Diabetes: Scientific Research for Type I Diabetes (cont.)

Moderator: We are almost out of time. What other clinical trials are going on currently?

Dr. Furlanetto: There's a broad range of trials. On one hand, there are additional trials aimed at preventing the progression or worsening of diabetes in patients who have just gotten the illness. New onset diabetics still have about 20 percent of their islets remaining, and if these can be preserved, their diabetes will be much easier to control and the incidence of complication much lower. The JDF and others are supporting studies aimed at preserving the remaining islets in new onset patients. There are also numerous studies underway to try to reverse or prevent some of the complications of diabetes such as kidney disease, eye disease, and nerve disease. These studies are listed on the JDF and other web sites.

null_null: How do parents stay up on the latest research and developments in finding a cure?

Dr. Furlanetto: Good question. The best way is probably in Countdown Magazine. This is published by the JDF. Each issue outlines one area of research, sometimes more, in diabetes. There are also a number of web sites devoted to diabetes, many of which include information on new studies and therapies. Asking your doctor can also be helpful.

cddcgd_WebMD: Is weight gain common among Type I patients?

Dr. Furlanetto: Unlike Type II diabetes, where obesity actually contributes to the diabetes, obesity is not a cause of Type I diabetes. However, patients with Type I often lose significant weight before the diagnosis is made, so when insulin therapy is instituted, they gain weight back. However, insulin therapy itself can sometimes lead to excessive weight gain if used inappropriately, particularly in patients who do not adhere to a meal plan and get regular exercise. However, under NO circumstances should patients withhold insulin to try to lose weight. This is dangerous!!

null_null: Does the JDF offer educational programs for newly diagnosed patients of Type I diabetes?

Dr. Furlanetto: Actually, no. The JDF can get you in touch with organizations that do, and we have a list of learning materials that are available. But the JDF is primarily a research organization. And it doesn't provide extensive educational materials themselves.

Moderator: What are the JDF's fundamental goals of their research program?

Dr. Furlanetto: There are four major research goals. To prevent Type I diabetes, to cure Type I diabetes, to prevent the complications of diabetes, and to cure the complications.

Moderator: Is there a priority?

Dr. Furlanetto: The JDF does have priority areas of research, and we've just done an internal review to reassess our priority areas. These will soon be published on the web site. Some of the areas include restoration of normal blood sugars, complications, hypoglycemia (low blood sugars), and vaccines.

Moderator: What are some of the complication of diabetes?

Dr. Furlanetto: There are four main complications of diabetes: eye disease leading to blindness if untreated, kidney disease which can lead to kidney failure if untreated, nerve disease, and hypoglycemia. Diabetics are also at risk for vascular disease such as heart attacks and strokes. It is important to realize, however, that good blood sugar control dramatically reduces the risk of all complications except hypoglycemia. Unfortunately, good control increases the likelihood of low blood sugars. This is the reason this has become a priority area of JDF research.

cddcgd_WebMD: What blood sugar level is ideal for diabetics?

Dr. Furlanetto: Fasting blood sugars between 80 and 120 are the targets; after eating, blood sugars less than about 170.

JHMCPHC_WebMD: My friend had triple by-pass surgery last November and was at that time put on insulin to treat his diabetes. He is now very moody, glum, and short tempered. Is this a manifestation of his disease or are they unrelated?

Dr. Furlanetto: In my experience, they are unrelated. Diabetes itself and, certainly, insulin do not usually result in personality problems. But diabetes is a chronic disease, and people with chronic illnesses have a higher incidence of depression and mood disorders. Your friend should be urged to get counseling for this.

cddcgd_WebMD: How many low blood sugars in a year should one expect to have with good control?

Dr. Furlanetto: Unfortunately, with good control, low blood sugars are much more common. One cannot really give a number. We hoped by therapy to minimize the low blood sugars, but it's virtually impossible to do if one is striving for good control. If one is having more than one severe low a month, you should definitely discuss this with your physician.

Moderator: How would someone go about donating to the research for Type I diabetes?

Dr. Furlanetto: You can go to our web site and the methods are outlined there. That's at www.jdf.org . In many towns, JDF sponsors fundraising events such as walks, galas, golf tournaments, and other such social activities. One can also contact the office directly to make a contribution at 1-800-JDF-CURE.

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