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08/02/09 04:57 PM

"is there a link between chronically elevated prolactin levels in a never-pregnant woman and type 2 diabetes? (MRI has ruled out any pituitary tumor)"
Asked By: jadesono  
Category: Other

Background Info Hide
at 36 my menses became irregular and within 6 months I was spontaneously lactating, having never been pregnant. several months of bromocriptine stopped the lactation temporarily, but the condition resumed within 2 weeks of discontinuing use. several months of dostinex were tried next, again a temporary fix. when an MRI ruled out any pituitary tumor, the doc mentioned that "this sometimes happens with diabetics" but at the time I was not a known diabetic, so they called it "idiopathic" and stopped looking for a cause. at 43, I was diagnosed with type 2 diabetes, and cabergoline was restarted to lower the chronically elevated prolactin level. by my April bloodwork, my prolactin had dropped to 6, so the drug was discontinued. by my July bloodwork, the prolactin had rebounded to 60 and the cabergonine has been restarted. could DM be the cause of the prolactin rise, or vise versa? could any of those meds have caused my diabetes? could the periods of non-treatment be a factor in DM?

Expert Answers (1)

08/06/09 03:02 PM

Hello Ms. JadeSon; Hyperprolactinaemia can be a part of normal body changes during pregnancy and breastfeeding, not in your case! It can also be caused by diseases affecting the hypothalamus and pituitary gland. (The MRI indicating no pituitary involvement). It can also be caused by disruption of the normal regulation of prolactin levels by drugs such as medicinal herbs or heavy metals. Hyperprolactinaemia may also be the result of disease of other organs such as the kidneys, ovaries and thyroid.

The diagnosis of Ty2 diabetes is based on the insulin hormone functions. Insulin is secreted from the pancreas, so, consequent I do not feel they are related to prolactin levels,(not an area of my expertise)!!

The diagnosis/classification/treatment of diabetes has strict criteria. Ty2 is a progressive decrease in pancreatic insulin secretion. Recent CDC statistics suggest that an estimated 5.2 million folks are undiagnosed. Prior to diagnosis you had certain blood sugar testing, objective data that fell into the criteria of diagnosing, (so you can investigate your lab result findings: tests include; A fasting blood glucose > or equal to 126mg/dl, or a blood screening 2 hours after a meal and a reading >200mg/dl, or A1c outside recommended ranges. Diabetes has a strong family history tendency. Obesity and sedentary lifestyles have been identified as strong risk factors, abdominal obesity, >35" for women, increases insulin resistance. Not everyone overweight will develop diabetes Ty2, there must also be concomitant defect in beta cell function of the pancreas. Weight loss will lessen insulin resistance but usually does not fully restore insulin sensitivity. Diabetes may be seen in diseases of the pancreas, such as cystic fibrosis, Cushing's syndrome, acrogmegaly and pheochromocytoma. Certain medications can cause high blood sugars. Work with your healthcare team. Ty2 ABC's:A1C<7%,BP<130/80,LDL<100,HDL>50,acticity>150min/wk. Regards Sue

Answered By: Susan Throop
Accreditations: RD, CDE, MA
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