Q: My nephew was diagnosed with diabetes. He had lost a lot of weight in a short time. Why does this happen to diabetics?
A: I suspect that a young person who developed diabetes for the first time (Type I diabetes) may have what is known as ketosis or keto-acidosis.
This is a natural process in individuals who are dieting to lose weight by cutting out carbohydrates. It can also happen during an illness when nausea or vomiting make it impossible to eat enough. If there is not enough glucose in the body, or the person is unable to use glucose in the normal way due to a lack of insulin, fat is broken down instead of being used to provide energy for the body.
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Byproducts of this process are ketones. These are related to acetone, or nail polish remover, and you may be able to smell this on the person’s breath. This is how diabetes was diagnosed in the old days before there were blood tests. Burning fat will, of course, lead to weight loss. Untreated diabetics will also urinate frequently and excessively and will lose weight due to dehydration.
Q: What is the difference between Type I and Type 2 diabetes? Are either hereditary?
A: Type I diabetes usually occurs for the first time in childhood. It involves the complete destruction of the islet cells of the pancreas, perhaps from a viral infection, so insulin injections are usually needed for the rest of the person’s life.
Type 2 diabetes is the kind most often found in an adult older than 40 years. Sufferers may not need insulin injections except perhaps when first diagnosed. They are usually treated with diet and pills. This is because the cells in the pancreas, although depleted, are not missing entirely.
The person’s body still produces small amounts of natural insulin.
Both types of diabetes may be inherited to some extent, but there is more of an obvious genetic link in the Type 2 or the late onset type.
Type 2 diabetes can be prevented, even in people with a strong family history, with good diet and weight control.
Clare Rowson is a retired medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
