Sugar, Sugar

Typically for our day and age, the news that Supreme Court nominee Sonia Sotomayor has Type 1 diabetes seems for the most part to have come and gone like those particles that appear for a nanosecond in a cloud-chamber experiment. And most of the media quickly deemed it to be of negligible importance. Can we return to it for a few minutes? I ask this as someone who has Type 1 diabetes, who has always had an intense general interest in medical matters, and as someone who has an even more intense interest in as many years of Supreme Court renovation as possible, after so many years of reactionary judicial damage.

We've been told that Judge Sotomayor usually has an A1C level of 6.5. The A1C test is the most important measure of blood-sugar levels in people with diabetes, because it indicates those levels for the previous four months. It tells us the average amount of glycated hemoglobin -- hemoglobin that has joined with glucose moleculesm -- over that period. Blood-sugar levels are crucial to the thirty million Americans who have diabetes because when they're high, they lead to the typical complications of diabetes -- kidney damage, blindness, compromises in circulation, amputations, etc. "Etc." includes death, if death, which is after all a simplification, can also be considered a complication. 6.5 is not bad. (Day-to-day, you check your glucose situation with a glucometer -- a little machine with a little lancet that you can set to draw blood from a fingertip with minimal penetration. It still stings. The prick of conscience, I call it -- especially when I allow myself into a situation where I am forced at gunpoint to eat a brownie or something like that.)

Judge Sotomayor's discipline and her obvious attention to the detail required to control diabetes are admirable. They are qualities of character that have obviously served her well in her profession and that will no doubt continue to do so. Believe me, it ain't easy, even for those of us with the supposedly easier Type 2 situation. But 6.5 is not a fabulous A1C result. Under 6 is the ideal. (The closest I've gotten is 6.1.) And Judge Sotomayor has -- well, a certain physical substantiality that also troubles me, since for people with diabetes, being at all overweight correlates with those dire complications listed above. The life span of a person with Type 1 diabetes is on average 8.5 years shorter than the rest of the population. So you could say that Judge Sotomayor may be in a way not 54 but 62. A big difference, especially when you think of not only the individual in question but the issues her opinions might affect over those 8.5 years -- freedom of reproductive choice, anti-discrimination cases, immigration, freedom of speech, corporate regulations, and so on.

That statistic, like most statistics, is as useful as a chainsaw would be to a neurosurgeon. It doesn't discriminate at all. The first in the endless list of questions it raises is: What is the difference in mortality rates between people who have Type 1 diabetes but keep their A1C level at 6.5 and the rest of the population? 7? 6.0? 5.8? Still, I worry about a condition that may so directly affect the length of this person's tenure on the Court. I'm sure she will be confirmed, I feel pretty sure that she will at worst maintain the delicate balance the Court is in now and at best will have more good influence on its general drift than Justice Souter had. And it's true that life itself is a terminal disease, and that the safe that may, God forbid, I think, fall on Justice Thomas's head -- or on the head of some other, non-diabetic nominee -- doesn't care what his or her A1C level might be. Everyone has vicissitudes of health and work and love. There is always trouble up ahead that we can't take into account here and now. But Judge Sotomayor's medical circumstance is in the here and now, and it's not negligible. And though at this point there's surely no point in worrying, I worry.

Comments

[danielmenaker]

Language! (To say nothing of) Accuracy! I hope and if I were religious would pray that Judge Sotomayor a) is confirmed and b) lives forever. I just happen to believe that her medical condition is not as negligible as the media would have it--that's all. And candidates' and nominees' existing health issues are a legitimate matter of public interest? Why else is such information released? May I be dead wrong--well, at least wrong--to be concerned.

[danielmenaker]

Sorry for the misplacement--the above was meant to be a reply to the comment below which starts, "Tthat is such crap," from JRsNana

[JRsNana]

It still is crap.

[JRsNana]

How is it that you seem to know more about Justice Roberts seizure disorder than anyone else? When he had his last seizure we were told his disorder was of unknown etiology. You seem to know more about it by saying that his disorder has a lesser statistical risk. If we don't know the etiology of his disorder, how do you know its statistical risk?

[SEQUOIABISON]

For the most part I am happy to see a fellow Bronxite get appointed to the Supreme Court, but I think there should be other considerations for a nominee besides academic achievements.

Sonia Sotomayor seems to have outstanding academic qualifications and this will be a great example for young people to emulate, but I also think how a person takes care of their health should also be an inspiration to our children.

From her appearance and her medical records Ms Sotomayor seems to be neglecting her health and ignoring the fact that diet and exercise play an important role in our lives.

If we want to teach our children how to be a well rounded individual we must emphasize not only academic achievements but also a healthy lifestyle, which includes eating and exercising properly to avoid degenerative diseases like Diabetes.

While this vegan salutes the choice of an Hispanic female, I think we need to give our children better examples of how to be successful in all phases of life, not only placing a strong emphasis on academic education but also educating ourselves with a similar devotion to our body’s requirements and showing some restraint when it comes to eating unhealthy foods, the complete package of academic achievement and healthy lifestyle is more in line with what we should be teaching our children.

