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October 22, 2002

Diagnosis and Symptoms

Question from the United Kingdom:

A year and a half ago, I was diagnosed with diabetes when I was pregnant, and because of a strong family history, it was thought that I probably had type 1 which was speeded up because of the pregnancy. However, since then blood tests along with home monitoring have made it apparent to my diabetes specialist that it is very likely I have MODY. He is currently putting me forward for genetic testing to find out for sure if this is what I have, but I am concerned. About three years ago, I was diagnosed with an underactive thyroid gland, and I am wondering if it is possible that this is caused by the diabetes or the diabetes is caused by this. If so, is it possible that either would disappear with correct medical treatment? I have heard some very mixed views on what the treatment and long term side affects are with MODY diabetes, and, since I am only 19, I do not want to cause any other serious medical conditions because of bad information or ignorance.

Answer:

The identification of a specific type of diabetes can be a tricky thing. type 1 and type 2 diabetes have in common the presence of elevated sugars. However, type 2 diabetes is more likely to occur with pregnancy. Maturity Onset Diabetes of the Young (MODY) is usually classified as a subtype of type 2 diabetes. Genetic testing is available to identify MODY so this will help with classification.

Finally, to make things even more confusing, type 1 diabetes is associated with hypothyroidism as both are autoimmune disorders. In the case of type 1 diabetes, an immune reaction has destroyed the endocrine pancreas. In the case of hypothyroidism, the immune system has destroyed the thyroid. It is unlikely that improved control of your diabetes will bring your thyroid function back.

I suggest you get your physician to sit down and talk with you and clear up some of these issues so you are not confused. This kind of request may go a long way toward making you feel more secure about the quality of your care. If you cannot feel this way, it is appropriate to find someone else.

JTL