Turner Syndrome Foundation
Turner Syndrome (TS) patients can have many diagnoses besides TS. They are at significant risk of developing autoimmune diseases, such as diabetes mellitus. November is National Diabetes Month, so let’s learn about this condition–its symptoms, diagnosis, prevention, and treatment. The Turner Syndrome Foundation (TSF) has resources that can help!
National Diabetes Month
Every November, the American Diabetes Association and the diabetes community come together to ring the alarm on the diabetes epidemic. National Diabetes Month is an opportunity to show the world what life with diabetes is really like and provide ways to manage it. For the millions of people who are at risk for diabetes, including those with TS, it’s a time to educate themselves, find resources, and make sure all the people around them are aware of the risks, too. And for the millions of people living with diabetes, it’s a chance to tell their stories and increase awareness.
"Diabetes taught me discipline."
What Is Diabetes Mellitus?
Diabetes mellitus–or just diabetes–is a condition in which the body produces little or no insulin (type 1) or doesn’t use it properly (type 2). This causes an increased blood-glucose (sugar) level which, if not treated, can cause more severe health
complications, including heart, kidney, and nerve problems. Because TS patients are at risk for heart and kidney problems already, the potential damage from prolonged increased blood-glucose levels is a concern. Being aware of diabetes and your blood glucose level can help prevent future health problems.
Type 1 diabetes results in the patient being insulin dependent (they must take insulin). Type 2 diabetes typically does not result in the patient being insulin dependent. Most with type 2 diabetes won’t need to take insulin, but some might. Studies have shown that there is a two to four times higher occurrence of noninsulin dependent (type 2) diabetes in TS patients. This article explains more in depth glucose metabolism in TS patients. There are some theories as to why (mainly genetic reasons related to the X chromosome), but nothing has been pinpointed as of yet.
See the links in the Sources section below for articles about patients diagnosed with both TS and diabetes.
Symptoms & Diagnosis
The Centers for Disease Control (CDC) and the American Diabetes Association (ADA) list the following as some of the symptoms of both type 1 and type 2 diabetes:
- feeling more thirsty than usual;
- urinating often;
- losing weight without trying;
- presence of ketones (a byproduct of the breakdown of muscle and fat that happens when there’s not enough available insulin) in the urine;
- feeling tired and weak;
- feeling irritable or having other mood changes;
- having blurry vision;
- having slow-healing sores; and
- getting frequent infections, such as gum, skin, and vaginal infections.
While TS requires a single blood test (karyotype) to diagnose, diabetes requires repeated blood tests to diagnose and manage
it. Initial blood work will be done to determine the patient’s hemoglobin A1C level. A normal A1C is considered below 5.7, “prediabetic” is considered 5.7 to 6.4*, and diabetic is considered above 6.5. If a patient is diagnosed with diabetes, they will be instructed to do regular self-monitoring with a finger stick and blood glucose monitor, or with a wearable monitor.
* Not all medical providers subscribe to the term “prediabetic.” Some consider anyone with an A1C over 6.0 to be diabetic.
Treatment Options
If a healthy diet and exercise do not bring a patient’s blood glucose under control, the doctor may prescribe one or more medications, including pills or insulin injections. The oral medications to treat diabetes have many names and come in many dosages, like most other pills. Metformin is often the first oral medication prescribed for type 2 diabetics.
Insulin can be administered through self-injections or an insulin pump, a small, computerized device attached to the body by a needle and thin tube that pumps doses of insulin into the body as directed. As mentioned above, insulin is generally prescribed to type 1 diabetics, but may be prescribed for type 2, as well.
Prevention
The biggest tip both the CDC and ADA recommend to prevent and treat diabetes is maintaining a healthy diet and exercise. They may not prevent a diabetes diagnosis, but they can lessen the severity of any complications. This can be relatively easy for TS patients, as they’re often already familiar with what a healthy diet and exercise should look like, due to their other health issues.
Resources
TSF provides helpful information and resources about diabetes for TS patients:
- TSF is hosting a webinar on January 25, 2023 titled “Diabetes: Diagnosis, Management, and Research,” presented by Catherina Pinnaro, MD, MS from the Stead Family Department of Pediatrics at the University of Iowa. Click the button on the left to register for the FREE webinar.
- View the past webinar “Living with Type II Diabetes” (read more here). Dr. Henry Anhalt gives a more detailed description of many of the topics covered in this blog post in his webinar and PowerPoint presentation.
- For more detailed information about the connection between TS and diabetes, check out our previous blog post.
- See TSF’s website for more information on different autoimmune diseases associated with TS.
Sources
Diabetes Overview, American Diabetes Association
Type 1 Symptoms, American Diabetes Association
Diabetes mellitus and Turner Syndrome, National Institutes of Health/National Library of Medicine
Glucose Metabolism in Turner Syndrome, National Institutes of Health/National Library of Medicine
Symptoms and Causes of Diabetes, Mayo Clinic
Diagnosis and Treatment of Diabetes, Mayo Clinic
Type 1 Diabetes Mellitus Associated with Turner Syndrome, European Journal of General Medicine
X Chromosome Gene Dosage and the Risk of Diabetes in Turner Syndrome, Oxford Academic, Journal of Clinical Endocrinology & Metabolism
Written by Helen Rhoads, TSF volunteer blog writer. Edited by Kayla Ganger, TSF Professional Membership Liaison, and Susan Herman, TSF Blog Coordinator. Designed by Susan Herman.
© Turner Syndrome Foundation, 2022
