いま、1型糖尿病は
2009年12月14日
Started losing hair easily after discharge from a hospital.
Let us consider a case of a female patient who developed type 1 diabetes, was hospitalized near her house and was discharged from the hospital, and then came to our center for the first time.
"Doctor, my hair has been falling out in a bunch. Is there something wrong with me?"
In most cases, they ask me this question at the very end, looking worried. Needless to say, I am talking about female patients.
For a woman, hair is as precious as her life, and that has been so since forever. One day, she finds a whole bunch of hair in her brush, or sees many strands of long hair falling out while washing her hair. And this starts happening every day…. They have every right to be surprised about this.
These patients require insulin injections. Initially, they must have been shocked in some ways by that fact, but after released from hospital, they were coming to understand that it could not be helped. And that is around when they find hair falling out. They may feel eerie, start to have a gnawing suspicion that they could have other disease or something happened to them, or become worried and begin to lose confidence in themselves. Their reactions make perfect sense.
In such cases, I usually tell them with a smile.
"Please don't worry. You hair will grow again for sure. It will become normal again in about six months."
It is very important for us, healthcare professionals to clearly tell patients not to worry when what they are worried about is of no matter.
Having developed type 1 diabetes was a big deal for your body also.
Hair loss can be often observed not only in type 1 diabetes but also in other severe illness, for example, prolonged high fever, serious drug eruption, and prolonged high blood pressure in the case of type 1 diabetes. Hair loss is often experienced when your body goes through and comes out of such condition.
Taking type 1 diabetes as an example, it can be assured that each body cell was also in the state of severe glucose deficiency at the onset of diabetes. Some body cells would die due to glucose deficiency. Within our bodies, old cells die and are replaced with new ones every day. When you scrub yourself while taking a bath, dirt comes off. They are old skin cells. So is yellow nasal discharge that you have when you are recovering from a cold.
With the onset of type 1 diabetes, hair root cells that produce hair are damaged and die that likely lead to hair falling out in a bunch.
Those old cells are going to be replaced with new hair root cells.
Once blood glucose levels become stable with insulin treatment, new hair root cells are generated by cell division producing new hair. Therefore, your hair should grow again and become normal in a while.
What other things are happening?
Another thing that often happens to female patients is that they stop getting a period they used to have regularly. This too will become normal in most cases once blood glucose levels become stable with insulin treatment. However, in some cases, patients have a harder time getting a period back.
I usually wait and see for six months or so. If my patients do not get a period back in about six months, I refer them to gynecologists.
Once they start receiving gynecological treatment, they get a period back as if their bodies were reminded of original period cycle.
For those who did not have a period regularly even before developing type 1 diabetes, various gynecological treatment may be needed before they get a regular period.
©2009 Yasuko Uchigata
髪の毛が抜けるんです
「先生、髪の毛がごそっと抜けるんのです。大丈夫でしょうか?」たいてい、診察の最後になってお聞きになられます。心配そうに、お聞きになられます。もちろん、全員、女性です。 女性にとって、髪の毛は、大昔から、命と同じなのですね。命と同じで、とても大切なものなのです。ごそっと抜けるようになった、ブラシに長いものが付いてくる、髪を洗っていると、長いものが何本も抜けていく・・・、それも毎日・・・。これを見てびっくりされるのは、至極当然なことです。 インスリン注射を欠かせなくいことになった、ことに対して、ある意味、ショックであったろうと思いますが、退院後は、それはそれで仕方のないことと自分の中なかで理解はできるようになってきてはいても、そのころになって、ごそっと髪の毛が抜け始めるわけですから、気持ちが悪い、また別の病気になったのか、私の体はどうかなったのか、と疑心暗鬼(疑診案擬)になって、不安になって、自分に対して自信が持てなくなり始めるのは、とても、当然なことでしょう。 たいてい、微笑んで、私は言います。
「大丈夫ですよ、ちゃんと生えてきますからね」心配ないことには、心配ないのだと医療者がきちんとお話する、これはとても、大事なことですね。
「6ヵ月くらいしたら、もとに戻っていますからね」
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