Question:
I am an RN at an adolescent psychiatric facility. We have a black female
who is being well controlled by metformin and glyburide. She is on a
weight-loss diet and has lost 10 lbs in the past 2 months. We anticipate
having to adjust her
breakfast glyburide soon as her pre-supper BG levels are dropping to the
60's. There is so little info on this type out there, as informal
resource person on diabetes for our docs, I would appreciate any input.
Answer:
Sounds like she's got either "MODY" or "Type 1.5"
diabetes. Both Maturity Onset Diabetes in Youth
(abbreviated "MODY") and Type 1.5 diabetes can occur in youngsters and young adults, and both
seem to respond to Type 2 therapy (including weight loss, and oral
medications like metformin and
glyburide). Maturity Onset Diabetes in Youth is a older
term for Type 2 diabetes in youngsters, which was initially recognized in
some White families in Michigan, but also occurs in Hispanics, in Native
Americans, and in African Americans.
It's reassuring to hear that your patient is well-controlled
and losing weight. Clearly, her doses of
medications will need to be decreased soon. Once her weight is down more,
her diabetes should be even easier to control: there's even some hope that
her kind of diabetes might not need ANY meds if she loses weight! Hopefully,
you have access to a dietitian who's skilled with dealing with adolescents,
who can help her cope with the expected stresses that any teenager
has with meal planning, let alone a teen with a severe emotional problem.
Original posting 18 Jan 96
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