Dr. Jeanne R. Bonar

Yes. That is why controlling the diabetes watching the blood pressure control and evaluating the cholesterol are important factors. Treat any blood pressure problems early as that can compound you chances of cardiovascular disease. Many doctors alway use "statins." But that depends on your levels. Statins do not prevent the first "heart attack' unless they are very abnormal. The ration of total cholesterol to the HDL (High Density Lipoprotein) should be 4 to 1 or lower. The level of the HDL is important as it is the "good" cholesterol and helps keep the blood vessels clear. However, most physicians use statins on all diabetic patients. They are not indicated over 75 years old (some experts say 70 yo). However, at your age, you need to consider checking the "lipid panel" yearly or more frequently. The most common cause of death in type 2 diabetes is cardiovascular (heart or stroke). Good blood sugars are fine, but avoid high blood pressure also. I would like to have the blood pressure done in the doctor's office to be 135 over 80. Home pressures are usually lower. The statistic on blood pressure are what we know from the doctor's office. Please treat the blood pressure early before it is too high, then damage has been done. Many blood pressure drugs are easy to take and have no side effects. I find it is more difficult to control if the patient delays treating a slightly high blood pressure.

Small, non-invasive tumors need to be left alone and followed. Consider if they are functional? Are all the hormones being secreted? Is the Prolactin level high? Many so-called "tumors" are really just irregularities in the gland and can be followed by a CT or MRI on a yearly basis. If the tumor is functional, making too much hormone like growth hormone, then it should be removed. Check any tumor of more than 2 mm for pressure on the optic nerves. Many tumors are just incidentally found and just need yearly follow-up as long as there is no expansion or trouble.

If you are able to eat or drink, take something with sugar. Always carry sugar or glucose tablets with you. You can also use juice. If you are disoriented, a friend or family member should be taught how to use Glucagon shots (it comes in a nasal spray now, which you could also use the glucagon). Glucagon is prescription. I think carbonated drinks with sugar are absorbed faster. However, apple juice in the small cans are easy to carry, or orange juice if that's your preference.

Repeat the test and include a free T4. Also, I would request thyroid antibodies, family history, Total T4, and Total T3. During pregnancy, the binding hormone increases and a T3 resin uptake is inversely related to your thyroid activity. Don't just rely on one TSH. If your thyroid is malfunctioning, you should ask your obstetrician about your symptoms also. After the repeat test, if there is still an abnormality, then request an endocrinologist.

Non-steroidal analgesics such as ibuprofen,Motrin, Aleve, naproxen used for pain can frequently cause gastritis or ulcerations. Stop the NSAIDs, the above drugs fall into that category. Celebrex is prescription and is easier on the stomach. If you are buying pain drugs over the counter, check with pharmacist if they are NSAIDS.

Children need a regular diet with all the food groups. They should avoid excessive sweets and carbohydrates. However, complex carbohydrates, bread, starch are all part of a regular diet. Try to maintain a normal weight. Do not focus excessively on the diet or the child can rebel. Children on insulin often need a bedtime "snack" to avoid nocturnal diabetes.

Yes, you can. It is important to be under good control when you become pregnant. However, if you are not, try to achieve tight control as soon as possible. During pregnancy, the amount of insulin you use will increase because of the growth of the placenta, which produces hormones that make your body more resistant to insulin. Commonly, I see my diabetic pregnant patients monthly during the first trimester (first 3 months), then if they are in "good control," continue monthly. Definitely during the last trimester of pregnancy the requirement of insulin rises sometimes dramatically. So we check once a week. Keto acidosis is very dangerous to the infant (also to you), however, third trimester keto acidosis often results in a still birth. I like using the insulin pump during pregnancy and use CGMS continuous glucose monitoring. Then it is easy to dial up more insulin in the "basal rate" and add more 'boluses for meals. Learn to estimate your carbohydrates and correct for the high sugars. I have had very successful pregnancies in patients with close monitoring and "good" sugar control. Years ago, we did not have these instruments and prenatal care was low, so I witnessed patients coming into the emergency room and the baby was in distress along with the mother. Obstetricians could do nothing at that time. So many intrauterine deaths occurred in the third trimester. It is best to plan a pregnancy. Achieve the "good" control before and you will have smooth sailing. You need to pay a lot of attention, but it is only for 9 months and it is worth it.

I assume you are type 1 and are taking insulin at age 23. Manage your diabetes as you would anywhere. Check blood sugars or add one of the new Continuous Glucose monitoring devices GGM. They can show your sugar on you phone. Free style Libre 2 (soon on phone) or Dexcom 6. If you prefer not to wear a simple device, you can check your blood sugar in the restroom or before lunch in the break room. Do it naturally and wash hands. Do not "hide" your problem from your coworkers. If there is a problem, they may need to help. Keep sugar or glucose table in your purse, desk, or convenient place for lows. If you have a physical job, probably you should not be employed around hazardous equipment, but most jobs (carpentry, electricians, etc.) can be handled with the same attention.

Yes, but not so young. Type 2 diabetes does frequently run in families more so than type 1. Watch your weight eat healthy. Stay active. But the genes may still manifest themselves later in life. With both mother and grandmother having diabetes, suppose it is type 2 possible your chance is 20%, but you can help by keeping diet and exercise under control. You cannot change your genetics as yet. Maybe later.

Depends on how much behind he is. And other developments. Some children are early "bloomers" some are late 'bloomers." However, if it's significant, the lack of growth hormone from the pituitary can be responsible. An endocrinologist should be consulted. An MRI of the Pituitary could be in order. Your pediatrician should have some ideas if this within a certain percentage of "normal" or if he is really far behind. Low thyroid also can cause growth retardation. That is easy to check with a blood test. Is there a familial incidence of small adults? So, in summary: genetic, Pituitary, just late in growth spurt, or thyroid deficiency would all need attention.

Yes, but indirectly. If the diabetes in not "well controlled," also watch for high blood pressure which is common in diabetes and should be treated early. However, diabetes in itself is not the cause of the high BP. If you just have diabetes and are controlling it well, then the question of heart disease rests on your genetics, not just the diabetes.

It is an antibody that is destructive to the islet cells that produce insulin from the pancreas. There is a rarer type of diabetes called MODY (Maturity Onset Diabetes of the youth). He needs close follow-up at that age. And of course depends on what you mean as "prediabetes??"

No, there is no surgery to treat diabetes. If you require surgery for a different problem, that would be okay as long as the surgeon knows you are diabetic. But unfortunately, we cannot treat diabetes with surgery.

No. How tall is he now? What is the development of genitalia?

You cannot just lose one part. The subcutaneous fat is all over. Cutting portions and perhaps exercises to develop your ABS will help.

Most public schools have a school nurse. They usually have a plan to administer juice or carbohydrates if a child has a low blood sugar. If the child cannot respond they should call the paramedics. Don't take the advice of a random teacher or student. Paramedics don't mind being called as the out come of such visits is usually just fine. They can administer Intravenous dextrose (sugar) and have a rapid response.
You need to have a way to be reached or the doctor.

It is correctly HbA1c or some call it glycohemoglobin. With an A1c of 5.2, no treatment is necessary. You are most likely controlling with diet. Up to 7 A1C is fine without medications.

No, but many patients who are diabetic develop high blood pressure. It should be treated early.

No not just for diabetes. If something else occurs such as a car wreck yes you may need a transfusion. However not just for the diabetes.

Very definitely. Diabetics need to pay more attention to dental hygiene and periodontal disease. See a dentist for inspection and cleaning twice a year. At home, brush at least twice a day and floss between teeth.