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August 25, 2007

Other, Other Illnesses

Question from Minneapolis, Minnesota, USA:

My daughter was diagnosed with type 1 diabetes about 18 months ago. At the time of diagnosis in the Emergency Room, she was displaying other symptoms. Eventually, after a small intestine biopsy and a liver biopsy, she was diagnosed with celiac as well. Recently, her gastroenterologist said she may have NASH (nonalcoholic steatohepatitis) as well without any biospies to support it. Our daughter is gaining weight despite a new kick boxing regime. We feel lost and helpless. Are there any clinics in the United States that specialize in the management and treatment of multiple diseases?

Answer:

Any pediatric diabetes group should be able to deal with type 1 diabetes and celiac disease since these co-exist in around 5 to 10% of all our patients. NASH usually occurs when there is obesity and more likely type 2 than type 1 diabetes and there is not much specific treatment, only monitoring of liver functions and weight. You may want to have a consulting conference with your diabetes team or consider seeking a second opinion. Both the University of Minnesota and the International Diabetes Center should have excellent pediatric endocrine services to help you.

SB