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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.

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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Last Updated: Tuesday April 06, 2010 15:08:52
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