Diabetic Live

Who’s Managing Their Diabetes in This Economy: When an economic crisis hits, like the one currently at play on the world’s stage, citizens respond with decreased spending and a tightening of the economic belt. The problem comes when the very things we chose to reduce spending on are those things that improve our quality of life.

News accounts discuss the potential of recession weight gain. This happens when stress and a desire for less expensive food combine to add weight to our bodies.

The way this works is that foods with refined flour and sugar are often less expensive and more readily available. Fast food restaurants are generally less expensive and equally filling as more expensive restaurants. The end result is buying less healthy food options because they are cheap while losing the battle of our own personal bulge.

As telling as this is there are other forces at work. Because the cost of diabetic care is expensive there are some diabetics who are reducing the cost of their care by foregoing blood glucose testing and holding back or even eliminating medications used to treat diabetes.

The Miami Health Examiner reports, “The typical monthly bill for someone with diabetes runs $350 to $900 for those without insurance, and the cost is rising as newer, more expensive medicines hit the market. Also, emergency care and a short hospitalization can easily top $10,000, and long-term complications cost even more.”

The American Diabetes Association indicates a trend in employers placing pre-existing conditions on new workers who are diabetic in an effort to reduce company spending. In turn individuals are asking their primary healthcare provider for free samples or inquiring about help from pharmaceutical companies to help cover the cost of medication. Other patients are simply reducing the amount of medication they take.

For some patients regularly scheduled appointments are being cancelled due to lack of available funds. All of this is happening at a time when diabetes related emergencies are on the rise in American hospitals.

PhillyBurbs.com reports, “Federal law allows health plans to look back six months for a medical condition that was present before the start of coverage in a group health plan, if the person was without “credible” coverage 63 days or longer, according to the U.S. Department of Labor. Insurers say employers also can request look-back reviews with new plans and employees.”

Because diabetes is tied to multiple chronic conditions such as heart disease, retinopathy and even stroke there is a rising alarm in health care practitioners who are seeing patients view their managed care as expendable in tough economic times. The end result may likely be a greater incidence of diabetes and a greater incidence of peripheral diseases that developed during a time when there was little the patient could do to pay for their own health care needs.

Add to this the cohabitation of depression with diabetes and you can also see that many diabetics may forego regular physical activity in favor of entertaining the stress the may feel at not being able to manage their disease effectively.

It is possible we will only see the full effects of this delicate house of cards after the economic crisis is over.

It is troubling to see cost saving measures go from turning out lights when you leave a room to leaving yourself unprotected from the complications of diabetes.

If you haven’t already done so you might speak with your doctor about what options may be available to keep your health managed by finding ways to reduce the overall costs.

A Diabetic Action Plan: While the medical profession argues about whether anyone can truly be considered cured of diabetes patients are often discovering that the best plan of action involves recruiting others.

Patients throughout America are looking at ways to manage their diabetes in a very proactive and informed way. If you are going to be successful in the control of your diabetes you will need to put together a group of individuals willing to help. This may include accountability partners, nutritionists, doctors, support groups and dieticians.

Sometimes the nutritionist and dietitian will be the same individual, but you will need to rely on them to help you come up with a meal and dietary plan that takes into account your needs and as many ‘wants’ as possible. You should have some control over what you eat, but a nutritionist can help you learn why certain foods are better choices.

If you take this first concept into your own hands you will likely find yourself failing and frustrated. Self-sufficiency is great for John Wayne movies, but it’s a horrible idea for anyone living with diabetes. The support you can find in others will be an incredible boost to your willpower and resolve.

You will likely be asked to lose weight, exercise more and eat better meals. You stand a much better chance of success if you have someone else willing to walk with you through the difficult changes diabetes can bring to your life.

Food labels are meant to be read – actively. A diabetic will need to reduce overall carbohydrates in their diet. You need to read labels to formulate a daily battle plan. Sugar is a refined carbohydrate, but it is not the only one. Eliminating sugar without counting carbs will not allow you to reach your self-managed diabetic goals.

