From Oxford, England:
My 11 year-old son has had Type 1 diabetes since he was 2 years old. He is now believed to have familial periodic paralysis also. (I have just been diagnosed with this condition and the penetrance is 100% in males so it's highly likely.) His consultant has asked me to do some research to see if anyone has clinical experience of this combination of diseases.
I have never encountered an instance of the hypokalemic autosomal dominant form of period paralysis and as far as I can discover the actual metabolic error has not yet been defined in molecular terms nor has the gene defect been determined or the location of the gene. I did look in the computerised catalogue of the National Library of Medicine (Medline) and could find no listing that included diabetes.
As I glanced through the literature, I came across a number of articles which suggested the possibility of a link between this disorder and glucose metabolism. I'll list them so that you can ask your endocrinologist about them.
- Pediatric Cardiology 17:31,1996. The use of calcium channel blockers to treat FPP, the same drugs have been used to counteract excessive insulin action in a condition called nesidioblastosis.
- Acta.Neur.Scand 71:69,1985. Interesting but not much help.
- Acta.Neur.Scand 56:525,1977. The use of diazoxide to treat FPP, another drug used to counteract insulin action.
- Acta.Neur.Scand 54:167,1976. A description of prolonged glucose loading causing episodes of hypokalemic paralysis.
At the least, I would have thought it worth doing antibody studies on your son just to make sure that he has indeed got the autoimmune form of diabetes and not some metabolic variant that might afford a clue to the link.
On a simplistic level I would have thought you had to be especially careful, if this boy became acidotic, that he did not get problems with a low serum potassium even though I think that it is a disturbed gradient between inside and outside the cell that is the problem.
Original posting 14 Dec 97
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