Sunday, February 20, 2011

Type 2 Risk Factors

I'm getting poor accuracy from the current sensor, and especially after I recorded great accuracy from the previous sensor, I'm debating with myself about whether or not to pull this sensor early.
When minimed had to replace my receivers, it would also send me a sensor, since the time after the receiver broke was obviously time that the sensor wouldn't be working. Dexcom didn't do that.
Dexcom tells me that the reason I don't have insurance coverage yet is that my doctor hasn't sent them a particular paperwork item - a CMN which I'm guessing stands for certificate of medical necessity. I'm not sure I believe them that he didn't send it, since I once faxed them stuff they claimed not to have gotten. But I need to call his office again anyways.

I was thinking the other day about risk factors for type 2 diabetes that don't get much publicity, and why. Since the risk factors that do get publicity are the ones we blame people for- eating and exercise habits in particular- the ones we don't talk about are important in terms of guilt. They're also important because of who causes those other factors.
Whether or not type 2 risk factors contribute to type 1 diabetes is an open question. The acceleration hypothesis suggests that maybe if a person has insulin resistance plus antibodies, they're more likely to develop diabetes more quickly. A large study of children in California found that obese children were about 10% more likely to have diabetes antibodies. Children diagnosed with type 1 diabetes are typically smaller at the time they are born. My take is that the accelerator hypothesis has some merit but that insulin resistance does not contribute to more than a small portion of cases in the development of type 1 diabetes.

Anyways, some risk factors for type 2 diabetes that affect a significant portion of type 2 diabetics include:
- antipsychotic medication usage, past or present
- some antidepressants, such as lithium
- corticosteroid medication usage over a period of time (those of you who've seen insulin dosage changes in a type 1 on steroids shouldn't be surprised). This may be for asthma, cancer, immunosuppression (for transplants and/or autoimmune diseases), as well as other diseases
- bisphenol A consumption, which comes from food and drinks that are in plastic. Food from plastic contributes significantly to the metabolic syndrome
- genetics (alright, that one's not a secret)
- some mineral deficiencies, such as zinc
- liver disease, particularly hepatitis C
- antiretroviral HIV treatment (one video about HIV that I watched suggested that heart disease and diabetes are becoming the largest causes of deaths in young men with HIV)
- alcoholism (although alcoholic diabetes is kind of a hybrid between types 1 and 2 as it tends to cause damage to the pancreas)
- smoking
- polycystic ovarian syndrome (10% of women overall have this, although it's more like 9% of straight women and 35% of lesbians)
- hypogonadism in men
- some types of oral contraceptives
- maternal diabetes during pregnancy, of any type
- heroin, methadone, probably marijuana, and high doses of anabolic steroids
- smoking (past and present)
- sedentary life style (past and present)

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