Supplements are great, but look for more. Dieticians always prefer fresh whole foods to supplements and other pre assembled food options. When it comes to vegetables choose lots of dark rich colors. Vegetables that are lighter in color often have fewer beneficial nutrients to offer. The darker the better – the less refined the better.

Pay attention to how much you are eating. Protein is something we all need, but diabetics may need less than they think. A good rule of thumb is a portion size about the size of your palm. This is roughly 3-4 ounces of meat or fish. You should find the leanest cuts possible and then trim off any fat you may encounter. Lean fish should be considered a solid option at least twice a week.

Recent reports indicate intense exercise for short periods of time can help you remove excess blood sugar from your system. Three to four days a week you should consider 4-8 separate bursts (30 seconds per burst) of physical activity on an exercise bike, elliptical or treadmill. You can improve cardiovascular health and lose weight by implementing longer, but less strenuous physical activity of at least 30 minutes a day.

Conditions of excess weight do not generally happen overnight so you should not expect immediate results even if it seems difficult at times turn the tide. You will need to cheer over small victories and invite your support team to cheer with you.

In the end maybe it doesn’t matter so much whether doctors believe diabetes can be reversed. What matters is that you stop the disease in its tracks and demonstrate by your lifestyle choices that you do not want it to advance any further.

Could Losing Your Job Trigger Diabetes: Many Americans are becoming all too familiar with the term, “Pink Slip.”  Jobless rates are higher than they’ve been in a very long time, and once stable employment is now anything but.

There have been wise men and women throughout the years that say stress will show up physically. Maybe not today or tomorrow, but if you worry long enough there will be physical issues that reveal themselves.

Stress can make itself known in things like the loss of a loved one, the physical relocation of a family or even the knowledge that you or a loved one has a precarious medical situation. Experts have said that some stress may not be a bad thing, but long-term accumulated or harsh and sudden stress can break down defenses and usher in life altering medical side effects due to stress.

The Harvard School of Public Health recently conducted a study on the impact of job loss and the onset of medical difficulties including diabetes. Interestingly this study provides two interesting, yet opposite findings. The first is that individuals with medical difficulties might be the first to be ‘let go’ in an economic crisis. On the other hand an individual who may appear in good health can develop profound medical issues following a release from their job.

An MSNBC report indicates, “Those who lost their job — white or blue collar — through no fault of their own (for example, if their employer closed its doors) the odds of reporting fair or poor health increased by 54 percent. Among respondents with no pre-existing health conditions, it increased the odds of a new health condition by 83 percent.”

The stress of losing a job can be compounded by trying to find a new job. This can be further aggravated by having to learn a new job. This may be most traumatic for those who lost their job unexpectedly as opposed to those who were actively seeking a job change for personal reasons.

The MSNBC report indicates the following health concerns among those losing jobs in the current economic climate.

• Stroke
• Hypertension
• Heart disease
• Heart attack
• Arthritis
• Diabetes
• Emotional/psychiatric problems

Currently this leaves 5.7 million jobless Americans at risk for future health issues like the ones listed above. This may be the long-term cost of a recession. We may feel some of the effects now, but there will continue to be a payment required long into the future.

Working to reduce stress is always important, but even more so during troubled times.

Adding to the trouble is the fact that normally healthy individuals will often deviate from their normal food intake and exercise patterns. The reason for the change may be due to the need for a second job, lack of available funds to purchase the food that might be a better choice for their overall health, and a shifting of interest from looking at life in a ‘big picture’ kind of way to just trying to get through another day.

The consequences for this shift may prove important in rising diabetes diagnoses. As depression becomes more common there may be an even greater instance of diabetes in the United States and around the world.

If possible you should work to reduce your stress as much as possible and work with your health care provider to establish a plan to keep you in the greatest feasible health during and after this recession.

It may seem easier to simply let your health go, but there are always consequences for every action. When it comes to diabetes it is best to place an emphasis on avoidance whenever possible.

