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A different diabetes: Type 1


For the past two years I have developed a friendship with a beautiful family in St Vincent, our mutual worlds brought together by their daughter, who has Type 1 diabetes. From them I have learned there is a recent peak of interest regarding Type 1, and so I have decided to dedicate the next several weeks to a thorough review. This column has in the past focused mainly on Type 2 diabetes, because that is what most adults (age 18 and older) suffer from, including the population in St Vincent and the Grenadines. Type 1 diabetes, on the other hand, is less frequent in the population, and in some important ways is quite different from Type 2.{{more}}

First let’s get some old ideas out of the way:

Old idea: “Type 1 diabetes happens only in children” – FALSE.

Type 1 diabetes is definitely diagnosed more in younger people, BUT over the past several years we are noting that more and more older people have actually Type 1 diabetes and not Type 2, as we previously thought. Case in point: my dear brother-in-law was diagnosed with Type 1 diabetes when he was 36 years old.

Old idea: “people with Type 1 diabetes die young.”– FALSE.

In the old days before insulin, yes, this was true, but not now. Type 1 diabetes REQUIRES insulin for medication, because pills by mouth will not work. THEY WILL NOT WORK, NO MATTER HOW MUCH YOU TAKE. However, now that we have insulin, and all kinds of it really, people with Type 1 diabetes have a life expectancy close to that of people without Type 1 diabetes.

Old idea: “people with type 1 diabetes will go blind and end up on dialysis.” – FALSE.

Just like people with Type 2 diabetes, the key here is getting blood sugars, and blood pressure, under control. For ALL DIABETICS, your chances of having kidney or eye problems increase rapidly if you let your sugars get out of control, and worse if they stay out of control. It does not matter Type 1 or Type 2, this is true for all people with diabetes. However, if you keep your sugars controlled, there is actually a very good chance that none of those issues will develop at all. My current champion patient is an 82-year-old man who had Type 1 diabetes since he was 11 years old. Notice how old he is: that means when he was diagnosed as a kid there was only the old kind of insulin around. When this man was a boy, he injected insulin four to six times a day to keep his blood sugars controlled. He had some low blood sugars and some high, of course, but overall he kept it under control. Now at age 82, he has NO kidney problems, his eyes are PERFECT, and he has no heart disease and no nerve problems, NONE.

Use him as your poster child/hero and remember that it CAN be done.

That’s our start for this week. Next week, we will get into more detail about Type 1 diabetes. Stay with me here, Vincies! Until next week, stay safe and healthy.

Anita Ramsetty, MD

Medical Director Endocrine Care Group

Tel: 843-798-4227