Mayo Clinic Q & A - November 2013 Archives

DEAR MAYO CLINIC: My wife is 31 and was diagnosed with type 1 diabetes at age 7. She had a baby three months ago, and her blood sugar levels were never really controlled. Doctors tested her kidney function and said there is “a little damage” but nothing to worry about. They said a pancreas transplant might be an option. How risky is this? What medications will she need to take following the transplant? ANSWER: Most patients with type 1 diabetes do not require a pancreas transplant, because newer insulin regimens can keep their blood sugar under control. However, someone in your wife’s situation should consider a pancreas transplant, especially if she has frequent “insulin reactions” — meaning her blood sugar goes very low without her realizing it.

Dear Mayo Clinic: Does smoking have an effect on diabetes? Answer: Yes. There is some evidence that cigarette smoking can raise the risk of developing diabetes. And for those who have diabetes, smoking can increase the number of complications from the disease, as well as the severity of those complications. Someone who has diabetes has too much blood sugar (commonly called blood glucose), which can lead to serious health concerns, such as cardiovascular disease, nerve damage (neuropathy), kidney damage, problems with the eyes and feet, bone and joint disorders, and skin problems. Smoking may increase the risk of diabetes because it can increase blood sugar levels. It also affects the body's ability to respond to its own insulin — a hormone whose main job is to keep the level of sugar in the bloodstream within a normal range. Eventually, smoking may lead to insulin resistance. Thus, the more a person smokes, the greater the risk of diabetes. Heavy smokers — more than 20 cigarettes a day — almost double their risk of developing diabetes, when compared with nonsmokers.

Dear Mayo Clinic: My father was recently diagnosed with diabetic kidney disease. Is there a chance this can be reversed, or will he have it for life? What changes, if any, should he be making to his diet? Answer: It is not uncommon for people who have diabetes to develop kidney problems. When diagnosed early, it may be possible to stop diabetic kidney disease and fix the damage. If the disease continues, however, the damage may not be reversible. Diabetic kidney disease, also called diabetic nephropathy, happens when diabetes damages blood vessels and other cells in the kidneys. This makes it hard for them to work as they should. In the early stages, diabetic kidney disease has no symptoms. That's why it is so important for people with diabetes to regularly have tests that check kidney function.

DEAR MAYO CLINIC: I was recently put on medication for high blood pressure. Does it matter what time I take it? I thought I was supposed to take it before I go to bed. But when I do, I’m up all night using the bathroom. Also, is this medication something I will have to take for life? ANSWER: It usually is not necessary to take your blood pressure medication at night, unless your doctor has told you to do so. Whether or not you have to take the medication for the rest of your life depends on a variety of factors. In some cases, lifestyle changes can lower or eliminate the need for blood pressure medication. What you eat and how much you exercise can help control blood pressure. Lowering the amount of salt in your diet and eating plenty of fruits and vegetables, along with whole grains and low-fat dairy foods, can have a positive effect. Regular physical activity can also help lower blood pressure and keep your weight at a healthy level. Weight is a big factor in high blood pressure. Research has shown that, in people who are overweight, lowering one’s weight by just 10 percent can lower blood pressure.