Munchausen by Proxy

[Tom the Cop]

My daughter, now 13, was diagnosed with Type 1 diabetes and is now insulin-dependent. There is no history of diabetes in my family and her mother, (my ex-wife), says there is none in hers either. I am concerned because my ex-wife fits the profile of a mother who would harm her child for medical attention. Is it possible for her to have induced Type 1 diabetes in my daughter? If so, how do I go about confirming this?

[Dr Steve]

My daughter, now 13, was diagnosed with Type 1 diabetes and is now insulin-dependent. There is no history of diabetes in my family and her mother, (my ex-wife), says there is none in hers either. I am concerned because my ex-wife fits the profile of a mother who would harm her child for medical attention. Is it possible for her to have induced Type 1 diabetes in my daughter? If so, how do I go about confirming this?

Tom:

Sorry to hear about your daughter...the good news is that there will be a cure for type I diabetes pretty soon (within the next 10 years, I think).

Muchausen-by-proxy is characterized by a parent who gets secondary gain from the child being ill, and the parent creates or amplifies symptoms in the child to continue to get attention from the medical field. Most often, this results in unnecessary surgeries being performed.

Type I diabetes is pretty provable with a simple blood test, and really isn't a good target for Munchausen patients. There's no way to induce type I diabetes (we don't know what causes it yet) as it's a deficiency in the production of insulin by the pancreas.

Now, your ex may indeed elicit sympathy and attention for herself through your daughter's diabetes, but that alone won't meet the criteria for Munchausen's disease.

Here's an article on MBP: http://kidshealth.org/parent/general/sick/munchausen.html

A lot of kids with type I diabetes don't have any relatives with the disorder, so that doesn't make me particularly suspicious.

Hope this helps, and hope your daughter is ok!


your friend,



Steve