From Saranac Lake, New York, USA

I work for an home health agency and care for a 10 year old girl who has child onset diabetes and Bardet-Biedl syndrome whose blood sugar levels fluctuate quite frequently, and when she gets stressed, it becomes increasingly apparent. Right now, her school district is trying to get her in school, however the parents and the child do not wish to do this, at least not as quickly as the school would like. How do Bardet-Biedl syndrome and diabetes interact? Are problems with diabetes more severe? what complications could arise from the two disorders interacting with one another?

I don’t think that you are really dealing with two separate conditions. Aside from retinitis pigmentosa and polydactyly, the most obvious presenting symptom of the Bardet Biedl syndrome is obesity which in turn can lead to insulin resistance and ultimately to insulin dependence. Essentially, this is the same as type 2 diabetes in an otherwise normal child and should be treated as such.

There are two aspects to this of which the first is control of blood sugars with diet, exercise, oral hypoglycemic agents or insulin as needed, and the second is the very difficult challenge of losing weight. I imagine that this child’s reluctance to go to school is related to her obesity and perhaps to some visual problems, but the malformations of the syndrome do not have any special impact on the control of her diabetes or on he incidence of complications other than that of stress.

DOB