My daughter is 18 and has Type 1 diabetes. She has been a diabetic for 5 years. She has been noncompliant with this disease. She has had 7 DKA’s in the past 5 years. We have had her on Prozac and Ritalin [medications to help improve mood] and even chromium. Nothing has helped. We recently switched her doctor to an adult endocrinologist. He is very unhappy with her A1c which is 12. He wants to put her Avandia to see if her body will react to the insulin better. He said she wasn’t in the honeymoon any more. The Avandia drug is for Type 2 diabetics — will this work for my daughter? I am scared she is just willing to give up on life.

Avandia [rosiglitazone, a pill for Type 2 diabetes] increases insulin sensitivity in type 2 diabetes. There are no formal indications for Avandia in children or adults with type 1 diabetes. I would suggest talking to your new doctor about why he wants to use Avandia for your daughter.

MSB
Additional comments from Dr. Quick:

It’s unclear from your letter if your daughter has had the opportunity to interact with a counselor who’s trained in dealing with teens with chronic disease. If yes, encourage her to continue. If not, insist she see one, preferably one who’s affiliated with a diabetes team.

This doesn’t sound like a situation where adding pills for diabetes would be likely to help improve her mood.

WWQ