Ask D’Mine: Lipoatrophic Diabetes and Much Ado About Tea

There’s so much to know about diabetes, and so much to keep up on. We’re very grateful for the research efforts of our snarky yet beloved advice columnist here at Ask D’Mine — veteran type 1, diabetes author and community educator Wil Dubois.

{Need help navigating life with diabetes? Email us at AskDMine@diabetesmine.com}

Julie from Nevada, type 2, writes: I was told I have lipoatrophic diabetes, in addition to other health issues including high cholesterol, high triglycerides, and arthritis. Now I’m worried about my daughters. They say these things are not hereditary, but how can I be sure?

Wil@Ask D’Mine answers: Who said these things aren’t hereditary conditions? Not to depress you, but… umm… they are. All of them. Diabetes is definitely a family gift (more on your unique type in a minute), as is susceptibility to elevated cholesterol and trigs. Of course, there’re over a hundred flavors of arthritis, but, for instance, the very nasty rheumatoid arthritis — another one of those lovely diseases where the immune system goes bonkers and attacks the home team—has a genetic component to it. Actually if you read about it, you might suffer diabetes déjà vu: “blah, blah, blah, some researchers, blah, blah, believe an infection such as blah, blah might trigger the disease in those genetically susceptible.”

Sound familiar, type 1s?

I’ve got a few thoughts to ease your mind, but first we gotta talk about your lipoatrophic diabetes ‘cause I’ll bet most of our readers have never heard of it. Thankfully, it’s quite rare. Rare enough that I can’t even get any good statistics on just how rare it is, but the best guess is that it affects 1 in 400,000 people. By comparison, our “rare” type 1 diabetes effects (depending on the part of the world you’re in) around 17 in 100,000. That makes type 1, if my math is right, 68 times more common than lipoatrophic diabetes.

So just what the Sam Hell is lipoatrophic diabetes?? the rest of you are asking. In Julie’s case her diabetes has taken an ugly turn that is causing her hypothalamus to freak out and over-produce growth hormones and the tongue-twisting adrenocorticotropic-releasing hormones (basically, steroids). This toxic cocktail in her blood is literally killing her body fat and might cause some of her muscles to atrophy, too. In most cases the damage is limited to certain areas of the body, but can be widespread.

Yes. Major suckage.

And just where does lipoatrophic diabetes fit in to the overall picture of diabetes? OK, here we go. Recall that the family tree of diabetes has two major branches: diabetes mellitus and diabetes insipidus. Insipidus is an uncommon form of diabetes caused by a defect in the kidneys. Mellitus is the branch that includes T1, T2, LADA, gestational diabetes, pre-diabetes, and Julie’s rare form.

Other interesting tidbits: super-high trigs are common in lipoatrophic diabetes, high enough to be difficult to tame; and the disease is characterized by extraordinary insulin resistance. Like more than 1,000 units of insulin a day extraordinary.

By the way, if the word lipoatrophic tickles the back of your mind but doesn’t jibe with what I’m telling you, you might be recalling that in the olden days of beef and pork insulins, localized mini-lipodystrophies were sometimes seen at injection sites. The immune system would attack the injection site and kill off a small zone of fat. They were caused by the body rejecting the animal-based medicine. In theory, always injecting in the same spot with modern insulins can also kill off the fat tissue in that area, one of the reasons all you injectors and pumpers out there should rotate your sites.

Now, Julie, as to your daughters, all of your woes might be passed on to them. Or some of your woes might be passed on to them. Or maybe none of your woes will be passed on to them. There are no guarantees, good or bad. I guess this will be small comfort, but I always feel that forewarned is forearmed. If your girls know that there’s a risk, however small, then they can make sure their docs know what’s lurking in the family tree. Everyone can be watching. It’s not a perfect solution, but I’d argue that good surveillance beats the hell out of the head-in-the-sand approach every time.

Vaughn from Minnesota, type 2, writes: I read that white tea is a powerful antioxidant and green tea helps your body burn fat. Is there any truth to these claims that tea can affect the health of diabetics?

Wil@Ask D’Mine answers: Well, the British conquered more than half the known world drinking tea (not bad for a country just a hair bigger than Minnesota), so that suggests some power. As to the medical benefits that you read about tea, it’s technically true, but don’t get too excited just yet.

White tea is the least-processed of all the teas and it is an antioxidant. That said, I think calling it a “powerful” antioxidant is going a little far. Antioxidants include Vitamins C and E, flavonoids and carotenoids. Beyond tea, you can “get” assorted antioxidants from fruits, veggies, coffee, olive oil, oregano, eggs, and my favorites: dark chocolate and red wine. For what it’s worth, it looks like beans and berries are the antioxidant leaders when it comes to “powerful.”

But wait! Do we need a powerful antioxidant, even if green tea were a powerful antioxidant? Maybe not. This study suggests too much of a good thing will kill you.

Meanwhile, green tea, which seems to have hit the Big Time recently, has been under the metaphorical microscope. Maybe it, like red wine and dark chocolate, helps lower heart disease risk. If I have to choose between a cup or green tea or some red wine and chocolate, I gotta say, it’s a no-brainer for me. Green tea might also lower cancer risk. And yes, it does seem to burn fat. Yep. Just not a whole hell of a lot of fat.

Now I need to mention my mother here (and hopefully, she doesn’t read today’s column). Her eye doc had suggested Mom drink green tea every day as there is also some research suggesting that it can be helpful in slowing down glaucoma and other eye diseases. Of course, this research is on rats. But rats are people, too. So Mom has been drinking green tea every day: doctor’s orders, after all.

But…

But, she was drinking bottled iced green tea with honey. After all, honey is natural, too, right? The carb count was right up there with a soda pop. In fact, this “tea” was really just tea-flavored sugar water. Sure, it had some honey. But the ingredients were water, corn syrup, sugar, honey… Luckily Mom isn’t a diabetic, but clearly, some teas can affect the health of diabetics.

Caveat emptor.

Ya gotta read the damn food labels.

FYI, final tea trivia: white, green, and black tea are all from the same plant: camellia sinesis, a.k.a. “the tea plant.”

I think we need to approach tea like everything else: all things in moderation, don’t expect miracles, and don’t drink the damn stuff if you don’t like it.

Now I’m feeling the need to anti-oxidize. Where did I put that corkscrew?

Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.