Glycemic Control during Gender-Affirming Therapy in a Patient with Type 1 Diabetes

• Type of Material: Article
• Authors: Sarah H. Campbell, Geisel School of Medicine at Dartmouth; Kristin L. Flint, Emory University; J. Sonya Haw, Emory University; Georgia Davis, Emory University; Priyathama Vellanki, Emory University
• Language: English
• Date: 2019-10-01
• Publisher: American Diebetes Association
• Publication Version: Final Published Version
• Copyright Statement: © 2019 by the American Diabetes Association.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.2337/CD19-0016
• Title of Journal or Parent Work: Clinical Diabetes
• Volume: 37
• Issue: 4
• Start Page: 398
• End Page: 400
• Grant/Funding Information: P.V. is supported in part by grant K12HD085850 from the National Institutes of Health
• Research Categories: Health Sciences, Public Health; Gender Studies

Abstract

A 20-year-old transgender woman (natal male with feminine gender identity) with a 15-year history of type 1 diabetes presented to the clinic to begin gender-affirming hormone therapy. The patient was diagnosed with type 1 diabetes at the age of 5 years. Around the time of diagnosis of type 1 diabetes, she experienced two episodes of diabetic ketoacidosis but has had no additional episodes since adolescence. At initial presentation to the endocrinology clinic, her A1C was 6.8% (51 mmol/mol) on therapy with insulin detemir 33 units each night and mealtime insulin lispro at a 1:8 insulin-to-carbohydrate ratio. At this time, she was experiencing approximately one episode of hypoglycemia per week.