Pre-diagnosed Diabetes: Approach to Better Options: If you accidentally slip with a knife and cut your finger deeply then the use of a Band-Aid might not be enough to fix the damage. Stomach cancer can’t be treated with antacids. Vision problems can’t be treated by simply eating more carrots. You may see the logic in these statements, but wonder what this might have to do with diabetes.

In America and around the world people are being treated for symptoms of diabetes without an actual diagnosis of diabetes. These patients will visit with their health care practitioner for a variety of issues such as kidney problems, heart issues, high blood pressure and some neurological disorders. While these issues may be addressed it is possible a symptom is being treated while the disease is ignored. This is where the topic of diabetes may be treated with the proverbial Band-Aid.

In the National Health and Nutrition Examination Survey, just recently released through the journal Population Health Management 6.3 million Americans are being treated for diabetic symptoms without a proper diagnosis.

What this means in real terms is that these individuals may not even be aware they need to work at controlling their blood glucose. These patients will not be testing their blood sugar and will likely be eating the same foods they’ve always eaten.

This also means that $18 billion is needed every year to pay for costs related to the care of patience who probably should be diagnosed with diabetes. It is estimated that undiagnosed diabetes accounts for 25% of all diabetic cases.

Researchers claim that if this money were added to the total financial payment for diabetes care it would bring the tally to nearly $200 billion annually.

WebMD cites other findings discovered by researchers.

• The economic cost of undiagnosed diabetes is $2,864 per person.
• Incremental costs of undiagnosed diabetes begin at least eight years before diagnosis.
• About 4%-6% of men 35 to 64 have undiagnosed diabetes.
• About 14% of men 65 to 69 have undiagnosed diabetes.

The study’s authors write, “To the best of our knowledge, no study has investigated the health care use patterns and economic costs for patients with [undiagnosed diabetes], although present research does show an increase in medical costs in the years leading up to diagnosis.”

WebMD indicated, “Scientists used data from more than 3 million people included in the National Health and Nutrition Examination Survey to estimate costs and numbers of people in the U.S. with undiagnosed diabetes, tabulating bills for treatment of various symptoms of the disease.”

The study seems to suggest that if these individuals who may be in the earliest stages of the disease could be identified early enough it might be possible to minimize costs while maximizing their individual managed care simply by giving them tools needed to treat the disease of diabetes instead of the symptoms.

Factually the needed care for treating a symptom of diabetes will be very different from treating the disease. The first may result in a continued need for treatment of a symptom while the second provides a framework for long-term management of a disease.

While the diagnosis of diabetes is missing in many cases it is still probable that the cost for taking care of undiagnosed diabetes will still be significantly higher than for someone who is not diabetic.

The primary symptom treated, but not always linked to diabetes, is heart disease.

Redefining Diabetes Care and Prevention: What if the key to curing diabetes was simply a matter of fine-tuning your metabolism? What if science could develop a proactive approach to managing individuals at risk for diabetes? Data presented recently at the American Association of Clinical Endocrinologists (AACE) 18th Annual Meeting & Clinical Congress seems to indicate these two objectives may be possible.

Dr. Francesco Rubino of Weill Cornell Medical College said, “Metabolic surgery is one of the most important research opportunities for the next decade in medicine.”

A press release from the AACE indicates, “A growing body of evidence suggests that the mechanisms of diabetes resolution after surgery involve intestinal signals.” In other words the bowel may be a key control mechanism in the prevention and treatment of diabetes.

We reported in recent months that bariatric surgery has allowed many diabetics to effectively reverse the development of their disease. In most cases medical science has been unable to say with certainty why this surgery allowed a remission or possible cure for diabetics in their care. What they were certain of is that it worked. This type of surgery has been typically reserved for those who are morbidly obese. In fact, government health programs have even paid to have this surgery completed on patients in their programs.

