DEAR DR. DONOHUE: I am 20 years old, and I was recently diagnosed with type 1 diabetes. Three years ago, my younger brother, now 18, was given the same diagnosis. We cannot find diabetes anywhere else in our family. My previous impression was that type 1 diabetes was genetic. I realize that it has to start somewhere, but are my other younger siblings at risk for it?

I’ve read that it will be almost impossible for me to give birth to a normal healthy baby and that I will age 20 years faster than normal. Is my body really 40? Do you have answers for me? – A.H.

ANSWER:
Type 1 diabetes is the somewhat-newer name for what used to be called insulin-dependent or childhood diabetes. The pancreas of people with type 1 diabetes makes little to no insulin, so insulin has to be furnished by injection or in other forms. Most of the time, the onset of this kind of diabetes occurs before age 20.

Genes have a hand in both type 1 and type 2 diabetes, but more so in type 2 than in type 1. (Type 2 diabetes is the more prevalent kind, the kind that usually appears later in life and the kind that can often be controlled through diet and oral medicine.) If one identical twin develops type 1 diabetes, the other twin has a 30 percent to 50 percent chance of also coming down with it. Identical twins have identical genes. If genes were the only factor involved as a type 1 diabetes cause, both identical twins should get it. Something else, in addition to genes, has to be at work.

People with one first-degree relative with type 1 diabetes have a 5 percent to 10 percent chance of also having it. A first-degree relative is a parent, a brother or a sister. If two first-degree relatives have it, then a person has a 20 percent chance of also having it. That’s where your other brothers and sisters stand.

Your body is not 40 years old. Strict control of blood sugar prevents or substantially lowers the risks of diabetes – early heart disease, kidney failure, impaired vision, nerve disturbances and blood vessel damage.

You can give birth to normal children. A diabetic woman, planning to become pregnant in the near future, needs to inform her doctor so both can keep close tabs on the woman’s blood sugar levels.

The diabetes booklet furnishes information on this somewhat-common illness. People can obtain a copy by writing: Dr. Donohue – No. 402, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order – no cash – for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I read that people with hypothyroidism (too little thyroid hormone) should avoid cruciferous vegetables and soy. I have been taking thyroid medicines for many years and have my thyroid levels checked periodically. Does this restriction apply to me since I am on medicine? – W.B.

ANSWER:
You don’t have hypothyroidism anymore. Your medicine makes you normal.

Your hormone status is checked regularly. If you haven’t gone out of your way to avoid those vegetables and soy in the past, you don’t need to do so now.

Examples of cruciferous vegetables are Brussels sprouts, cabbage, kale, broccoli, cauliflower and turnips. They contain substances that interfere a bit with thyroid hormone synthesis. People who already have a deficiency of the hormone could possibly incur a greater deficiency by eating those vegetables. People with normal hormone levels don’t run any risk. The same goes for soy.

DEAR DR. DONOHUE: My son-in-law got tired of picking the seeds out of watermelon, so he swallows them whole. He encourages his small children to do the same. Is this practice harmful? – M.D.

ANSWER:
It’s not harmful if the children are not so young that they could choke on the seeds. I have to confess: I swallow watermelon seeds. I like to.

Your son-in-law shouldn’t force the children to swallow the seeds if they don’t like to do so. He can buy seedless watermelons.

DEAR DR. DONOHUE: My EKG showed “sinus rhythm with poor R wave progression. Borderline first degree AV block. Consider anteroseptal infarct.” I was then given a radioactive stress test, preceded by a Persantine infusion. The stress test report says: “Normal pattern of Cardiolite distribution. Ejection fraction is 65 percent. There is no evidence of ischemia.” Does this all mean I should get my affairs in order, or might I live to 100? I am 80. – M.M.

ANSWER:
All this means you have a great chance of living many more years.

The mention of poor R wave progression and the consideration of a septal infarct on the resting EKG raise a question of an old heart attack (infarct) in the front of your heart. Forget the first degree AV block. It’s nothing.

This report probably prompted your doctor to order a stress test for you. During an ordinary stress test, people get on a treadmill whose speed and incline increase every three minutes. This exercise “stresses” the heart. If heart arteries are blocked, changes occur on the EKG, which runs throughout the test.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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