I have type 2 diabetes, take metformin, and I have a son who is going to be one year old. When I was pregnant the referring doctors could not agree as to whether or not the metformin should be continued, so I decided not to use it to protect the baby. When he was born, he was okay, but at eight months of age, we had a a tolerance curve done on him, and he wasn’t able to absorb the injected glucose in the established time. We want to know how high his risk of developing diabetes is.

Other thing is that we are going to the United States in a few weeks, so I would appreciate any recommendation to a hospital or doctors in Miami, Orlando or Tampa, just to have a second opinion.

I am not clear as to what test was performed when your son was eight months of age. Generally, it is quoted that the offspring of parents with type 2 diabetes have a 40-50% chance of developing type 2 diabetes. However, it is not often expressed until the child is older. Unless your child is experiencing difficulty growing, I am not sure what the problem is.

There are pediatric endocrinologists available in Miami, Tampa, and Orlando. It may be helpful to see someone there to answer your questions more thoroughly.

JTL
Additional comments from Dr. David Schwartz:

I think the safest drug to control mother’s glucose levels during pregnancy is insulin. So I think it appropriate to have stopped the Glucophage [metformin] during your pregnancy.

I am sorry that I do not really understand what you were explaining about the tolerance test. Did your eight month old baby undergo an intravenous glucose tolerance test? An oral glucose tolerance test? I don’t think either of those are necessary in an eight month old without more specific indications. Indeed, the normal expected values in an eight month old would be hard to establish.

If you have type 2 diabetes, there is some increased chance for your child to grow up to also have type 2. Ways to limit that risk would be to establish good eating and exercise habits throughout childhood! Prevent obesity! A well-rounded diet with plenty of exercise is the way to go. If there is a family history of type 1 diabetes, there may be a modest increase in risk for your child to develop type 1 diabetes.

There are excellent children’s hospitals and pediatric diabetes specialists in Tampa (and St. Petersburg), Orlando, and Miami. I doubt that any one could see you on such short notice, other than an emergency situation, but an appointment for a scheduled visit may be possible. You can find contact numbers on the Internet. If you call the main numbers, ask to be connected to the pediatric endocrinology offices. If there are language issues, be prepared. I know that some of pediatric endocrinologists in Florida speak Spanish, while others do not.

DS

[Editor’s comment: You can check the International Society for Pediatric and Adolescent Diabetes website for a list of pediatric endocrinologists who specialize in diabetes, or contact the American Diabetes Association.

SS]