The AAEC said, “Dr Rubino’s personal research showed for the first time that the effects of bariatric surgery on diabetes cannot be entirely explained by weight loss, and are intrinsic with the change of intestinal anatomy characteristic of these procedures. As a result, experts have been studying the biological impacts of the surgery on mechanisms of glycemic control, and are exploring the possibility to use gastrointestinal surgery to treat diabetes.”

This line of thinking has allowed Rubino and others to consider the metabolic significance associated with the procedure and how it affects patients. Rubino claims, “It would be premature at this point to argue every diabetes patient is a candidate for gastrointestinal surgery. However, there is enough evidence that surgery should be considered as an option to endocrinologists in the treatment of type 2 diabetes.”

A synergistic approach is taking place within this approach to diabetes care. Endocrinologists and surgeons are working together to bring specialized skills and insight to the interventions associated with this field of diabetes care. Rubino said, “Recognizing the need to work as a team across disciplines that includes endocrinologists and surgeons is the first critical step to address the issues and opportunities that surgery offers to diabetes care and research.”

The AAEC is also pursuing preventative measures related to prediabetes that include both pharmaceutical approaches along with treatment aimed at assisting in solution development for metabolic challenges faced by those on a collision course with diabetes.

While lifestyle alterations have always been a primary key in keeping diabetes at bay, new approaches being discussed include the use of medications such as, “Metformin, acarbose, glucagon-like peptide 1 agonists and thiazolidinediones.”

EndocrineToday.com quoted Daniel Einhorn, MD in a recent report when he claimed, “These medications illustrate a specific ‘plan of attack’ for treating prediabetes. But it’s important that caution is exercised.”

It should be noted that there is no current FDA approved program to treat prediabetes, but scientists remain interested in pursuing this course of action in an attempt to put a proactive plan together to turn the tide of onset diabetes in America.

Baseball Coach Takes a Dive and Lives to Tell About It: If you haven’t heard of the Fargo-Moorhead Redhawks don’t worry, you’re not alone. The Redhawks are a professional baseball team that is not affiliated with Major League baseball. They are part of the Northern League, which has teams in both the United States and Canada.

The Redhawks manager Doug Simunic has been with the team since 1996. Fans seem to like him. Players work hard for him, but Simunic was having off the mound trouble that finally caught up to him. “Anything healthwise that puts you in a stressful, unhealthy situation will always be a wake-up call. My doctor told me, ‘Don’t stop living.’ He wants me to make the choices I need to make.”

For Simunic that means many changes brought about by the development of Type 2 diabetes. “I should have been aware of not eating some of the things I like to eat,” he said. It was no-holds barred. Whatever goes, goes,” Simunic told Inforum.com.

Simunic’s eating habits caused his weight to escalate, which brought about intense feelings of fatigue. This led to less willingness to workout, and the downward spiral accelerated.

For Simunic it was deteriorating vision that finally convinced him to seek help. At 53 years of age this baseball coach found himself forced to change course.

• No bread.
• No potatoes.
• More fruits and vegetables.
• Smaller portions.

Like a mantra these ideals play in Simunic’s mind as he plans his meals. He’s also been convinced to head back to the gym and work up a sweat. Inforum.com indicates Simunic has lost about 50 pounds since his diagnosis and the controlled measures he’s had in place for his diabetes may allow him to eliminate medication soon.

The Inforum.com report indicates, “Simunic has been regularly throwing batting practice to his team for the first time in about five seasons.” Simunic said, “I’m a little more limber than I was the last few years. I can participate with my team and feel like I want to.”

As the Redhawks start their baseball season it is likely fans will also notice a difference in their team’s manager.

Redhawks General manager Josh Buchholz said, “I’m happy he’s dedicated to making a change. He’s back to doing what he loves to do, which is being out there with his team.”

One of the most difficult things for newly diagnosed diabetics to manage is to make the major changes needed to see positive life-enhancing results. As you can see, simply being involved in sports is no guarantee you will avoid diabetes.

The Inforum.com report indicates that manager Doug Simunic was not shocked to learn he had diabetes. He knew his lifestyle was problematic, but it took a very public wakeup call for him to begin to do something about it.

