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From North Carolina, USA:

My 16 year old daughter just received the results of her hemoglobin A1C test. The doctor indicated that her sugar level was averaging 210. The physician said that oral medication does not work well for people her age. My daughter is trying hard to control her sugar with diet and exercise. She has managed to keep her sugar at about 140 (fasting) but I don't know how long her "motivation" will last. What is the current thinking on oral medication for teens? I am a 46 year old non-insulin dependent diabetic.


I really doubt that oral therapy is at any stage the best therapy for a 16 year old, as your daughter probably has autoimmune Type 1A diabetes (perhaps of the slow evolving form), where insulin treatment even at low doses is highly recommended.

The other possibilities, without knowing your descent and how exactly the diagnosis was made and whether she was ever on insulin before, are Type 1B diabetes (if she is of African American or Hispanic descent). The way to distinguish these two forms is to ask your doctor to arrange for your daughter to have a serum antibody test done. In Type 1A diabetes the test is positive whilst is negative in the type 1B form of the disease. If the antibody test is negative then besides Type 1B diabetes there are a number of much rarer forms of diabetes such as MODY and the various Mitochondrial Diabetes.

Treatment for the antibody-negative Type 1B and mitochondrial diabetes (differential diagnosis among them requires very special and costly lab tests that generally don't change treatment approach) is to concentrate on whatever regimen keeps the blood sugars as close to normal as possible monitoring this with a blood glycohemoglobin (HbA1c) test.


Original posting 15 May 1998
Posted to Medications: Pills for Diabetes


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Last Updated: Tuesday April 06, 2010 15:08:58
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