AOPA Turbine Pilot Magazine - December 2018 - 26

FLY WELL

Sweet talk

BY DR. JONATHAN M. SACKIER

Revenge and Mexican cave fish are sweet
WE HAVE A GLOBAL EPIDEMIC ON OUR HANDS, or
glands, to be precise-specifically the pancreas, one
of the "sweetbreads," a gland deep in the abdomen.
It's home to the Islets of Langerhans-which sounds
like a desirable flying destination, but are the cells
where insulin is made. This hormone, and the effect
it has on the human body, is our destination today.
So, brakes, contact, and chocks away.
Humans must consume a balanced diet in order
to fly (and do other stuff people do), which includes
carbohydrates, protein, and more. Without sugarcoating this, consuming huge amounts of sweet food-and
huge amounts of any food-has contributed to the

Loss of control of sugar levels can lead to
hypoglycemia (low blood sugar) or
hyperglycemia (high blood sugar), both of
which can have serious consequences.

DR. JONATHAN SACKIER answers pilots'

questions through
AOPA Pilot Protection Services (www.
aopa.org/pps).

increased incidence of diabetes mellitus, a condition
in which either not enough insulin is made or cells are
resistant to its effect.
Sometimes presenting during otherwise healthy
pregnancy, an early onset version of the disease occurs
in fit young people where autoimmune destruction
of islet cells is to blame. However, obesity and massive sugar intake are driving the surge in diabetes.
Initially, diabetes induces fatigue and malaise, and is
often downplayed as, "I've got a little bit of sugar in my
urine." Basically, the kidneys give up trying to filter the
stuff and glucose floods out. In fact, mellitus derives
from Latin for "honey," referring to the sweet taste of
diabetic urine. Whoever decided to taste urine? If you
donut care what you eat, and how much, don't be surprised when you become a victim.
The implications are significant. High sugar concentrations damage multiple blood vessels, which
increases the incidence of stroke; heart attack; kidney disease; impotence; loss of fingers, toes, and
limbs; and very often, blindness. Nerves are damaged,
causing often-severe pain, disturbed sensations, and
altered gut function. Skin integrity falters, and resulting ulcers may fail to heal.
Treatment always starts by controlling weight
and diet, and introducing exercise. Drugs are added,

26 | AOPA PILOT December 2018

at first oral and then, often, insulin injections are
required. Longer-lasting medications have been
developed to reduce required frequency of administration. Patients must check their blood sugar with
skin pricks daily (or more often), adjusting dosage
of medications accordingly. Miniaturized sensing
technology incorporated into contact lenses can measure glucose in tears to help patients manage their
diabetes. Losing control of sugar levels can lead to
hypoglycemia (low blood sugar) or hyperglycemia
(high blood sugar), both of which can have serious
and even life-threatening consequences-one of the
reasons FAA takes diabetes very seriously.
In some cases, insulin is pumped into the
patient via a computerized device to help control
glucose levels. Sometimes, pancreas transplantation is necessary, maybe in concert with a kidney
transplant when diabetes has induced renal failure.
Transplantation of islet or stem cells is also a means
to address the disease.
In 1882, Robert Koch ascertained that tuberculosis was caused by a bacteria that came to bear
his name. For years, the BCG (Bacillus CalmetteGuerin) vaccination has dramatically reduced the
scourge of TB. A recent scientific study has shown
that BCG can positively affect blood sugar levels.
Additionally, although not yet finished, a study from
Finland is evaluating a coxsackie virus vaccine that
might prevent diabetes. Keep your eyes peeled-
and your oranges, as eating fruit is the right kind
of sweet.
Other fascinating developments? The titular
Mexican cave fish is essentially diabetic but with no
ill effects, which might help us understand diabetes. The Australian platypus, an egg-laying mammal,
produces venom that may play a role in treating diabetes. Now put that soda down and maybe eat some
broccoli-there is some evidence that sulforaphane,
a substance found in the humble veg, may help manage blood sugar.
For diabetes regulated solely with diet, FAA allows
office issuance by the AME if there is a favorable
report from the treating doctor and HbA1c (a blood
test documenting glucose levels over time) shows
good control.
AOPA
EMAIL DrJonathanSackier@gmail.com

http://www.aopa.org/pps http://www.aopa.org/pps

AOPA Turbine Pilot Magazine - December 2018

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