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Question:

From West Monroe, Louisiana, USA:

My 17 year old son was diagnosed with probable type 1 diabetes almost nine months ago, and at that time, has had all the classic symptoms (thirst, urination, weight loss), his fasting blood sugar was 289 mg/dl [16.1 mmol/L], and his hemoglobin A1c was 11%. For about a month, he was on insulin before breakfast and supper, and during that time, his blood sugar readings continually dropped lower and lower so his doctor took him off of insulin completely. He has had no insulin now for eight months with normal readings. We just had blood work done, and his fasting blood sugar was 92 mg/dl [5.1 mmol/L], two-hour post-prandial was 110 mg/dl [6.1 mmol/L], and A1c was 4.6%.

Could he still be in the honeymoon phase? Is it possible he has type 2 diabetes and can control this with diet and exercise? He will be 18 next month and says he is joining Marines if they will have him. I would like another opinion about his diagnosis.

Answer:

I think that your son could be in the honeymoon phase, since he has only had diabetes for nine months. On the other hand, it is not common to withdraw insulin completely as in his case. I remember reading a scientific paper about a boy with type 1 diabetes who remained off without insulin for a long time (about two years if I remember correctly) just because of the high amount of physical activity he was doing. In this case, the honeymoon phase will end (but we don't know exactly when), and when it ends, your son will resume insulin injections at some point.

If you want to be sure which type of diabetes your son has, you have to ask doctor about antibody testing (i.e., ICA 512, insulin antibodies, and GAD antibodies), that are very common in type 1 diabetes. IF your son doesn't have any antibodies, he could have type 2 diabetes, which, when well controlled, could be managed without insulin for a very long time period.

AS

DTQ-20030911224817
Original posting 18 Sep 2003
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:52
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