Re: Ashley's Story

You could find some interesting information about Type I and Type II
diabetes on this website :

http://metabolic-syndrome-institute.org

olivier


Charles Antony a écrit :
>>     You have made a variety of medical statements in your post which are
>> inconsistent with Type 1 and Type 2 diabetes as I know them.    I'm not
>> trying to be sarcastic or even ironic when replying at a time in which
>> Ashley's condition must be devastating to you.   However,  I am afraid
>> that
>> your research has not been deep enough and/or you have been too anxious
>> and
>> too intent in looking for "some way out".
>
> Actually, you are right. I typed in Type II, instead of Type I. I meant to
> say Type I. It must have been the exhausting night. Thanks for your
> response. I really appreciate you taing the time.
>
>> Some remarks from my side   (Research Engineer with diabetes,  not a
>> medical
>> person)
>>
>> 1.  Ashley is exhibiting symptoms quite typical of a Type 1  (Type I)
>> diabetic.
>>
>> Although thirst,  excessive urination and the like are symptoms of
>> developing diabetes,   the acceleration effect of prednisone could easily
>> have masked them.
>>
>> FWIW,  I did not experience any of the classical physical symptoms other
>> than blurred vision and, of course, high blood sugars.
>>
>> 2.  A juvenile Type 1 diabetic can go from "no physical symptoms" and
>> normal
>> blood sugar to sky-high sugars and DKA coma in a week.
>>
>> As a parent of a suspected Type 1 diabetic child,  you must be aware of
>> the
>> symptoms of DKA.   Please read and try to understand these medical papers:
>>
>> http://www.ispad.org/clin-2.htm
>>
>> http://www.emedicine.com/EMERG/topic373.htm
>>
>> Please memorize the symptoms  and/or post them in view somewhere.
>>
>> The first symptom of approaching DKA is high blood sugar.   Since DKA can
>> cause rapid-onset death,  please,  please, please continue to monitor her
>> blood sugar.
>
> We do monitor her blood sugar level twice a day, everyday. Thanks for the
> wonderful links.
>> Pay special attention to her blood sugar at 2 hours after a meal.   A
>> non-diabetic would be expected to be at 5 mmol/L  or lower at that time.
>>
>> It is not clear to me why you "weaned" her from insulin injections.  
The
>> first treatment for DKA is insulin injection.  Daily insulin injections
>> are
>> a preventative against DKA.
>>
> The doctor told us to reduce the dosage of insulin if her sugar level
> consistently drops, and it did. I'll check with the nurse.
>
>> 3.  Type 1 diabetes is genetically induced and mildly hereditary.   It is
>> an
>> autoimmune disease triggered by "something or other".
>>
>> "Something or other" can be a variety of stress factors,  ranging
from a
>> virus to a food allergy to personal stress.     A Type 1 diabetic can have
>> no known diabetic relatives of any Type   (like me, for instance),   or be
>> part of a family in which every child and grandchild of a T1 is also T1.
>>
>> In contrast,  Type 2   (Type II) diabetes is almost always strongly
>> hereditary.
>>
>> Sorry,  but your statement:
>>
>> ". . .     No one from Ashley's family (from both of her parents' sides)
>> is
>> diabetic. Ashley's illness cannot be hereditary. . . ."
>>
>> is totally in error.
>>
>> There is no known,  reliable preventative therapy for approaching Type 1
>> diabetes.   There is no "restorative" therapy (transplant from
sibling)
>> There is no way to protect other family members.
>>
>> Type 1 is an autoimmune disease.  Researchers are experimenting with
>> immune
>> suppressive drug therapies but there is nothing available outside of the
>> clinical trials.
>>
>> 4.  Prednisone unmasks developing diabetes of any type.    It
"orders" our
>> livers to produce extra glucose.    If our beta cells have been damaged by
>> some form of diabetes,   they cannot handle the extra glucose and our
>> blood
>> sugars rise.
>>
>> There is a theory that the extra work load produced by the release of
>> extra
>> sugars can accelerate an existing diabetic beta cell destruction
>> mechanism.
>> Therefore,  in theory, prednisone can accelerate the arrival of developing
>> diabetes.   That is not the same as "induce" or "cause"
diabetes.
>>
>> 4.  An HbA1c of 0.064 is not "slightly elevated"   It  is high, and
>> consistent with approaching full-blown diabetes.
>>
>> My HbA1c has not been that high since I switched from old-fashioned
>> insulins to modern insulins several years ago.
>>
>> (Think about the above statement if your doctor prescribes
"old-fashioned"
>> insulins when and if the time comes.   The modern insulins:    Humalog,
>> Novolog,  Apidra;   Lantus and Levemir  are much easier to use.    Easier
>> to
>> use means better control which means lower chance of diabetic
>> complications.)
>>
>> The best study of HbA1c  I have seen is the U.S. Third National Health and
>> Nutrition Examination Survey (NHANES) which reports an average of 5.0% for
>> non-diabetics.    NHANES is a large study with enough subjects to produce
>> an
>> expectation of accuracy.
>>
>> (Note that  most of us use the percentage version of HbA1c,  i.e.  6.4%)
>>
>> 5.  Exercise helps control blood sugar in any and all diabetics.
>>
>>  When I was in my honeymoon stage,   the only way I had available to knock
>> down a high blood sugar was riding a stationary bike.   A 4-minute mile
>> would knock my sugar down by an average of 1.1 mmol/L.
>>
>> 6.  Injection,  either by syringe,  pen or insulin pump is the most
>> reliable
>> and accurate method of delivering insulin.     There is an experimental
>> "inhaled" insulin being tested.     I cannot imagine using it on
either a
>> child,  or any Type 1 diabetic.
>>
>> Please investigate the costs and capabilities of an insulin pump.   It is
>> the most powerful and reliable insulin therapy available right now.
>>
> We are in the process of procuring one
>
>> Most insulin therapies for children are "second-best" therapies, 
used
>> because the child has limited understanding and is unavailable to the
>> parents during much of the school day.     Pump therapy is capable of
>> sidestepping these limitations.
>>
>> 7.  "is it possible that she was rashly misdiagnosed?".       I
cannot
>> believe that  (except for the fact that Type II is being mentioned so
>> often
>> when applied to a child with clear Type 1 symptoms).    Non-diabetics do
>> not
>> experience blood sugars much above 8 for any reason at any time.    Two
>> readings of 11 or more are considered sufficient for the diagnosis by most
>> docs.
>>
>> I commend whoever put Ashley into Emergency care when she spiked to 18
>> mmol/L.    She was in serious danger at the time.
>>
>> The gentleman who put together this web site
>>
>> http://www.rajeun.net/gtt.html#Diabetes and Hypoglycemia
>>
>> http://tinyurl.com/c5xqo
>>
>> has harvested responsible medical citations of blood glucose readings for
>> non-diabetic and diabetics when stressed by glucose ingestion.
>>
>> Note that he uses the U.S. notation of mg/dL.    ( 18 mg/dL  = 1.0
>> mmol/L.)
>> Ashley's 18-20 mmol/L correspond to U.S. blood sugars of 324 - 360 mg/dL.
>>
>> Mr. Toussier is not a doctor but, as I stated,  he quotes responsible
>> medical sources.\
>>
>> Good luck and please,  please test her blood sugars frequently.   DKA is
>> dangerous.
>>
>> Regards
>>  Old Al
>>
> Thanks a lot. Take care.
>>
>
>
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