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January 28, 2015

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Question from Seattle, Washington, USA:

My college aged son has had type 1 diabetes since age 4. He has been on insulin pump therapy for over 10 years. His A1cs usually are 6.5 to 7.5. He is active and has generally good health. This fall, his A1c has gone up to above 8, and he has had a problem that appears unrelated to the diabetes; he has developed several cysts (testicular, earlobes, soft tissue). He sees an endocrinologist for his diabetes care quarterly, but when away at college, goes to the general practitioner (GP) at student health. The GP had a testicular cyst ultrasound done and they determined it was nothing to worry about. Now, with the other cysts popping up, and a higher than usual A1c, I am worried there could be some underlying cause, such as an infection or cancer. He can't get in to see his endocrinologist until March. Is there any urgency to this situation? Is there any known connection between cysts and type 1? My son is very independent. I am asking just to offer him more information so he can decide what additional check up, if any, he needs.

Answer:

I have not seen these lesions, but it does not appear to be an emergency. I am not sure there is a relationship between the HbA1c and these cysts. I can think of none. The testicular cysts has already been looked at. I think he can probably wait to talk to his physician about it more in March. It is not uncommon to see the HbA1c drift up in the middle of college or other busy times. That would be the more important talk, I think. Have him think about things he can do to keep his glucose levels down, even in the midst of a busy schedule.

JTL