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Diabetes shouldn't affect Sotomayor's ability to serve on Supreme Court

Potentially the first justice with Type 1, experts she can expect to live as long and productively as anyone else if she manages the disease well.

May 28, 2009|Karen Kaplan and Melissa Healy

LOS ANGELES AND BETHESDA, MD. — If confirmed to the U.S. Supreme Court, Sonia Sotomayor would not only be the first Latino to sit on the high court, but also its first known member with Type 1 diabetes.

The Juvenile Diabetes Research Foundation in New York says that the disease shaves an average of seven to 10 years off of a patient's life, but experts said Wednesday that patients like Sotomayor who manage their disease well can expect to live as long -- and work as hard -- as healthy Americans.

"There's absolutely no reason whatsoever that she should be less effective at all," said Dr. Peter Butler, chief of endocrinology at UCLA Medical Center. "I'm confident she'll see off most of the other members of the Supreme Court."

Type 1 diabetes affects an estimated 3 million Americans, who typically are diagnosed during childhood.

When Sotomayor was diagnosed at age 8, in the 1960s, patients with Type 1 diabetes weren't expected to live full lives. But improvements in monitoring and treatment have changed this outlook. Among the patients who thrive with Type 1 diabetes are five-time Olympic swimming champion Gary Hall Jr. and Chicago Bears quarterback Jay Cutler.

Doctors still don't know what causes the disease, formerly known as juvenile diabetes. For some reason, patients' immune systems attack the cells in the pancreas that make insulin, leaving them unable to produce the hormone, which, like a key, opens the cell for sugar, or glucose, to enter.

Because the cells are unable to take in glucose from food, the glucose builds up to dangerous levels in the bloodstream. Without proper blood glucose control, diabetics increase their risk of developing cardiovascular disease, kidney failure, nerve damage and blindness. They are more likely to die from complications than from the disease itself.

Patients compensate by monitoring their blood-sugar levels every few hours and injecting themselves with synthetic insulin as often as five times a day. Some patients rely on external insulin pumps to maintain a steady flow of the hormone into their bodies.

People with Type 1 diabetes account for about 5% to 10% of all cases of diabetes mellitus, according to the federal Centers for Disease Control and Prevention. The more common variety of the disease, Type 2, affects people whose bodies produce insulin but aren't able to use it effectively.

Diabetes can be especially harsh for women, according to the CDC.

The most common complication is a heart attack, with lower survival rates for women than for men. Complications accelerate with age regardless of gender, but diabetic women are particularly vulnerable to heart disease, hypo- and hyperglycemia, vision problems and depression.

But patients who maintain careful control of their blood sugar can live just as long and just as well as healthy Americans, said Dr. Robert Vigersky, director of the Walter Reed Healthcare System's Diabetes Institute in Washington, D.C., and incoming president of the Endocrine Society.

In fact, Vigersky sees an aging boom on the horizon as more patients learn to keep their blood sugar within target ranges.

"I've had patients who've had it for 60 years with minimal complications," he said. "We'll be seeing a whole cohort of those who were properly treated in 1960s and '70s and '80s that are going to be living healthier and longer."

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karen.kaplan@latimes.com

melissa.healy@latimes.com

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