"Hybrid" or "Mixed" Diabetes
"Hybrid" or "Mixed" Diabetes
While for the most part it is easy to determine if a child or teenager has type 1 or type 2 diabetes, some children have elements of both kinds of diabetes. This phenomenon may be called "hybrid" or "mixed" diabetes*. It is not surprising that some children have elements of both type 1 and type 2 diabetes, given the fact that more children are becoming overweight. Youth with “hybrid” diabetes are likely to have both:
- insulin resistance that is associated with obesity and type 2 diabetes, and
- antibodies against the pancreatic islet cells that are associated with autoimmunity and type 1 diabetes.
Signs and symptoms
The signs and symptoms are the same as those for type 1 and type 2 diabetes.
Management.
At the time of diagnosis, the clinician should attempt to determine which type of diabetes is present. Measuring antibodies against islet cells and assessing insulin production by measuring C-peptide levels help make the distinction. C-peptide levels are best determined about a year after diagnosis. The presence of hybrid diabetes may affect how the child or teen is treated. Insulin injections are likely to be needed (as for type 1), and oral diabetes medications may be used to improve insulin resistance (as for type 2). It is important to counsel the child or teen about healthy eating habits and the need for daily physical activity so he or she can reach a healthy weight.
* Some may use the misleading term "double" diabetes. Patients should be assured that this does not mean that they have a greater risk for complications or "extra" disease compared to those with type 1 or type 2 diabetes
See Also
