>>> NOVEMBER IS NATIONAL DIABETES AWARENESS MONTH, AND
ACCORDING TO THE CENTERS FOR DISEASE CONTROL THIRTY MILLION
AMERICANS ARE LIVING WITH DIABETES AND THE NUMBERS ARE ON
THE RISE AMONG CHILDREN AND TEENS.
CAROLEE MCGRATH SAT DOWN WITH DR.
CHELSEA GORDNER, AN ENDOCRINOLOGIST FROM BAYSTATE
MEDICAL CENTER TO LEARN MORE.
SO TYPE 1 DIABETES IS
PROBABLY THE LESS COMMON DIABETES, WHAT
WE USED TO CALL JIVE NILE DIABETES, HAPPENS IN YOUNGER
INDIVIDUALS AND THE BODY STOPS MAKING INSULIN SO THE ONLY
TREATMENT WE HAVE IS TO TAKE INSULIN.
>> HOW WOULD YOU KNOW THAT YOUR CHILD WOULD BE SUFFERING FROM
THIS?
>> THE SYMPTOMS HAPPEN PRETTY QUICKLY SO JUST OVER A FEW DAYS,
YOU HAVE EXCESSIVE THIRST, EXCESSIVE URINATION, EXCESSIVE
HUNGER AND OFTEN WEIGHT LOSS AND YOU CAN GET VERY SICK, VERY
QUICKLY WITHIN TWO TO THREE DAYS WITH TYPE I DIABETES.
>> AND WHAT ARE THE TREATMENTS BECAUSE I KNOW WE HAVE COME A
LONG WAY.
>> IT HAS BEEN AROUND SINCE 1921, INSULIN, THE MAINSTAY OF
TREATMENT.
THERE ARE TWO FORMS THAT PEOPLE USE, A LONG-ACTING INSULIN THAT
YOU TAKE ONCE A DAY AND THEN A SHORT-ACTING INSULIN THAT YOU
TAKE WITH MEALS BUT WE HAVE COME A LONG WAY IN THAT SOME PATIENTS
USE INSULIN PUMPS.
>> AND WHAT ARE THE DIETARY RESTRICTIONS?
>> I THINK A LOT OF INDIVIDUALS WHO AREN'T AS FAMILIAR WITH TYPE
I DIABETES THINK PATIENTS ARE VERY RESTRICTED, CAN'T EAT
CARBOHYDRATES, COOKIES, ET CETERA.
WE DON'T LIKE TO RESTRICT THOSE FOODS WITH YOUNGER PEOPLE
PARTICULARLY, AND TRY TO ENCOURAGE A HEALTHY DIET AND
MATCH THE INSULIN UP TO WHERE THEY ARE EATING.
>> SO TALK ABOUT TYPE 2 DIABETES.
>> IT IS MORE COMMON THAN TYPE I
DIABETES.
HAPPENS MORE OFTEN IN ADULT BUT WE ARE STARTING TO SEE IT IN
YOUNGER INDIVIDUALS NOW.
THAT RESULTS IN BEING OVERWEIGHT, NOT EXERCISING,
THOSE SORTS OF THINGS.
>> SO IF YOU TAKE WEIGHT OFF AND START MONITORING WHAT YOU ARE
EATING, CAN IT BE REVERSED OR ARE THERE STILL CERTAIN
TREATMENTS?
>> WELL, THAT IS THE QUESTION.
IT COMES DOWN TO SEMANTICS . IF YOU HAD TYPE 2 DIABETES AND
LOST WEIGHT AND WERE ABLE TO MAINTAIN IT WITH YOUR DIET,
THERE HAS BEEN REALLY GOOD STUDIES SHOWING WEIGHT LOSS
SURGERY CAN REVERSE DIABETES AND MAKE IT GO AWAY TO A LARGE
EXTENT FOR MANY YEARS.
>> ARE THE SYMPTOMS THE SAME BETWEEN TYPE I AND TYPE 2?
>> GREAT QUESTION.
BECAUSE IT IS RELATED TO YOUR LIFESTYLE AND OVERWEIGHT, IT
OFTEN CAN BE DIAGNOSED AT LONGER TERMS
BUT THE SAME SYMPTOMS APPLY, BEING OVERWEIGHT, BLURRY
VISION, DRINKING AND EATING OBSESSIVELY.
>> WHAT ARE SOME OF THE OTHER
LINKS AND COMPLICATIONS THAT COME FROM TYPE 2 DIABETES.
>> BECAUSE OF THE CHRONICALLY HIGH BLOOD SUGARS AFFECTS ALL OF
THE CELLS IN YOUR BODY AND THE ONES WE FIND THE MOST ARE ARE
THE EYES, THE KIDNEYS, THE NERVES IN YOUR FEET AND THE
HEART.
