Q. I’m 45 and a C6 quad for 17 years. I just read Tim Gilmer’s article on diabetes [October 2016] that mentioned a Canadian study saying people with SCI are 2.5 times more likely to develop type 2 diabetes than the general public. I go in for yearly check-ups, but my doctor never mentioned this. Should I get a diabetes test? And if so, what test? Is there a way to reduce my odds of developing type 2 diabetes? If you get it, is it reversible?
— John

A. Here are some type 2 diabetes basics: A hormone, insulin, regu­lates the correct balance of glucose (blood sugar) in your blood — sig­naling the liver when to release glucose for needed energy and when to store it in the liver, muscles and fat cells when glucose levels rise. Type 2 diabetes happens when the body does not respond properly to insulin (insulin resistance), or doesn’t make enough insulin, which causes glucose lev­els in the blood stream to rise.

Excess glucose levels produce an inflammatory response in the vascular system, which leads to vascular damage. Over time this can cause serious compli­cations, from kidn