Growing up I learned a lot from Justice William O Douglas, he always looked very healthy and went hiking in our national parks every summer.

[JRsNana]

The self-righteousness your statement has really pissed me off. Your inference that Judge Sotomayor is a 'bad example" for children because of her disease is absolutely horrifying. Type I diabetes (the kind Judge Sotomayor, Mary Tyler-Moore, Adam Morrison (NBA player) have) has an unknown etiology. An infection is the most likely cause. Early in life, an infection triggers an autoimmune process that destroys the beta cells in the pancreas, leaving it functionally inoperative. No amount of diet and exercise in the world can help you avoid that. Diet and exercise can help keep people with Type I in better overall health, but it will NOT keep anyone from getting the disease. Please keep in mind that she (and almost all) Type I sufferers were diagnosed as children.

[JRsNana]

Ok - I've been shot down on posting what I really wanted to say to you so I'll try again.

You've got Judge Sotomayor and her disease broken down into a good lifestyle versus bad lifestyle issue and you could NOT be more WRONG. Type I diabetes is an equal opportunity disease. It doesn't care if you are a vegan, a vegetarian, a carnivore or a Twinkie fanatic. It is probably caused by an infection early in life that triggers an autoimmune process which destroys the ability of the pancreas to produce insulin. It may also be genetic in nature. The etiology is not certain. For you to say that "we need to give our children better examples......" you show that you know very little about her disease and are out spouting inaccuracies based on your lack of knowledge of the disease. That can be very dangerous. Diet and exercise can help mitigate symptoms once a diagnosis has been made but that alone cannot "cure" it as seems to be your contention. Please do not attempt further to promote Judge Sotomayor as a "bad example" to our children. Just the opposite is true. She has shown that one can have a disease like this one and still have full and successful lives.

[SEQUOIABISON]

Sorry if you are offended by my comments JRsNana but I personally think their is a direct correlation between Diabetes, obesity and a high fat diet, which we have control of.

I think we are all entitled to set the criteria for the people we would like to see sitting on the Bench making decisions that would affect all Americans.

Unlike you, I believe that Sonia Sotomayor’s lifestyle was a contributory factor for her physiological ailments.

Her statement revealing some of her favorite foods is quite telling, she said:
"Because of my very Puerto Rican taste buds," Sotomayor loves what might sound like exotic fare to some: pig intestines on warm bread, pig feet and beans and pig tongue and ears.” Yahoo News

You may believe that victims of this disease are just unlucky and had no control whatsoever with what happens to their body, regardless of their lifestyle, but you are mistaken.

Being a vegan and an animal rights activist my preference for a Supreme Court justice would be a Hispanic vegetarian female from the Bronx, whose decisions would reflect her lifestyle and compassion for our fellow mammals. My second choice would be Dennis Kucinich.

Some supporting views:
http://www.vrg.org/journal/diabetes.htm

[toppergem]

Really? Death is waiting around the corner of all of us. You can step out of your door on day and get struck by lightening, drive down the street and get hit by a drunk driver, have a heart attach or stroke, at any moment in time anything could happen...there are no guarantees. So the health of any justice on the Supreme court is a very small concern. They will be on the bench as long as time allows. Stop worrying!!! Judge Sotomayor could out live you and me, or we could out live her...who knows.

[llisa]

Statistics. You can't plan your life around them.

Stop worrying.

[jade7243]

Sounds to me like you're sticking your nose into someone else's health business with pseudo-rationale that "you are worried."

Do you seriously not think that Judge Sotomayor, who has been managing her health for the vast majority of her 55 years, without your assistance, really needs your advice, input, concern? Are you just as worried about Justice Ginsburg who is battling pancreatic cancer? Or what's your worry level for Clarence Thomas, a middle-aged slightly overwieght black man, who is prone to hypertension, diabetes, heart disease and stroke? Got any sage advice for him?

Or what about the risk for all of the men on the court of getting prostate cancer? Have you calculated their PCA levels? Should they really be overdosing on the Viagra and Cialis? What is the probablity of them getting bitten by a deer tick and contracting Lyme disease?

Be afraid.... be very afraid...

[kassandranobody]

Health was not a consideration for Roberts- who has seizures
Sonya has at least 20 good years left in her
Hasn't Souter only been there for 15 ir so?

[Daniel Menaker - Huffpost Blogger]

As I understand the matter--and I could be wrong--at this point in his life, Roberts' seizures pose considerably less statistical risk of mortality or incapacitation than does Judge Sotomayor's condition.

[JRsNana]

That is such crap. You have decided against Judge Sotomayor and you are now trying to use her disease as a wedge issue to make your case against her. A seizure disorder, especially one of completely unknown etiology, and having shown itself to be random in nature, can be an extremely risky situation. At least Judge Sotomayor knows what she's dealing with. Roberts does not.

[We-Are-The-Ones]

Base ignorance.