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Question:

From Halifax, Canada:

My son was recently diagnosed with type 1. His doctor said he is very sensitive to insulin. What does this mean? He is an aboriginal child. This chronic illness has reached epidemic proportions within our communities. Need more information.

Answer:

I am not sure that we have all the information needed to answer your question precisely; but I will try to give you a synopsis of what is known. To begin with there have been a number of surveys of the incidence of diabetes in a variety of circumpolar populations. The overall incidence was initially significantly less than in Caucasian populations although there is significant variation between the various groups, e.g., Algonkian, Athabaskan, or Eskimo. To some extent this variation seems to be related to the extent that these aboriginal peoples have adopted western habits and diets and in the last thirty years the consequent incidence of diabetes has tripled. Interestingly this increase has been less amongst groups that still depend on seal oil and salmon in their diet.

As far as I can discover there have been no surveys of diabetes in childhood and in the abstracts from the National Library of Medicine I could find only one brief reference to Type 1A or autoimmune diabetes which was in an Aleut.

My first suggestion would be to talk to your son's doctor and find out if the diagnosis of Type 1 was based on antibody studies or whether it was simply because of his age and insulin dependence. If the antibody test was indeed positive then the insulin sensitivity is not unusual in the early months, especially in younger children. Traditionally it is thought to be caused by an imbalance between the action of exogenous injected insulin the remaining but inappropriately functioning islet cell insulin.

If the antibody test was or should turn out to be negative then your son may have what has come to be called Type 1B or antibody negative, insulin dependent diabetes. This accounts for over 50% of new onset cases in childhood in Hispanic and African American groups and less than 10% in North American Caucasians. The basic pathology of these cases is not yet understood although some, especially in the African Americans appear to be due to a chromosomal abnormality. As far as I can find out the incidence of this kind of diabetes in Eskimos has not been studied, understandably because diagnosis is both expensive and difficult to organise. The possibility is of interest though because a significant number of these children come off insulin after a few months and can be managed on oral hypoglycemics or even on just diet and exercise. In your son's case, then, it is possible that he is a Type 1B diabetic and that sensitivity represents simply a diminishing need for insulin.

DO'B

Original posting 17 Aug 1998
Posted to Insulin and Diagnosis and Symptoms

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