Dr. Silva Arslanian chat transcript on diabetes
Share with others:
Excellent series! My question concerns the efficacy of test strips measuring blood sugar levels and insulin pumps. For what grout of persons are test strips appropiate? Are they a substitute for the "finger prick"? Why are they not more available to patients? As to insulin pumps, are they effective and why aren't they more available? Thanks for your great work!
Dr. Silva Arslanian: Any person with diabetes, either type 1 or type 2 diabetes should monitor glucose levels at home using meters which read glucose levels off of a strip on which a drop of blood is put. Thus, the person has to prick his or her finger. Pumps are typically used for people with type 1 diabetes. They are available as long as insurance companies are willing to pay for them. Pumps provide a better way of delivering insulin to patients compared to insulin shots.
Francis: Question: Is it possible for type 1 diabetes to become type 2 diabetes?
Dr. Silva Arslanian: Type 1 diabetes and type 2 diabetes are 2 totally different diseases. In the case of type 1 diabetes the cells in the pancreas which produce insulin become diseased and stop producing any insulin. In the case of type 2 diabetes, the pancreas produces insulin but the body does not respond to it, i.e. the body is resistant to the action of insulin. If a person has type 1 diabetes and gains weight and becomes overweight his or her body will become insulin resistant but nothing will change as far as the pancreas not being able to produce insulin.
Byron: If I may follow up my own previous question, my impression is that test strips and insulin pumps are not widely perscribed in the rural areas WPA. Why? Fuurther, if these technologies are effective, what are the obstacles to making them more available in the rural areas?
Dr. Silva Arslanian: Typicaly health care delivery may not be as up to date in rural areas as it is in urban areas where tehre are major tertiary care centers. I suggest any one who has diabetes mention to his/her doctor or health care team that he/she wishes to use better technology to take care of their diabetes. With teh availability of internet one can acquire knowledge easily nowadays.
codeslinger: When it comes to diet, how much should consumption of soft drinks and sugary treats and breakfast cereals be limited? Is there a "safe" amount?
Dr. Silva Arslanian: There is no room for soft drinks in your body. A humans body is made up of around 60-70% of water, not Pepsi, not Coke. so, in my dictionary you are wasting your money on buying and consuming something that is not healthy. As far as cereals, I suggest not sweetend or sugar coated cereals because as it is they have enough carbohdrates. the more complex the carbs the better off. Of course and occasional one is OK. the bottom line is MODERATION.
Francis: I was wondering if it was possible for a child initially diagnosed with type 1 diabetes to somehow develop type 2 as a teenager
Dr. Silva Arslanian: No. They are 2 different diseases. Someone with type 1 diabetes will need insulin injectiosn for life. Thsi is not the case for tyep 2 diabetes.
codeslinger: What role does exercise play in Type 2 diabetes? Is it a non-factor?
Dr. Silva Arslanian: Excercise plays a very important role in type 2 diabetes. Not only it helps with weight control, but it improves the body's response to insulin, i.e. it makes the insulin resistance less. Regular physical activity should be part and parcel of the routine management for type 2 diabetes.
Francis: If I may, I'd like to ask a follow-up question. Our daughter has had type 1 diabetes since she was very young and is now becoming very obese. Can insulin make a child obese? Is there anyway to avoid this? She is currently taking high doses of insulin.
Dr. Silva Arslanian: Insulin does not make someone obese. Extra calories and genetic make up do that. Howevre, an obese person will require more insulin than a lean one beacuse their body becomes insulin resistant. Also, when calory intake is more than what the body can burn then the blood sugars run high and consequently the doctors/nurses/parents chase them with insulin. I suggest a nutritionist evaluate your child's nutritional intake in relation to her activity pattern and make some recommendations.
Byron: Following up on the urban/rural divide in the detection and treatment of the disease, many in the rural areas simply do not have internet access nor, in many cases, the ability to digest the information even if they do. 1) Are there outreach programs to reach the rural population? 2) What, in your opinion, are some of the specific areas in which rural areas may suffer as opposed to their urban counterpart, in terms of detection and treatment?
Dr. Silva Arslanian: There are some outreach programs for diabetes. UPMC has a program in Johnstown. There may be similar ones in other rural areas but I'm sorry I am not familiar with. I wonder if the western PA American Diabetes Association office woudl be of help.
codeslinger: Any suggestions on weaning a child from soft drinks to simply water?
Dr. Silva Arslanian: Burgain with them. tell them that you will give them half of the cost of monthly consumed soft drink and the other half for you and stop bying it. Beleive me money talks! I suggested this with the parents of a 15 year old teenage patient of mine who had never tasted water in his life, and it worked like magic!
Byron: What are the promising technologies on the horizon for monitoring and treatment? For instance, I understand in the UK, monitoring through the retina has been approved, but has not been approved for use in the U.S.
Dr. Silva Arslanian: the most promising monitoring is continous glucose monitoring (CGMS) which is a device which inserts a small needle under the skin that monitors real time glucoses. But, even in the high tech centers it is still not easily available.
pghdiabperson I heard that my 7 old child could be diabetic if she wets the bed. Is that possible? It's happened twice in the last month
Dr. Silva Arslanian: PLEASE take care to her doctor to be checked without any delays. Bed wetting could be one of the signs of diabetes. If diabetes is not diagnosed in a timely fashion the person with it may get extremely sick. It could be a life threatening situation.
HS Hispanics and Latinos have a greater chance to be obese and have diabetes. Is this true? Are there any programs oriented to the Hispanic / Latino community in our region?
Dr. Silva Arslanian: Yes, this is very true. There is a program for Hispanic children at children's -Hospital of Pittsburgh run by Dr. Diego Chaves-Gnecco. 412-692-7337. he may know more about the adult program.
Dr. Silva Arslanian: Thank U all. You had great questions. Value your health and live, eat, drink, move HEALTHY. Junk food is only benefiting the companies who make it and not you.
First Published August 29, 2007 1:11 pm
