Mixed diabetes (double, hybrid) means the coexistence of type 1 and type 2 diabetes. Mixed diabetes is diagnosed mainly in children and adolescents who are struggling with overweight or obesity. What are the causes and symptoms of mixed (dual) diabetes? What is the treatment?

Mixed diabetes( double , hybrid, 1.5 type diabetes, DD, double diabetes) means the simultaneous occurrence of the characteristics of both types of diabetes . For type 1 diabetes it will be the presence of antibodies to pancreatic islet cells, and for type 2 diabetes - insulin resistance and obesity.

So far, no precise data on the prevalence of mixed diabetes have been published and the actual number of patients remains unknown. All because of the lack of precise definitions for the different types of diabetes found in children and adolescents, and the evolution of symptoms over time.

Combined (double) diabetes - causes

It is believed that genetically predisposed children first experience abnormalities in insulin production and develop type 1 diabetes, and then - as a result of obesity and related metabolic disorders - develop insulin resistance, characteristic of type 2 diabetes.

Obesity plays a key role in the development of "double diabetes".

The reverse is also possible, where obesity and / or type 2 diabetes lead to type 1 diabetes. Excessive weight gain results in insulin resistance, which forces the pancreatic islet cells to produce more insulin. Overloaded cells are destroyed, releasing autoantigens, which initiate the formation of diabetes-related antibodies in genetically predisposed people .¹

This theory has been confirmed in research by diabetologists from the Children's Hospital in Pittsburgh (USA). Based on nine years of observation of 260 hospital patients, they found that 25 percent. children with initially diagnosed type 1 diabetes show symptoms of type 2 diabetes, and almost half of obese children admitted with symptoms of type 2 diabetes showed symptoms of type 1 diabetes after a few years .²

Mixed (double) diabetes - symptoms

For diabetesmixed indicate:

1. Symptoms of type 2 diabetes + dyslipidemia, hypertension, increased BMI

2. Presence of some features attributed to type 1 diabetes, such as polyuria and thirst, weight loss, development of ketoacidosis

3. Presence of anti-exsudative autoantibodies in blood tests.

It should be noted that the features of type 1 and type 2 diabetes may coexist at the time of diagnosis or develop over time, i.e. the existing symptoms are joined by new symptoms characteristic of another type of diabetes.

Worth knowing

A patient with mixed (dual) diabetes is characterized by one of two situations:

1. A patient with the typical symptoms of type 2 diabetes mellitus has antibodies in blood tests (which are a feature of type 1 diabetes). It does not require insulin therapy for a long time.

2. A patient with type 1 diabetes coexists with insulin resistance, and there may also be other components of the metabolic syndrome, such as dyslipidemia and hypertension (characteristic of type 2 diabetes).

Combined (double) diabetes - treatment

For patients with type 1 diabetes and insulin resistance, one option is to include biguanides, including metformin, in treatment as an add-on to standard insulin therapy, which results in a decrease in gluconeogenesis and an improvement in insulin sensitivity .¹

The fight against obesity in children and adolescents will also be a method supporting the treatment of double diabetes.

Bibliography:

1. Sieniawska J., Rębowicz K., Osiak W., Beń-Skowronek I., "Double diabetes": coexistence of type 1 and type 2 diabetes, "Pediatric Endokrynologia" 2016

2. Double Dose Of Diabetes Baffles, http://www.cbsnews.com/news/double-dose-of-diabetes-baffles/

Category:

Diabetes