Description A condition where t...
Description
A condition where the patient (usually a teenager or young adult) has features of both Type 1 and Type 2 diabetes. Most children, teens and young adults with diabetes have Type 1 diabetes. In Type 1, there usually are antibodies against the cells in the pancreas that make insulin, and there is no insensitivity to insulin. In Type 2 diabetes, the opposite is the case. In double diabetes, patients have both antibodies against the beta cells and resistance to insulin. Overweight patients with Type 1 diabetes are at greatest risk of developing this disorder. The disorder generally develops gradually and first manifests itself as an increasing need for more insulin to control the glucose level. It is estimated that 15-20% of teens with Type 2 diabetes actually have double diabetes. In patients with Type 1 diabetes maintaining a healthy weight is the best way to avoid developing this disorder.
Symptoms
More insulin is needed to control the glucose level. Elevated glucose levels cause increased urination (polyuria), increased appetite (polyphagia), increased thirst (polydipsia), blurry vision, fatigue, and weight loss.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be done. The provider may order a blood test to detect antibodies against the beta cells of the pancreas. Glucose levels will be measured as well.
Tests:
Comprehensive metabolic panel (CMP)
Specialists:
Internal Medicine, Family Practice, Diabetes, Endocrinology and Metabolism
Workup:
A history and physical exam will be done. The provider may order a blood test to detect antibodies against the beta cells of the pancreas. Glucose levels will be measured as well.
Tests:
Comprehensive metabolic panel (CMP)
Specialists:
Internal Medicine, Family Practice, Diabetes, Endocrinology and Metabolism
Treatment
Therapy is aimed at maintaining the proper weight and controlling the blood glucose. Most patients are given both insulin and pills to treat Type 2 diabetes. These medications include: acarbose (Prandase, Precose), acetohexamide (Dymelor), chlorpropamide (Diabinese), glimepiride (Amaryl), glipizide (Glucotrol, Glucotrol XL), glyburide (DiaBeta, Glynase, Micronase), metformin (Glucophage), miglitol (Glyset), pioglitazone (Actos), rosiglitazone (Avandia), repaglinide (Prandin), tolazamide (Tolinase), tolbutamide (Orinase), and troglitazone (Rezulin). Body weight control is best achieved through a healthy diet and exercise. Patients who are able to lose weight will sometimes experience loss of resistance to insulin resulting in better glucose control with less insulin.