title: Factitious diabetes mellitus and spontaneous hypoglycemia. Consequences of unrecognized Munchausen syndrome by proxy.
abstract: OBJECTIVE
  To increase health-care professionals' awareness and knowledge of factitious illness by proxy, or Munchausen syndrome by proxy, in relatives of diabetic patients.
  
  
  METHODS
  A case report is described of a 14-yr-old male who has a 6-yr history of diet-controlled diabetes mellitus, and a 6-mo history of reported spontaneous hypoglycemia.
  
  
  RESULTS
  Neither diabetes nor spontaneous hypoglycemia was present in this child on objective testing. The child was subjected to inappropriate use of a strict diabetic diet and daily glucometer measurements for at least 8 yr. The father had convinced his son and health-care professionals of these diagnoses, in spite of evidence of the contrary.
  
  
  CONCLUSIONS
  When confronted with history and clinical findings that contradict laboratory findings, health-care professionals should have a high index of suspicion for factitious illness and should pursue it aggressively with the help of legal services.
authors.affiliation: Division of Endocrinology, University of Alberta, Edmonton, Canada.
authors.forename: C S
authors.initials: CS
authors.lastname: Kovacs
authors.forename: E L
authors.initials: EL
authors.lastname: Toth
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring; D003920:Diabetes Mellitus; D003927:Diet, Diabetic; D005220:Fathers; D006801:Humans; D007003:Hypoglycemia; D008297:Male; D016735:Munchausen Syndrome by Proxy / Q000175:diagnosis*
chemical_list: D001786:Blood Glucose