Q&A with the Consultant

Objective: To learn from questions raised by other Windfal graduates
 
On each Windfal course, patients are invited to set questions for the Diabetes Consultant to answer. The course has been running since September 2005 and there are now a large bank of questions. Windfal participants have told us they would like to know what questions other groups have set, to learn from the answers. This has been the inspiration for this page.
 
The questions are listed below. Please click on a question to take you to the answer.

List of questions

Will it affect my kids?

It is thought that type 1 diabetes occurs in people who are born with an inherited risk and are then exposed to some external factor that triggers the condition. It runs in families because of the shared genetics and shared exposure to environmental triggers.
The risk of getting type 1 diabetes in the general population is 1 in 300 - so in 300 people, one will get type 1 diabetes.
 
If you are a woman with type 1 diabetes, the risk of your children also getting type 1 diabetes is 1 in 50 - that means that if you suddenly have 50 children all at once (!), one of them will get diabetes.
 
If you are a man with type 1 diabetes, the risk of your children also getting type 1 diabetes is 1 in 15 - that means that if you suddenly have 15 chidlren all at once, one of them will get diabetes. No-one know why the risk is greater for fathers. But it is important to remember that if a child of yours does get diabetes, you will be able to help them cope better with it because you are an expert yourself - that's what the WIndfal course is all about. There is evidence that the diabetic children of people with good diabetes control also have good control themselves.
 
So keep learning!

Can you tell us a bit about insulin pump therapy?

Insulin pump therapy is also called CSII (Continuous Subcutaneous Insulin Infusion). It involves having a small electronic pump, about the size of a mobile phone, with insulin loaded into it. This is connected by thin plastic tubing to a small cannula (a plastic needle just a little wider than an insulin injection needle), which is inserted into the fat immediately below the skin on the abdomen.

The insulin is pumped in continuously and extra doses are given around meal times. It is like an intensive version of the basal bolus insulin regimen that all the Windfal graduates were on before doing the course. It needs a very good knowledge of how to adjust your insulin according to your carbohydrate intake and a very strong commitment to blood glucose monitoring to succeed.
 
In the UK, it is generally tried after the basal bolus regimen has failed or if there are still specific problems (particularly night-time hypos). It is used more often in the USA, but does not guarantee good blood glucose control. Research studies have shown an average improvement in HbA1c of 0.5% (the diabetes control marker). But how good or bad it is at improving blood glucose control really depends on the individual. It will suit some people well but not others.
 
If you would like to know more about insulin pump therapy or think it might be right for you, please contact our Diabetes Specialist Nurse, Cathy Jenkins.

Can stress or depression bring on diabetes?

There is no evidence that stress or depression can bring on diabetes. For example, diabetes does not occur more in the survivors of major disasters, such as an atomic bomb. But both stress and depression can destabilise your blood glucose control.

This can be for various reasons. If stressed or depressed, you might not look after yourself so well. So you might not be so careful with checking your blood glucose or getting your insulin doses right. You might eat or drink differently to usual. Also, during stressful times, the body produces "stress hormones". These have the opposite effect to insulin in the body - they increase the blood sugar. So during stressful times, you may find that you need to take a little more insulin.

Now go back to 'Q & A with the consultant' or another page or why not try the 'Quiz'.

Should I have kids by a certain age?

Dr Maria Barnard's answer will appear here.

Why don't pancreatic cells regenerate?

Dr Maria Barnard's answer will appear here.

Will there be a cure?

Dr Maria Barnard's answer will appear here.

Further questions

Can you tell us whether supplements work?
Does mood affect my diabetes and does diabetes affect my mood?
What is the long-term effect of having "too many" hypos?
Is there any evidence that sweetners are harmful long-term?
Is there really any difference in the absorption rate of insulin in the different parts of the body and is it significant?
What are stem cell transplants and could I have one?
Is there something about pregnancy itself that helps regulate blood sugar levels or is it the intensive effort put in by the woman and her diabetes nurse?
How is my healing / bruising affected by diabetes?
Are there any medications that I should avoid or be careful with?
What exactly do cholesterol and triglycerides do?
By what mechanism do stress hormones raise blood glucose?
What new developments are there in treatments / cures?
Does diabetes affect the teeth and gums?
Is there a correlation between diabetes and energy levels?
What am I burning during exercise?
Why does my body feel different now that I have diabetes?
Why does flying destabilise my blood glucose levels?
Stem cells / transplants - what's the latest?
Do big fluctuations in blood glucose matter if the HbA1c is OK?
How much insulin do non-diabetic people make?
What about the new "artificial pancres" in the news recently?
What new developments are there in treatment?
Can you screen for / prevent type 1 diabetes?
How does menopause affect diabetes?
Do hypos cause memory loss?
Can you develop insulin resistance with type 1 diabetes?
What happens in exercise?
Working on it!