Many simply assume they will deal with diabetes if/when it comes. They feel as if they can eat what they want and just take some medicine to make it better after the fact. This line of thinking creates an atmosphere for diabetes that remains out of control. When diabetes remains a ‘loose cannon’ it can often lead to complications that can be fatal.

Simunic made the hard choice to battle back from the negative place he found himself in. Today he admits feeling better than he has in years.

Way to go, coach.

Diabetes: An Epidemic’s Affect on the Workplace: According to Forbes.com a recent U.S. study bluntly suggests that obese and diabetic workers are less productive than their normal weight counterparts.

The report followed more than 7,000 workers and the findings showed that overweight or diabetic workers missed more than 2 hours of work because of health related problems when compared to other average weight co-workers. This estimate is based on weekly findings.

This translates to a potential 104 hours or more annually when the employee will not be available to work. That means these workers will use just over 2.5 weeks of sick leave each year just on weekly hours lost.

The Forbes.com report also states, “The survey found that obese people with type 2 diabetes reported impairment during 20 percent to 34 percent of their daily activities, such as taking care of children, shopping and exercising.”

These findings come from the American Journal of Health Promotion.

What this news means for business owners is that wellness programs can be of benefit to their overweight and diabetic employees as well as all other employees. The dollars business owners invest in wellness initiatives counteracts absenteeism based on health concerns. It can also provide strong motivation for individuals to succeed in weight loss goals or diabetic management plans.

Some believe that the extra funds required to administer this type of program are well worth it for a more the potential of a consistent workforce.

Meanwhile TheAge.com.au is reporting that Australian citizens are also struggling with advancing weight gain, “The National Health Survey, released this week by the Australian Bureau of Statistics, has found disturbing increases in the numbers of adults and children who are overweight or obese. Using the body mass index yardstick, the survey shows that 68 per cent of men and 55 per cent of women were overweight or obese in 2007-08, compared with 64 per cent and 49 per cent in 1995. The highest overall rate, 67 per cent, was in the 55 to 74-year age group. Between 1995 and 2007-08, the proportion of obese children has risen from 5.2 per cent to 7.8 per cent — a rise almost entirely among boys, whose obesity rate has gone up from 4.5 per cent to an alarming 9.7 per cent (girls remain at 5.8 per cent).”

Between 2005 and 2007, “Lost productivity, welfare payments and careers’ costs,” increased by $37 billion dollars. This trend doesn’t show signs of stopping anytime soon.

TheAge.com.au argues that educational programs have not done an effective job at reaching the public and making a tangible difference. Far from decrying what doesn’t work to the exclusion of a solution TheAge suggests, “Two things are required to shift the public mindset. The first is to create a more holistic approach to obesity that takes it out of the realm of medical stigma and places it in a wider context of promoting and sustaining a healthier society through properly coordinated education and nutrition-awareness programs — something the Federal Government is already encouraging through its obesity inquiry and the establishment of the Preventative Health Taskforce.

“The second thing that should be done — in tandem with the first — is to toughen marketing guidelines, via a national co-ordinated strategy, to make it harder to advertise and promote unhealthy food, especially where children are concerned. For example, is it any longer appropriate for children who watch two hours of television a day to be exposed to up to 2200 junk-food advertisements a year?”

Whether it’s America, Australia or any of a great number of countries around the world diabetes is a real and present companion. Knowledge and wellness remain key components to the care and prevention of diabetes.

Link Between Triglycerides and Diabetic Nerve Damage: Triglycerides have recently been implicated as a primary factor in nerve damage among diabetics. This has led some in the medical community to suggest that Triglycerides should be monitored in much the same way glucose levels are.

FreeMD describes Triglycerides as, “Fats found throughout the body and the bloodstream. Triglycerides are a storage form of fat that provide energy for the body. Triglyceride is a form of fat that is made by the liver and intestines. Triglycerides are also present in food.”

According to a report in the upcoming journal, Diabetes, it is suggested that, “Diabetic neuropathy affects around 60 percent of the 23 million people in the United States who have diabetes. It is a complication in both type 1 and type 2 diabetes.”

