigrade) stance.

Early signs include increased thirst, urination, hunger and muscular weakness. Secondary infections due to immune-system impairment are common, in the skin, ear, urinary tract, prostate and respiratory system.

Regular blood tests, insulin injections and a special diet high in fiber and complex carbohydrates (and low in fat) are called for. High-sugar, semi-moist cat foods and dog foods must be avoided, even in healthy cats and dogs.

The high prevalence of diabetes and all of its serious complications in dogs, cats and people is reason for concern. In many instances, proper nutrition early in life -- no junk food (and sugar-laced cereals, candy and sodas for kids!) would save many lives and prevent much suffering.

GLUCAGON REALLY WORKS!!

Last evening as I was seated at my computer, the font size appeared very small on my monitor. That was strange, since I had not changed them at all. I enlarged my page, but still was unable to read the print. Since it was my usual time to check my glucose readings, I inserted the strip and got a ☞34mg/dl☜ reading!! I began to think to myself, how was it that I was still conscious? There was no dizziness only an inability to focus clearly. I immediately went to my refrigerator and quickly took out my Glucagen HypoKit. Inserted the sterile water into the glucose powder and injected into my muscle after the solution was shook. The great thing about the Glucagen Kit was that it began to work within 5-10 minutes and when I checked my glucose at that time it nicely climbed to 160mg/dl. Much better than when I would treat my low blood sugars with soda or sweet carbs and end up with my glucose rising to the other extreme (rebound) of 200-300mg/dl. This Kit is great because it raises the blood glucose quickly without rebound. Normally I would have eaten something sweet, but my numbers were too low and I had a feeling that they were falling too rapidly.
BTW, I do not work for the company.

HYPOGLYCEMIA AT MY PHYSICAL THERAPY

This morning while I was at my Physical Therapy appointment with my Therapist, B.....I started to perspire. Experienced in the nuances of hypoglycemia, I tested my glucose and got a 42mg/dl. I showed B the results on my meter and began to ingest six sugar packets. I told her that I would be alright, but wanted to inform her ahead of time in case I was not. The irony with all this was that here I was being treated for a post fractured wrist because of hypoglycemia about two months ago and now I am again experiencing another bout with severe low blood sugar, but this time within the confines of Hand Physical Therapy. I proceeded with the proscribed exercises and when I left after about one hour, I again checked my glucose and got a repeat 42mg/dl......How strange!! It is as if the sugar ingested had no effect, or that the physical therapy for my wrist, reduced my blood sugar even further, or (and this is the one I think is correct) my glucose was dropping so rapidly and quickly,,,,,that the six packets of sugar was just enough to hold it at the same original level. I should have taken the cookies she originally offered, but even better, drank a sweet beverage which I should carry.

TYPE 1 DIABETES GETS SHORT- SCHRIFT

At my Primary Care Physician's office there are a number of R.N.'s who give classes to those with Insulin Resistance Disease(Type 2 Diabetes) to help provide better management. I met one of these nurses in the elevator today and asked her whether her patients were compliant or non-compliant? She did not know who I was, so I told her that I had Type 1 Diabetes and find that people with T1DM are usually better motivated, knowledgeable and compliant compared with Insulin Resistant Disease. In addition, I said that we for the most part do not have a "weight problem". I went on to tell her that when I was being treated by Fellows in the Endocrinology Department at that hospital that advertises, "don't you deserve this level of care", they (the Fellows) had a mind-set and disposition into just treating Insulin Resistant Disease(Type 2 Diabetes). In so doing, people with T1DM were at a disadvantage and getting "short-schrift". All she said was that most of Diabetes (90%) is of Type 2 and so Physicians will orientate themselves in that direction. This is what I propose:
1. People with T1DM should be treated by Clinical Immunilogists rather than Endocrinologists, since T1DM is "Auto-Immune" in etiology and a mind-set/bias appears in those Physicians who are trained in Endocrinology to just "handle" Insulin Resistant Disease.
2. A new medical nomenclature should be established where those with Insulin Resistant Disease should no longer be called Diabetic or having Diabetes, since it takes away from the true meaning of the word in those with T1DM as well as the fact that these are distinctly TWO DIFFERENT DISEASE ENTITIES.