My 12 year old daughter, who has had type 1 diabetes for about 10 months, suddenly started losing weight. She gained the weight back that she lost before being diagnosed, but in the last two months she has lost it all back again. Her readings are normal, and she is very active in sports. Her appetite is poor. She says she feels fine, but she looks very frail. She looks exactly like she did before being diagnosed and treatment began with the exception of the dry skin from dehydration.

Her next appointment with the endocrinologist is coming up soon, but I’m just curious if you might have any information to help me until then. I keep hearing about weight gain but nothing about weight loss. I don’t feel comfortable with her regular pediatrician answering questions related to her diabetes. Any advice will be appreciated.

I would consider a few things as a starting point. Certainly, you will want to confer with your daughter’s diabetes team!

First of all, while you indicate that her readings are “normal, ” I would want confirmation of that. Are you doing the checks or supervising and actually looking at the meter readings on the meter? Or is she merely reporting the results to you and/or you are looking at the logbook? To quote Ronald Reagan: “Trust but verify”! Are the test strips giving accurate information? Be certain that the correct control solution/strips/chip (if you have a meter that uses replaceable computer chips) are all correct and correlated.

If these are all confirmed, then I would think about hyperthyroidism, celiac disease, or Addison’s disease as possible causes of weight loss in a person already diagnosed with type 1 diabetes. These are conditions that also have anautoimmune basis to cause irregularities in the thyroid gland, intestines, and adrenal glands, respectively. Your daughter’s diabetes team can discuss this with you more.

I certainly have seen teens (more often girls) who manipulate their diabetes as a means to weight loss/weight control by either omitting insulin, exercising excessively, or making large changes in their eating patterns.

DS