A study by the University of Michigan and Wayne State University suggests a link between high Triglycerides and neuropathy. Coauthor of the study Kelli A. Sullivan, Ph.D. said, “In our study, elevated serum triglycerides were the most accurate at predicting nerve fiber loss, compared to all other measures.”

Forbes.com reported, “The study included 427 diabetes patients with neuropathy. Those with elevated levels of triglycerides were significantly more likely to experience worsening neuropathy over one year. Other factors, including blood glucose levels, weren’t significant.”

What this report seems to suggest is blood glucose levels are important in the development of diabetes, but it is blood fat in the form of Triglycerides that may be the predominant factor in nerve damage as a secondary effect of diabetes.

HealthInAging.org suggests, “Diabetic neuropathy affects peripheral nerves — those that are outside of the brain and spinal cord, such as nerves in the arms, legs, hands, and feet. Some elderly diabetics with neuropathy also develop a condition called diabetic myopathy (muscle wasting), in which the small muscles of the foot, as well as some other muscles, become thinner and weaker.”

Until now most in the field of medical science believed that blood glucose levels had everything to do with neuropathy, but this report places the blame directly on elevated Triglycerides.

Interestingly the primary means of controlling Triglycerides is through diet and exercise. This is the same process for better control of blood glucose. What this may mean is that approaching managed care seriously and in the same way may effectively treat both elevated blood glucose and Triglycerides.

In most cases Triglycerides are screened in virtually all blood tests administered among patients. It is possible to develop a home blood test that monitors both blood glucose and Triglycerides. This information can help diabetics form an action plan that assists them in effectively managing their own care.

The numbness associated with neuropathy has a very profound effect on diabetic patients who can’t always tell when medical attention is required because they don’t always feel pain in the same way other patients might. Long-term neuropathy can actually cause its own type of pain that requires daily and planned management.

According to Innovations Report, “The new finding adds to an emerging picture of the close connections between cardiovascular disease and diabetes. Elevated triglycerides are one of the most common features of the lipid disorders found in patients with type 2 diabetes, by far the most common form of diabetes.”

Rodica Pop-Busui, M.D., Ph.D., one of the study’s authors concluded by saying, “We demonstrated that the same lipid particles that contribute to the progression of atherosclerosis are also very important players in peripheral nerve fiber loss.”

He Refused to Despair: The Travis Kellegrew Story: Travis Kellegrew was a natural born cheerleader. He has inspired a crowd of fans to stand to their feet and encourage the home team. He’s been in uniform pushing his teammates to do better. He’s even resorted to dancing from time to time to bring everyone back to the focus of the game. When he’s not cheering his team on to victory he’s contributing in the game.

Kellegrew is quoted in Boston.com as saying, “We had goals sheets we had to fill out at the beginning of the season and every one of mine had something to do with fun. For the other two [sports] seasons, I’m the one in the stands leading the cheers. I’m definitely not quiet at games, whether I’m playing in them or not.”

At the age of 18, Travis Kellegrew was diagnosed with Type 1 diabetes. His mother, Barbara Kellegrew, works in the medical profession and certain elements of his life caused her some concern, “I had suspicions because he had the classic symptoms, so I already knew before the tests came back that that’s what it was. He’d lost weight, was thirsty all the time and had blurred vision. He had no idea what it was; he literally thought he was dying. I told my husband about my suspicions but waited to tell Travis once it was confirmed.”

Travis lost around 30 pounds in 3 months and just wasn’t feeling, “Right.” A call from his mom set lifelong changes in motion. Kellegrew told Boston.com, “I came home at 4, Mom had to work at 5 so she said, ‘Let’s take some blood,’ before she left. An hour later, she called and I could hear her screaming because she was so upset. I had no idea what it was, then Dad told me and next thing, we were on our way.”

In the end many are asking, “Why Travis?” Why someone honored for having “Most Team Spirit.” Why this young man who participated in an undefeated Chelmsford team? Why him? Why now?

