Dr. Einhorn introduces himself and explains what type 1 diabetes is and what test can identify if you are a person at risk.
My name is Daniel Einhorn. I am a clinical endocrinologist which is a specialist in diabetes and other hormonal disorders. My professional role is as a clinical professor of medicine at UCSD (University of California, San Diego) and as a Medical Director of the Scripps Whittier Institute for Diabetes, which is in La Jolla, California.
Type 1 diabetes tends to present in a very explosive manner. It’s not subtle. The type 1 diabetes would begin having frequent urination, blurred vision, weight loss, often real craving for sweets, and the presentations often to an emergency room or occasionally to the very astute doctor where the blood sugar will be tested and it will be sky high. That’ll be 2, 3, 4, 5, 600 and the diagnosis is made.
Typically you will have had no warning otherwise. It happens typically in relatively young, often lean, fit individuals because it has nothing to do with your lifestyle. Type 1 diabetes is an autoimmune disease where your body’s own immune system, for reasons we don’t understand, decides to attack the beta cells which are the insulin-producing cells in the pancreas.
Once that beta cell mass gets down to the critical mass, you don’t have enough insulin to handle day-to-day metabolism and you become quite sick. Historically, people have died with the initial presentation of type 1 diabetes. So there really are no warning tests that we have.
Having said that, if you come from a family where your immediate relative has type 1 diabetes -- a sibling, a parent -- you can do a test to see if you’re a person at risk, and that test is called an islet cell antibody screen, islet cells being those cells where the beta cells are that make insulin.
Islet cell antibody screen, if the test is negative, you’ve learned nothing, but if the test is positive then you’re at a much higher risk for developing type 1 diabetes in the years to come, and while you can’t do anything to prevent it from happening today, at least you can be alert to the possibility, and there are some new therapies that may soften the blow and may make it a much kinder, gentler illness than it is otherwise.
About Dr. Einhorn:
Dr. Daniel Einhorn received his undergraduate degree from Yale University, his medical degree from Tufts University School of Medicine, and his internship, residency and fellowship at Harvard Medical School. He served on the faculty of Harvard until coming to San Diego in 1984, and has since been a clinical endocrinologist with Diabetes and Endocrine Associates, Associate Clinical Professor of Medicine (Voluntary) at University of California, San Diego, and, until 2000, the Medical Director of the Diabetes Treatment and Research Center at Sharp Healthcare. He is the Medical Director of the Scripps Whittier Institute Diabetes Program. Dr. Einhorn has held many leadership positions with the Board of the American Association of Clinical Endocrinologists, the American Medical Association's Diabetes Advisory Council and The Endocrine Society. He Chaired the American College of Endocrinology Task Force on the Insulin Resistance Syndrome and the Conference on the Insulin Resistance Syndrome. He has served on the American Diabetes Association (ADA) Managed Care Initiative and on the regional ADA and Juvenile Diabetes Foundation, and as Chair of the Diabetes and Pregnancy Program of San Diego and Imperial Counties. He is a fellow of the American College of Physicians and the American College of Endocrinology. His research and publications cover diabetes prevention and reversal, recognition and treatment of diabetic complications, new technologies, new pharmaceuticals, combination therapies, and clinical decision-making.
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