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July 2, 2009

Weight and Weight Loss

Question from Hawaii, USA:

I'm 14 and was diagnosed with type 1 diabetes when I was six years old. I started off last summer being 125 pounds and then, all of a sudden, I stopped my menstrual cycle and gained 30 pounds in less that two months. I know it wasn't what I was eating because I'm very active. I'm a point guard and eat really healthy to be quick and in shape. It wasn't like fat that I was gaining; it was more what I thought was just water weight because I got puffy and swollen. I would gain 10 pounds overnight. I went to the doctor and they thought it might be PCOS so they put me on Glucophage, which stopped the weight gain. But, later, I took a test and it wasn't. So, ever since I gained these 30 pounds, I've been working and doing everything I can to lose them and nothing will work. I've tried everything imaginable and it's really depressing me. It's hard to keep up in basketball and that's my dream and my love. I hate this. Can you please help me with any diagnosis or advice you might have?

Answer:

You ask very interesting and good questions. But, it is difficult to address them well without more specific and better information.

Are you exaggerating when you say you gained “10 pounds overnight” or should I take you literally (that is that you gained an actual 10 pounds from one day to the next)? I do not know how anyone could say that you don’t have PCOS (“PolyCystic Ovary Syndrome”) when they tested you while you were taking the Glucophage. The Glucophage treatment could cause various blood tests that incriminate PCOS to normalize. There is no specific test to prove or disprove PCOS. Are your family members overweight? Do you have Latin or African-American heritage? If you are of Pacific Island heritage, there may be a predilection for weight gain (examples include people from Samoa). Are you still taking Glucophage? What are ALL your other medications and supplements? What doses? I would need more details of your previous menstrual periods. Are you having sexual intercourse? Have you been tested for pregnancy?

You gave no information about the status and degree of control of your type 1 diabetes. What are your insulin doses? What are the values of the last years worth of HbA1c values?

Furthermore, you did not indicate that your type 1 diabetes is under the direction of a pediatric endocrinologist. What type of healthcare professional is taking care of your diabetes with you? Certain conditions that commonly dovetail with type 1 diabetes should be screened for on a regular basis. An underactive thyroid gland is one and could contribute to some of your symptoms. I am glad that you try to stay active and that you eat “healthy” but I don’t have enough details.

I think that the BEST way to address this important issue with you in the most timely way is to ask that you have a consultation with a PEDIATRIC ENDOCRINOLOGIST. There are several in Hawaii. There are a couple at Tripler Army Hospital (but they may not be available to you; I don’t know) but my directory indicates two others in Honolulu.

Write again if you think we can help further.

DS