FACTITIOUS DIABETES-MELLITUS AND SPONTANEOUS HYPOGLYCEMIA - CONSEQUENCES OF UNRECOGNIZED MUNCHAUSEN-SYNDROME BY PROXY

OBJECTIVE - To increase health-care professionals' awareness and knowl edge of factitious illness by proxy, or Munchausen syndrome by proxy, in relatives of diabetic patients. RESEARCH DESIGN AND METHODS - A cas e report is described of a 14 old male who has a 6-yr history of diet- controlled diabetes mellitus, and a 6-mo history of reported spontaneo us hypoglycemia. RESULTS - Neither diabetes nor spontaneous hypoglycem ia was present in this child on objective testing. The child was subje cted to inappropriate use of a strict diabetic diet and daily glucomet er measurements for at least 8 yr. The father had convinced his son an d health-care professionals of these diagnoses, in spite of evidence t o the contrary. CONCLUSIONS - When confronted with history and clinica l findings that contradict laboratory findings, health-care profession als should have a high index of suspicion for factitious illness and s hould pursue it aggressively with the help of legal services.