From Central New Jersey, USA:
Our son was diagnosed one year ago with type 1 diabetes at the age of thirteen years and two months. At the time he was 5'9", 150 pounds, Caucasian and physically mature. He was asymptomatic, but was diagnosed based on an initial urine test taken for a camp physical. Initially, he had blood sugars in the 400's (HgA1c: 8.5), but within a month was brought into normal range using about 22 units a day of pork insulin (N and R). At the time of diagnosis, he was shown to be negative for both GAD and Islet Cell Antibodies.
After that initial month, he was switched to human insulin, and for the past year has been on only 4-5 units a day. The past month, he has been in camp and is down to 1/2 unit a day and has to take 4-6 carb snacks at night so he doesn't wake up low (his blood sugars range from 68-99 during his stay at camp; however, if he overindulges in pizza, he can produce a blood sugar in the low 200's, although this is a rare occurrence). His latest blood test reveals HA1c and C-peptide to be in the normal range, and a retest for GAD antibodies still is negative.
Given this information, does this sound like he is simply in a traditional honeymoon period for type 1 diabetes? Could there be an alternative diagnosis of his condition and, if so, what other tests could be performed to clarify his situation?
It is pretty clear that your son has diabetes from the history and laboratory data around the time of diagnosis. Equally, he must be making his own insulin at the moment if you are giving such small doses of exogenous insulin - and as expected he has good c-peptide levels. Absence of autoantibodies at this stage is not so unusual but I agree that he is having a long honeymoon period.
The occasional high sugars are an indication that he is still glucose intolerant and I would expect his insulin requirement to rise in the next few months.
Original posting 30 Sep 1998
Posted to Diagnosis and Symptoms
Last Updated: Tuesday April 06, 2010 15:09:00
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