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Question:

From Richmond, Virginia, USA:

My 30 year son who lost 25 pounds in three months (now weighing 145 pounds) and was was admitted to the hospital with a blood sugar of 650 mg/dl [16.1 mmol/L], and, from what information we have been able to find, seems to fit the profile for typeá1, but one doctor was treating him for typeá2 with oral hypoglycemic agents, and the next doctor, although he agrees with my son that he has type 1 diabetes, has told him to continue these medications and his diet and see what happens.

The best info that I have been able to get suggests that the use of oral medication for type 2 may be effective for a while, but will cause the body to up its attack on the remaining functioning beta cells. Should my son insist on a referral to an endocrinologist? These doctors are internists, and I thought it was standard medical procedure for anyone with diabetes to see a specialist.

Answer:

This is a common question with newly diagnosed diabetes. Without a test for the gene, or dynamic metabolic tests, it is very hard to appropriately classify a patient.

I would recommend that your son see an endocrinologist regarding this issue. It will get your son's treatment off on the correct beginning. Only about 10% of patients with diabetes see an endocrinologist. It may be that appropriate classification will allow for appropriate therapy and follow-up can continue through your primary care physicians. This is a popular model, and one which I recommend if there is a question regarding classification or therapy.

JTL

DTQ-20010804141626
Original posting 13 Aug 2001
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:24
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