More cases emerge of double diabetes

ASSOCIATED PRESS

Having one type of diabetes is bad enough, but two? Doctors are seeing a new phenomenon dubbed double diabetes that makes it more difficult to diagnose and treat patients, especially children.

The mix can strike at any age and comes in various forms.

For example, children who depend on insulin injections because of Type 1 diabetes can gain weight and then get the Type 2 form in which their bodies become resistant to insulin.

Also, someone with classic Type 2 symptoms who is not responding to therapy can be developing the insulin-dependent form of the disease.

Other patients may not fall clearly into either category.

The labels are important because different forms of diabetes require different treatments.

Yet “there are many people in which it’s very blurred as to what kind of diabetes they have,” said Dr. Francine Kaufman, a University of Southern California pediatric endocrinologist and past president of the American Diabetes Association.

No good statistics are available on this complex disease mix.

The Children’s Hospital of Pittsburgh counts about 25 percent of child patients with Type 1 diabetes who also are overweight and have other Type 2 features, said Dr. Dorothy Becker, a pediatric endocrinologist and leading double-diabetes researcher.

An ongoing study to determine the best treatment for child Type 2 diabetes is uncovering many participants who harbor antibodies that signal they have or are developing the Type 1 form, too, Dr. Kaufman said.

Diabetes occurs when the body cannot turn blood sugar, or glucose, into energy, because it either does not produce enough insulin or does not use it correctly.

With the Type 1 form, the patient’s immune system attacks the insulin-producing islet cells in the pancreas. Once thought to strike only in childhood, it also can develop in adults. Symptoms usually appear suddenly and can become life-threatening quickly. Insulin, given by shots or a pump, is required to survive.

With the Type 2 form, the body loses its ability to use insulin properly, even though the pancreas pumps out extra, and drugs often are given to rev up that production even more. Type 2 usually develops slowly, and once was thought to hit only the middle-aged but now is striking even overweight children.