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About once a year, though, I diagnose someone with diabetes mellitus. Normally, a hormone called insulin pushes sugar from the blood into the body’s cells where it can be used for fuel.

The name comes from the Greek words for “to flow through” and “sweet.” The Greek physicians used to diagnose the condition by actually tasting the urine. The concentration of sugar in the blood remains within a fairly narrow range.

Now, Irina, I must reassure you that the first part of the above scenario is played out in my office about every two weeks.

In fact, if an identical twin has diabetes, the other twin gets it only about half the time.

Along the way, some of the predisposed individuals are exposed to something in the environment that triggers the diabetes. The virus misleads the body’s immune system into making antibodies against its own pancreas cells that make insulin.

About 30,000 people develop it each year, and their lives will never be the same.

Type 2 diabetes is caused, not by the absence of insulin, but by insulin’s not working properly.

If the body stops making insulin (type 1 diabetes), then adequate sugar doesn’t get into the cells.

Until June 23, 1997, type 1 diabetes was also called insulin-dependent diabetes mellitus (IDDM).

We did a simple urine test in the office, and two minutes later found that he had a huge amount of sugar and ketones in his urine. Even though the mom suspected the diagnosis, she was totally stunned. I sent them across the parking lot to the hospital lab for some bloodwork. A fasting blood sugar over 126 mg/d L or a random blood sugar over 200 mg/d L is diagnostic of diabetes.

I admitted the surprised boy to the Packard Children’s Hospital at Stanford for the whole family to learn a new way of life with type 1 diabetes mellitus.

(This is why type 1 diabetes is now also called immune-mediated diabetes).

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