Wednesday, December 5, 2012

What affect could dislocating a shoulder have on a person with type 1 diabetes?

Q. My friend and I are trying to role play a scene and her character (a detective with diabetes) just dislocated his shoulder. My character is a doctor and I wanted my response to be as medically accurate as possible. Could someone who knows more about diabetes tell me how a trauma like this might affect a person with type 1 diabetes?

A. The only possible connection between injury and type 1 diabetes is that a significant injury may mildly elevate glucose over a short period of time. The injury in and of itself will not alter long-term diabetic control. Opioids - to treat pain - do not affect blood glucose. It is very rare for a dislocated shoulder to become infected and in fact in the absence of penetration through the skin I am not aware of a single case. Your response as a physician would be very straight-forward and not really affected by this person's type 1 diabetes. You must obtain adequate pain control in order to 'reduce' the shoulder which means to move it back into place. After this the pain should virtually disappear although a few days of anti-inflammatory non-steroidal pain medications may be advised. May the muse of theater make you a master thespian. I wish you the very best of health and in all things may God bless.


What kinds of things might trigger type 1 diabetes?
Q. I think I might have diabetes. I'm going to go to the doctor real soon. Until then I have a question i'd like answered. Can anyone tell me, that has type 1 diabetes, what lead you to believe you have it, like i researched a little bit and most of the things said alot of time people get had an illness of some sort that triggered it or something. Any help is greatly appreciated. Sorry about the bad grammar and punctuation.

A. You are right for the most part, usually Type 1 (also known as Juvenile onset, or Insulin Dependant Diabetes), is generally contracted by individuals with a genetic disposition to having it in the first place, (basically this means that usually their genes were programmed with diabetes in the first place), however they ususally do not actually contract diabetes until they are a few years old, usually following a stressful or traumatic situation such as an infection, injury, or environmental change like loss of family, and their immune system attacks the Beta cells in the Islets of Langerhans in the pancrease which produce the body's insulin, leading to the person getting diabetes.
Another less common way for someone to contract diabetes is for them to suffer a traumatic injury to their pancrease or contract a pancreatic disease such as pancreatitis or Pancreatic Cancer, or suffer something like a car crash which damages the pancrease itself, causing the pancrease to fail to function properly and not produce insulin anymore, however this is very uncommon.

Also, if someone answers that it's caused by eating sweets or obesity, don't listen to them, they're thinking of Type 2 (also known as Adult onset, or Non-Insulin Dependent diabetes), type 1 diabetes has almost no relation to weight or dietary habits.


If I somehow manage to switch off the type 1 diabetes autoimmunity, will my beta cells grow back?
Q. If I somehow could manage to switch of the type 1 diabetes autoimmunity, will my beta cells grow back? They're all gone at the moment.

Or will a transplant or therapy of some sort be necessary. Dr John McDougall says cow's milk causes type 1 diabetes and once the beta cells have been fully destroyed they will not grow back - like chopping off a person's arm.

Let me know your thoughts. Thanks :)

A. Beta cells don't grow back once they are dead. Transplant surgery is not routinely done because of the complications caused by anti-rejection medication. I've never heard of a relationship between cows milk and type 1 diabetes, I don't believe that is a common hypothesis.


What happens in this situation to a person w/ Type 1 Diabetes?
Q. So what happens if someone with Juvenile/Type 1 Diabetes hasn't checked their insulin level or whatever for a while & they're engaging in a vigorous activity (like sports or running)? What happens when their sugar level becomes WAY above normal(like over three or four times than normal)?

Thank you very much for the help!

A. Hi
Yikes, I cannot believe what I'm reading here.

I've lived 50 years with Type 1 diabetes.
I was 7 years old when I developed it.
I'm in my late 50's now.
I married and had six pregnancies with only two babies both born prematurely and low birth weight, that I was able to carry successfully and raise to adults and are free of the condition.
My marriage fell apart 12 years ago and I've been rebuilding my life on my own, ever since.
It's been hard. It's been lonely. However, it has been quite an education as well as fulfilling. I have no regrets. I've made mistakes like we all do, however, I learned from those experiences.
I am ever so pleased to have made it to 50 years with the condition. The goals now, are to make it to 60 and 70 years with Type 1 diabetes. It is up to me and no one else, to make this happen.
Not that I've known anyone to make it to 70 years living with Type 1 diabetes. Still I live in hope.

I've had my resentfulness of the condition too but it doesn't make it go away.
In fact neglect can aggravate the chronic medical condition and harm your body, shortening your life span.

Running won't control the blood sugar levels.
It takes both medication and exercise as well as a heathy diet to keep well with this condition.

This person just needs to realise that this is their lot in life and now have to learn to live with it, manage it properly, and work with medical professionals, or die. Simple as that.

Being resentful and in denial of the condition does make it go away.
This behaviour is irresponsible and of concern.
Consequences will result in serious health concerns and complications including coma and death.

Type 1 diabetics need to check BSL's before breakfast, lunch, dinner and before retiring at night.

Type 1 diabetics need to take their medication/s regularly to keep BSL's within normal ranges to minimise complications for the body.

Type 1 diabetics need to eat regularly and healthy.

Type 1 diabetics need to carry snacks and jelly beans on their person and advise close associates that they have the condition.

From what you have described this is extremely dysfunctional and self destructive.

Won't take long before a major reality check will kick in which may be just what is needed.

Counselling is another option to get to the real root cause of this behaviour.





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