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Question:

From Romulus, Michigan, USA:

Have you ever caught type 1 in the very early stages? Is there any way we can stop it from getting worse?

Here is my story. I took my 11 year old for his yearly physical where they did a urine test and found ketones. So, they did a blood sugar test and it was 312 mg/dl [17.3 mmol/L] about 90 minutes after he had eaten. Then, they sent us to the Emergency Room of a hospital that had a pediatric endocrinologist's office. By time we got there, about two hours later, his sugar had dropped to 99 mg/dl [5.5 mmol/L]. They did more blood tests and we waited. Then, they gave him something to eat, about 75 grams of carbohydrates, and checked it again about a hour later. His blood sugar had gone up to 212 mg/dl [11.8 mmol/L], so they had him spend the night in the hospital. They taught us how to do everything we need to know about type 1, such as insulin shots, counting carbohydrates and checking blood sugars. But, they still weren't sure if he had it or not because he had no symptoms then or even now. His A1c reading was 6.0.

They sent us home to monitor his blood sugar for two weeks, four times a day. His fasting levels were 126 to 140 mg/dl [7.0 to 7.8 mmol/L]. Before meals, his blood sugars ranged from 120 to 160 mg/dl [6.7 to 8.9 mmol/L]. We went back to his doctor after two weeks and his A1c reading was 6.3. They started him on eight units of Lantus. They say we need to wait as there isn't anything we can do about it. Is there anything we can do? I feel like we can stop it since we caught so early.

Answer:

You are asking very common and reasonable questions. I apologize if my answer seems too short (or too long) or too "anything else."

First of all, you need to have on-going sessions with your pediatric diabetes team, including a Certified Diabetes Educator (CDE), to learn all you can to manage this diagnosis optimally, which, at the very basics includes how to dose and give insulin; best ways to keep him active; and devise a meal plan (you have been learning to track and count carbohydrates [sugars and starches] and dose insulin accordingly.)

Good attention to this can lead to prolongation of a common phenomenon in the first weeks of diabetes mellitus diagnosis called the "honeymoon phase." Please see other questions on this web site to learn more about this, but your CDE can help you.

If you are really interested in aggressively trying to slow the progress of diabetes, which is a progressive disease, you may want to see if your son might qualify for a research protocol using new medications and methods to modify the immune system in recently diagnosed patients with type 1 diabetes. Research protocols have VERY STRICT criteria to allow/disallow participation. Your pediatric endocrinologist may help. I often refer patients to TrialNet - a national, multicentered study involved in various aspects of diabetes research. Major TrialNet Centers include:

  • Barbara Davis Center for Childhood Diabetes, Denver, CO
  • Indiana University Medical Center, Indianapolis, IN
  • Stanford University Medical Center, Stanford, CA
  • University of Florida Medical Center, Gainesville, FL University of Florida
  • Minnesota Academic Health Center, Minneapolis, MN
  • Benaroya Research Institute at Virginia Mason, Seattle, WA

You can read more about TrialNet on the Internet. There certainly is a study for persons as young as eight years old who have been diagnosed with diabetes within three months of joining this trial.

DS

DTQ-20061018163300
Original posting 22 Oct 2006
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:10:10
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