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Question:

From Atlanta, Georgia, USA:

I have a brother, 31 years old, diagnosed with Type 1 diabetes 2 years ago. He is in overall good health. He is 6 feet, 3 inches and weighs 190 pounds. All of his A1c's are within the 6 - 6.1 range. When he was diagnosed, his blood sugar was 310. The highest it has been since then, including when he has been sick, has been 280. He does not have a meal plan and can eat what he wants, and portion sizes that he wants. He takes 6 NPH/2 Regular in the am, 2 units of R at supper(he can skip this and bring a high blood sugar down by exercise), and 3 units of N at bedtime. Exercise can bring his blood sugar down without any insulin. He has tried the Humalog, but 1/2 unit will bring him into hypoglycemia. When I say he can pretty much eat what he wants to, he can have a big meal for supper (steak, mashed potatoes), exercise, and his post meal is usually about 90 or so. With no insulin.

This is my question. Is my brother a Type 1 or II? Is it possible to have a two plus year honeymoon period? Is there any type of testing to determine if my brother is Type 1 or II? It seems to me he takes very little insulin for his height and weight, and he is not meal planning. I have a diabetic three year old who can take more insulin than my brother does! His doctors say he is a Type 1. Any insight would be very helpful! I think he could control his diabetes with better meal planning and a bit of insulin every day.

Answer:

Yes it is possible to have a honeymoon period which lasts over 2 years, especially when diabetes first appears in adulthood. If your brother is not overweight, and his physicians say he has Type 1 diabetes, he most likely has Type 1 diabetes, but his pancreas is probably still making a lot of insulin.

It sounds like you are understandably frustrated that it is much harder to control your young child's blood sugars. Diabetes often develops much more rapidly in young children than in adults. If your child's pancreas is no longer making much insulin, you will have to work harder to control his/her blood sugar than someone who's pancreas is still making a lot of insulin. In addition, as a young child grows, frequent changes in diet and insulin will be necessary. Adults do not have these frequent changes.

I suggest that you let your brother work with his own physician to control his blood sugars, and you work with your child's physician to maximize his control. Try not to compare the two, just continue to do the best you can.

TGL

Original posting 10 Mar 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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