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Author Notes:

Priyathama Vellanki, pvellan@emory.edu

S.H.C., K.L.F., and P.V. researched the data. All authors wrote and edited the manuscript. P.V is the guarantor of this work and, as such, had full access to all of the data and takes responsibility for the accuracy and integrity of the case presentation.

P.V. has received consulting fees from Boehringer Ingelheim and Merck. No other potential conflicts of interest relevant to this article were reported.


Research Funding:

P.V. is supported in part by grant K12HD085850 from the National Institutes of Health

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


Journal Title:

Clinical Diabetes


Volume 37, Number 4


, Pages 398-400

Type of Work:

Article | Final Publisher PDF


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.

Copyright information:

© 2019 by the American Diabetes Association.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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