AND SO THERE IS, AS YOU MENTIONED, A LINK WITH HEART
DISEASE.
PATIENTS WITH DIABETES ARE ARE AT RISK FOR DEVELOPING HEART
PROBLEMS AND SO WE HAVE TO MAKE SURE THAT EVERYTHING IS IN
CONTROL.
THE BLOOD PRESSURE, THE CHOLESTEROL, AND THEN WE FOCUS
ON HEALTHY EATING AND EXERCISE.
>> LET'S SAY PEOPLE DON'T FOLLOW THAT HEALTHY EATING AND
EXERCISE.
WHAT CAN HAPPEN IF THAT GETS OUT OF CONTROL?
>> WELL, IT CERTAINLY CAN IMPACT THE BLOOD PRESSURE, IT CERTAINLY
CAN IMPACT YOUR DIABETES CONTROL AND INCREASES THE LONG-TERM
RISKS OF THINGS LIKE STROKES, HEART ATTACKS, THINGS LIKE
INCREASING THE RISK FOR AMPUTATION.
>> YOU WERE MENTIONING THE NUMBERS ARE UP IN TEENS AND
CHILDREN WITH BOTH TYPE I AND TYPE 2 DIABETES.
WHAT IS BEHIND THAT?
>> WELL, THE TYPE 2 DIABETES IN YOUNGER INDIVIDUALS IS RELATING
TO THE OBESITY EPIDEMIC, SO MORE KIDS ARE OVERWEIGHT, LESS KIDS
ARE EXERCISING.
WE SEE IT ALSO MORESO IN HISPANIC AND AFRICAN-AMERICAN
INDIVIDUALS AND GENETICS DOES PLAY A LARGE ROLE.
>> AND TYPE I AS WELL IS ON THE RISE?
>> WE'RE NOT REALLY CERTAIN AS TO WHY IT IS ON THE RISE BUT IT
IS ON THE RISE IN YOUNGER INDIVIDUALS.
WE THINK AUTO IMMUNITY IS PROBABLY PLAYING A ROLE.
THE UNDERLYING PATHOLOGY OF TYPE I DIABETES IS THAT YOUR IMMUNE
SYSTEM IS ATTACKED AND FOOD ALLERGIES, MORE
AUTOIMMUNE CONDITIONS CAN CAUSE THAT.
>> SOMETHING THAT AFFECTS WOMEN, GESTATIONAL DIABETES DURING
PREGNANCY.
TALK ABOUT THAT AND AFTERWARDS LONG-TERM.
>> WELL, WOMEN WHO ARE OVERWEIGHT ARE AT RISK FOR
GESTATIONAL DIABETES AND THAT DOES IMPACT THE BABY LONG-TERM.
SO IF THE BABY ENDS UP BEING LARGE AS A RESULT, THE BABY HAS
A RISK OF DEVELOPING DIABETES.
>> SO HOW DO YOU TREAT THE MOTHER DURING PREGNANCY AND THEN
MONITOR THAT CHILD ALL THE WAY THROUGH?
>> SO WE DO MONITOR THE MOTHERS VERY CLOSELY AND THEY HAVE VERY
STRINGENT SORT OF TARGETS DURING THE PREGNANCY TO TRY TO KEEP HER
HEALTHY AND THE BABY HEALTHY AND WE JUST TRY TO ENCOURAGE HEALTHY
EATING, EXERCISE DURING THE PREGNANCY AND PREVENTING AN
EXCESSIVE AMOUNT OF WEIGHT GAIN.
BUT YOU ARE RIGHT, THAT BABY NEEDS LIFE-LONG MONITORING IF
THE BABY IS BORN EXCESSIVELY LARGE OR SMALL.
>> DOES BREASTFEEDING HELP WITH THAT AT ALL?
>> WELL, IT HELPS CONTROL THE WEIGHT OF THE MOTHER AFTER BIRTH
AND SO THAT DOESN'T IMPACT THE BABY SO MUCH BUT IT HELPS THE
MOTHERS' LONG-TERM HEALTH.
>> SO LET'S TALK ABOUT THE IMPORTANCE OF HAVING A NATIONAL
AWARENESS MONTH FOR DIABETES.
WHY IS IT SO IMPORTANT TO GET THE MESSAGE OUT TO PEOPLE?
>> SO MANY AMERICANS ARE UNDIAGNOSED AND THEY HAVE THE
SYMPTOMS FOR YEARS AND HAVE ALREADY DEVELOPED COMPLICATIONS.
IF WE CAN PICK UP THE SUBTLE SYMPTOMS EARLY, WE CAN START
INTERVENING WITH LIFESTYLE CHANGES, HEALTHY EATING AND
MAYBE MEDICATION.