Travis is active in three separate sports and was recently honored as Merrimack Valley Conference Athlete of the Year and is team captain for his Chelmsford High team. However, instead of throwing a personal pity party Travis is learning everything he can about his disease and working to manage the disease so he can continue to show team spirit and wear his school colors with pride. Travis spent time with, “endocrinologists, nutritionists, and dietitians to find the proper plan to keep healthy.”

Boston.com indicates, “Kellegrew has found the right balance between his diabetes and his active lifestyle. He takes three shots of insulin each day, injecting himself either in the thigh or the abdomen. He checks his blood-sugar levels four to five times a day and closely monitors his carbohydrate intake.”

Next year Travis plans to attend the University of Massachusetts at Lowell, but this year he’s received the adulation of coach Matt Dibble, “Everyone on the team is more educated and makes sure he has plenty of fluids during games. He’s on a strict regimen, but that’s what he wanted to do. He’s very dedicated in everything he does, including managing his diabetes. He’s just great to have around. He keeps things light.”

Kellegrew’s team spirit is evident when he talks about his future plans. At least for now they include an eventual return to Chelmsford as a math instructor. Sounds like a plan that does not allow Type 1 diabetes to control the future success of this team-spirited young man.

Sonia Sotomayor: Facing a High Profile Decision: She loved reading Nancy Drew mysteries and dreamed of becoming a forensics detective when she grew up. However, at the age of eight she was diagnosed with Type 1 diabetes and her dream required a shift.

Sonia Sotomayor found this condition altered the course of her life and future aspirations. Most recently this altered course has meant a Supreme Court nomination by President Obama to replace retiring Justice David Souter.

Sotomayor’s father died within a year of her diabetes diagnosis. Her mother stressed a strong education. This not-so-subtle push resulted in Sotomayor’s excelling to the head of her class in high school as well as her time at Princeton and Yale. Sotomayor turned in her Nancy Drew mysteries along the way to find inspiration in the television series, Perry Mason. The courtroom dramas helped her to determine the court would be her future. This became Sotomayor’s passion.

While the potential of the first Latina justice is being debated Sotomayor’s nomination has sparked its own sense of controversy. Can someone with a nearly 50-year history with diabetes be a meaningful candidate for the nation’s highest court?

Regardless of the ultimate answer to that question the American Diabetes Association (ADA) consider this a teaching moment for America’s citizens. Dr. Paul Robertson told CNN, “It’s wonderful for diabetics. I think it will go a long way toward being a major push against the stigma that some people with diabetes feel.”

Bill Ahearn is the vice president of Juvenile Diabetes Research Foundation International and he agrees with Robertson, “It’s a great educational moment for people in general. They can see that people that have type 1 diabetes have just as great a chance of success as anyone else. They have to be a mathematician, a doctor, a dietitian all rolled into one. It takes a lot of work, but it’s achievable.”

The questions surrounding the nomination have to do with potential health issues that could plague Sotomayor in her potential role as a Supreme Court Justice. The mere fact that Sotomayor has Type 1 diabetes has some wondering about issues related to kidney, heart and vision health (among other potential health concerns).

Experts indicate it all comes down to how Sotomayor has managed her own care over the past five decades. Robertson told The Huffington Post, “The advancements for management of type one diabetes have been just amazing over the last two decades because of the advent of insulin pumps and the ability of people to measure their glucose levels at home. We’re talking a whole different ball game now in terms of how well patients can do; what their longevity is like and how well they can function.”

You have to remember there once were prohibitions against diabetics fulfilling certain types of jobs. The fear was that the diabetic could find himself or herself in danger or be a danger to others if they passed out from the effects of diabetes complications. This could mean jobs that required the use of heavy machinery as well as other types of jobs were not available to diabetics. Advances in the distribution of insulin and self-management tools allow diabetics to engage in virtually any job today.

Does that extend to the nation’s high court? This is a question for which many diabetics are anxious to find an answer.