Question: I am a 57 year old diabetic and have been told that I have autonomic neuropathy. I hate summer, as I can’t bear direct sunlight, and over the past few years I have stopped sweating completely. Can you help me with my problem?
One of the complications of diabetes is the blocking of fine arteries. This may result in problems as diverse as gangrene of a toe to blindness.
If the tiny arteries supplying the nerves become blocked, that nerve does not receive the oxygen and nutrition it needs, and dies.
The autonomic nervous system performs most of the subconscious automatic tasks required by the body, including telling the sweat glands when to operate.
Neuropathy is a term that merely means nerve damage. Your auronomic neuropathy is thus damage to the autonomic nervous system caused by diabetes, and because these nerves have died and cannot send the appropriate signals, you cannot sweat.
This will make it very difficult for your body to maintain its correct temperature, and it is vital that you do not become overheated. Cool baths or showers, and an air-conditioned room in summer, would be appropriate.
You must keep your diabetes under careful control by taking your medication (Diamicron is one of a number of excellent drugs used to control diabetes in older people), having regular blood tests, and visiting your doctor when appropriate to prevent any further damage to your body.

Question: I have been suffering from type 2 diabetes, and have recently developed numb feet, and pains down the arteries of the leg. Could you explain what effect diabetes has on circulation, and what sort of specialist should I see?
There are two main types of diabetes—type 1 diabetes which usually affects younger people and requires insulin injections for control, and type 2 diabetes which is far more common, usually affects the elderly, and is normally controlled by diet and tablets.
Both types of diabetes can affect the small blood vessels (capillaries) and restrict the flow of blood. The most commonly involved small blood vessels are in the feet and eyes. In patients with inadequately controlled diabetes, poor circulation to the feet may cause numbness, redness, sores that won’t heal, and finally gangrene. In the eye, deteriorating vision is caused by poor circulation.
If the diabetes is well controlled, it is far less likely for these complications to occur.
Control of diabetes involves regular medication, a careful diet, checking the blood or urine levels of sugar, and checking with the general practitioner or specialist.
If a GP detects any problems that are significant, s/he will refer you to an endocrinologist (gland specialist). Some endocrinologists are super specialists, and treat only patients with diabetes.

Question: What is the difference between the diabetes children get and that suffered by oldies ?
There are two very distinct types of diabetes—juvenile (type one) diabetes and maturity onset (type 2) diabetes. The juvenile form may develop at any time from birth to the thirties, but the most common is between 10 and 20 years of age. Maturity type can start at any time from the thirties onwards, particularly in obese people, but is more common over 60. Juvenile diabetes is more severe and harder to control. It almost invariably requires injections of insulin once or twice a day for the rest of the patient’s life, as well as a strict diet.
In the mature form, diet and weight loss alone are often sufficient to control the problem, but some sufferers require tablets to be taken regularly, and a small number need insulin injections.
Diabetes is caused by either the failure of the pancreas gland in the center of the abdomen to produce insulin, or a reduced sensitivity of the cells in the body to insulin. The former tends to be the cause in the juvenile form, and the latter in the mature.
Insulin is essential for cells to take sugar out of the blood and into the cell, and without it, excess amounts of sugar build up in the blood and the cells are starved of a vital energy source.

Question: I have a bad family history of late onset diabetes. How can this be detected? Would a routine blood test for cholesterol find it? Are there any lifestyle changes I can make to prevent it? What are the early symptoms?
Late onset (type 2, or maturity onset) diabetes is a totally different disease to juvenile (type 1) diabetes. The former can be controlled by diet and tablets, while the latter requires regular insulin injections. There is a family tendency to develop type 2 diabetes, but it is not inevitable that you will develop it just because close relatives have the condition.
Diabetes is diagnosed by a simple blood test for the presence of excess sugar, but a test for cholesterol will not reveal the presence of sugar and diabetes.
You can delay, or prevent the onset of this form of diabetes by reducing the amount of sugar and fat in your diet, and by keeping your weight within normal limits.
The early symptoms are excessive thirst, passing more urine than usual, tiredness, blurred vision and frequent skin infections. If you are concerned that you may develop type 2 diabetes in the near future, your general practitioner can arrange for a glucose tolerance test (GTT) to be performed by a pathology laboratory. This test takes a couple of hours to perform, and can tell more accurately if you have diabetes, and sometimes it can predict if you are likely to develop the condition in the near future.