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Question:

From Virginia, USA:

My 2 year old son was diagnosed with Type 2 diabetes about 6 months ago. We control his blood sugar level with his diet. Is it unusual for a 2 year old to have Type 2?

Answer:

The great majority of Caucasian 2 year olds who become diabetic have Type 1 Diabetes, which is a disorder of the immune system. There are several possible explanations as to why he has been termed Type 2 Diabetes and it is important that you talk to the doctor to find out how this conclusion was arrived at. In the meantime there are a number of possible explanations for his not presently requiring in insulin. The first is that some Type 1 diabetics may show glucosuria and high blood sugars with the stress of a mild infection. If they get over this quickly they may not need insulin for many months; but eventually they all do. Nevertheless it is important to be sure of the diagnosis as it may be a good idea to give small amounts of insulin, not so much to control blood sugars as for immunological reasons. I he has not had an antibody test then it is important to get this done; you could call 1-800-425-8361 to find out the nearest center where this test can be carried out.

If, however, this test has already been done and he is antibody negative, there are a number of other possibilities. The first is that over half of African-American and Hispanic and some Caucasian children who have new onset diabetes are antibody negative and may not require insulin. Exactly what the problem is in these children, is not yet known; but is a convenience to call them Type 2.

The third possibility is that your son has one of a number of genetically determined causes for this mild diabetes such as mitochondrial diabetes, one of the three types of Maturity Onset Diabetes in the Young (MODY) or something very rare like ceruloplasmin deficiency. Getting a specific diagnosis in these instances may be rather complicated and is probably best deferred until he is much older. That is, provided you are able to keep him in good control as judged by A1c (Glycohemoglobin) levels every three months or so.

DO'B

Additional Comments from Linda Mackowiak, diabetes nurse specialist:

If your child does not have other health problems and if the diagnosis is truly diabetes (rather than transient hyperglycemia, etc) then it is possible that this is the honeymoon period of diabetes. In this case we would expect that your child will need to restart insulin within the next few months or so (although it's impossible to give you an exact time).

It is very important to continue to monitor blood glucose (or urine glucose) as well as urine ketones. Make sure to call your health care team right away when the blood or urine glucose is positive and especially if there are ketones present in the urine.

LM

Original posting 29 Jul 97
Updated 2 and 4 Aug 97

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