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From Maribor, Slovenia:

Is there any link in development of diabetes Type 1 soon after puberty and soon after that also hirsutism (idiopathic hirsutism or polycystic ovary syndrome)? Which antiandrogen drug (spironolactone or cyproterone acetate with ethinyl estradiol - Diane 35) do you advise in the treatment of hirsutism if the hirsute woman also has diabetes Type 1 (on insulin therapy) and liver disorder (Gilbert's syndrome)? I want to know if there is any information about the number of patients who develop diabetes Type 1 in their childhood or puberty and later also hirsutism.


I had a little difficulty following your description; but I think that the Gilbert's Disease must be a separate issue and one that probably presented first. The combination of diabetes, which may be quite mild initially, with masculinisation and polycystic ovarian disease is suggestive of a rare condition called "Type A insulin dependant diabetes." It is often also associated with a skin pigmentation called Acanthosis Nigricans and also with hypertriglyceridemia. The treatment of the masculinisation would normally be to use a standard estrogen/progesterone birth control preparation. The incidence of this syndrome is less than 0.1% of Type 1 Diabetics.

If you have access to a medical library you might find that the article by Flier,J. in Principles and Practise of Endocrinology and Metabolism Chapter 140, Syndromes of Insulin Resistance, pages 1249, 1995, will help you.


Original posting 9 Jul 97


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