May 20, 2015
Testing for Diabetes Diagnosis
Why are doctors misdiagnosing the type of diabetes? I find it shameful the number of people I have met in the last year that have been given the incorrect diagnosis. Granted most have been diagnosed with type 2 diabetes when, in fact they had LADA. I have also seen one that was considered type 2 and upon testing by an endocrinologist was found to have MODY #3.
It seems that many doctors still use age as the determinate for the type of diabetes. What makes me feel this way? I was contacted on Saturday by the parents of a teenager that had been diagnosed as type 1 and the parents were asking me if the doctor could be wrong. I did say possibly and asked why they thought this. The mother said he is about 30 pounds overweight and since he had not lost weight, they were wondering if their son might be a type 2. I advised them to have an endocrinologist retest him and then they would know for sure. They were able to get into the endocrinologist on Tuesday, May 12, and after the tests; they did find out that their son had type 2 diabetes.
When they called Tuesday evening, May 19, the mother thanked me for suggesting the endocrinologist. She said the endo did suggest that he stay on insulin for a few years and then see how the diabetes was affecting him. She added that the guidelines were insulin as the first line of treatment until he reached an older age. I said this is something that is still in study, but this should make it easier for their son to manage his diabetes. I did ask their son's age and she answered that he had just turned 13. I answered that then things were being done correctly and she and her husband should work with it and be thankful they had the correct diagnosis.
The mother then asked about pumps and a continuous glucose monitor. I said that would need to be talked about with the endocrinologist. I said I am not aware of any insurance that covers this for type 2 people, but I could not say for sure or how the endocrinologist would answer. I suggested to the mother that until she had her questions about equipment answered by an endocrinologist that she continue with the current treatment. She said that his glucose level was still too high and she did not know what to do about it.
I said she needed to call the endocrinologist and have the readings available for them and ask her questions. Then I asked if their son was rebelling and not testing as often as he should. She said that was possible and she would carefully watch when he was at home. I asked if he was eating more than he should eat and had food stashed for between meals or other times. She was uncertain, but would investigate. I suggested that she do this carefully and not to confront her son. She said the endocrinologist had cautioned her about doing this as well. I concluded by suggesting she ask the endocrinologist how often she should call with questions and if she could write the questions down to prevent calling every time they had questions. She said she had started this and was leaving room for answers. I assured that I would answer non-medical questions and give suggestions between doctor visits and possible calls. With that, she thanked me as they were learning and the URLs I had supplied were helping also.