Diabetes and the Supreme Court

Sonia Sotomayor, President Obama's pick to be the next Supreme Court justice, is a solid choice. Female, Puerto Rican family, childhood hardships, Princeton, Yale, distinguished career, appointed by a Republican President, solid legal record, not too old and not too young --she's 54. What's not to like? One topic people are talking about is that Sotomayor is a Type I diabetic. Obama mentioned it in his introduction, so it's certainly not being hidden. And diabetics (especially Type I's) are cheering the nomination as a teachable moment and an affirmation that people with Type I can do anything. I agree.It is reasonable, though, to at least discuss whether her diabetes will affect her longevity on the Court. Supreme Court appointees are one of the main ways a President can establish a lasting legacy. Justice John Paul Stevens was appointed by President Ford way back in 1975. Anton Scalia and Anthony Kennedy were appointed by President Reagan in the mid-80s. Sitting Justices were mainly appointed in their early to mid 50s. The exception: Clarence Thomas, who was appointed when he was 43.Most of the articles I've seen raise the question about whether her Type I diabetes will affect her performance and longevity, and they mostly say it won't. The Wall Street Journal article (Sotomayor’s Type 1 Diabetes Is ‘Non-Issue,’ Say Docs) is a case in point:

“I think that’s a non-issue,” said Zachary Bloomgarden, a clinical professor at Mount Sinai School of Medicine in New York City.Type 1 diabetics can’t metabolize sugar because their disease has killed off the insulin-producing cells that normally perform that function. As a result, they must monitor their blood-sugar levels and take insulin several times a day to manage their conditions. By keeping their blood-sugar levels within an acceptable range, sufferers can decrease their risks for heart attacks and other side effects, say experts.“There’s absolutely no reason why the fact that she has diabetes should be a factor in her longevity or should affect her ability to serve” on the Supreme Court, said Christopher Saudek, director of the Johns Hopkins Diabetes Center in Baltimore.

However, in the comments section Anne offers a perspective that might be more on the mark

Sotomayor and I are almost the same age and I’ve had Type 1 diabetes a year longer. Trust me, people who were diagnosed that long ago have begun to experience problems to varying degrees. I wish her well, but know she’s had much to overcome, and it’s not going to get easier as time goes on. The disease is quietly and slowly destructive to the circulatory system which affects everything else - and long timers like us won’t be likely to see any benefit from stem cell research…although we’re very optimistic for the children being diagnosed today. Keep a good thought for all.

In considering longevity on the Court, however, there are other factors to keep in mind besides her diabetes. Consider:

• Women in the US live about 7 years longer than men (perhaps a good reason to appoint only women to the Court!)
• Just because Justices can serve until death doesn't mean they will. Sandra Day O'Connor retired in her mid-70s. David Souter is retiring at 69.

All in all I don't see that her diabetes should be a major consideration in her appointment, but it should be a minor consideration.There is another interesting aspect to her appointment: As someone who likely would be uninsurable in a purely free-market health care system, she may be a sympathetic voice on the Court when/if challenges to an eventual health care reform law are entertained.