Author:

Dr. Hosein Shokouh Amiri

IAMA President

 

 With the launch of our new website, IAMA has created a section called "public awareness" which will be published by our member volunteers. The categories are medical cultural, educational, social and special ethical issues that our new and older generation is faced with.

We do not support political or religious articles since our organization is non-political and non-religious. 

To start this section, I will start with myself on the topic of Diabetes and Pancreas Transplantation.

 Diabetes is a very prevalent disease worldwide. There are 42.2 million diabetic patients all over the world. 9.4% of the overall population in the U.S. are suffering from diabetes which includes 12.2% of adults and 25.2% are persons older than 65 years old. In the U.S.A. diabetes is the leading cause of end-stage renal disease (44%) and (40%) of patients on the kidney transplant list are diabetics. This creates a huge burden on health care to treat and manage diabetes and its devastating secondary complications such as retinopathy, nephropathy, peripheral neuropathy, gastroparesis, coronary artery disease, dyslipidemia, etc. Only 5-10% of patients with diabetes are type I (Total shut down of pancreatic B cells due to autoimmune/ viral/ or unknown reasons) which happens rather early in life & require insulin from the very beginning in order to remain alive.

 The great majority (90-95%) of patients with diabetes are suffering from type II which is not due to insulin deficiency, but due to insulin resistance, mainly due to obesity & lifestyle situations. Treatments for the 2 types diabetes are completely different. For type I, beyond standard insulin treatment, pancreas transplant plays a major role & hopefully should be done before major secondary complications arise. For type II, the treatment will be weight loss, balanced diet, regular & more active physical lifestyle; some patients may require obesity surgery.

 If all above-mentioned attempts fail, then pancreas transplant may become an option even for type II diabetic patients. Actually, the pancreatic B cells are getting exhausted after too much activity in order to catch up on extra demand due to insulin resistance. In other words, these patients are changing from type II (insulin resistance) to type I (insulin deficiency plus resistance). A successful whole organ pancreas transplant currently is the best treatment option for providing the best glycemic control for these patients.

 Diabetes and its secondary complications are very complex issues and cannot be addressed in one session. 

We hope to see continuous contributions with topics of interest form our IAMA members in different specialties every 2 weeks. We will soon open a blog and will entertain different questions and answers from the public as well as our healthcare providers. 

 

Sincerely 

IAMA president 

 

 

 

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