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Question:

From Salisbury, North Carolina, USA:

I was diagnosed with diabetes when I was 12 and was on 2 units of Lente and 4 of NPH. At age 14, they put me on Micronase and took me off insulin. 12 years later, my hemoglobin A1c's were too low to please my doctor (5.1) and I had frequent hypoglycemic reactions so they placed me on Glucotrol XL. Now my A1c's are now 7.8's (which they and I considered too high, so they just doubled my doses to 10 mg a day). I was warned of the possiblity that eventually oral agents may not work for me. Does this happen to those with MODY? My mother was also diabetic by age 12 and was not on insulin unless sick. I was told I have MODY. Is that true? Will I give my children this?

Answer:

The specific diagnosis of the types of diabetes that are initially insulin dependant and which can subsequently managed for long periods without insulin has become more complex in the last few years. There are now at least five variants of MODY and in the commonest, which is MODY2 or hexokinase deficiency there are a number of sub-variants. There is also Type 1B antibody negative diabetes which is initially insulin dependant; but can often be managed later on oral medication. Particular diagnosis is usually not attempted because it is difficult to organise and expensive to carry out and most importantly it does not significantly contribute to individual care.

All of these forms of diabetes reflect partial deficiencies of insulin production so that in time the islet cells become unable to supply minimum daily needs and additional insulin may again be needed even after many years of successful oral medication.

DOB

Original posting 14 Mar 1999
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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