Prolonged honeymoon phase in an adolescent with diabetes and thyrotoxicosis provides support for the accelerator hypothesis

Pediatr Diabetes. 2008 Aug;9(4 Pt 2):417-9. doi: 10.1111/j.1399-5448.2007.00347.x.


A 14-yr-old female presented with diabetes and Graves' disease. Eighteen months later, she was euthyroid on carbimazole, and her haemoglobin A1c (HbA1c) was normal (5.2%) on a small insulin dose (0.3-0.4 units/kg/day). An assessment of her pancreatic beta-cell reserve, determined by comparing HbA1c and insulin dose, suggested that this was greater than other patients with type 1 diabetes in our service 18 months postdiagnosis (n = 185). We suspect that excess thyroid hormone led to an insulin-resistant state and accelerated her presentation with hyperglycaemia. Insulin resistance fell once normal thyroid function was restored and helped to attenuate further beta-cell destruction when beta-cell mass was relatively well preserved.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Female
  • Graves Disease / complications
  • Graves Disease / physiopathology*
  • Humans
  • Thyrotoxicosis / complications
  • Thyrotoxicosis / physiopathology*