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Question:

I have had doctors tell me recently about a study currently underway involving the administering of oral medication along with the insulin injections to aid in reducing the need for insulin injections. Do you have any knowledge of such a study?

Also, my 6 year old son who has been recently diagnosed with IDDM is on the diet that is mainly concerned with monitoring the intake of carbohydrates and not overly concerned with the sugar associated with those carbs. Will this diet remain as he gets older or will sugars become much more of an issue? Finally, what is his prognosis for a long, productive life if we closely monitor his blood glucose levels and diet? Thanks from a very concerned parent.

Answer:

Adults with Type 2 diabetes make insulin, but that insulin may not work effectively. Due to insulin resistance they may make a lot of insulin. They may do well on an oral hypoglycemic agent (pill) or a combination of insulin and an oral hypoglycemic agent. All of these treatments would be in conjunction with exercise and attention to food intake. There are two oral hypoglycemic agents which you may be thinking of, neither of which is a treatment for a six year old with Type 1 diabetes (whose immune system has destroyed the beta cells in the pancreas which make insulin). Troglitazone and metformin are newer oral agents that you may have been hearing about. These medications would work with the insulin in your body.

As far as the approach to food and diabetes, I would recommend meeting with a nutritionist who is a Registered Dietitian, and who has experience in the care of children with diabetes. Counting carbohydrates, as you are doing is a fine approach. It is also important to look at the 'big picture'; i.e., the whole diet of a child for the overall "healthiness" of it. Protein and fat do have an effect on blood glucose levels, but they work over a longer period and without the fast rise that carbohydrates give you. You may need to adjust insulin, activity and food accordingly.

As far as the long term outlook for people with diabetes: It is very scary and upsetting to read about long term complications. Keep in mind that the outlook is the best it has been, and there are a lot of people doing research to improve things even more. Do the best you can with what we have now, and know that there are things you can do to improve the long term outlook. Please see the information about the Diabetes Control and Complications Trial (DCCT).

LM

Original posting 4 Oct 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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