Do very many children diagnosed with type 2 diabetes have ketoacidosis at the time of diagnosis? Can type 2 sometimes look like type 1 when it is found in children with weight loss, ketoacidosis, and extremely high blood sugar?

Type 2 diabetes is usually not associated with the development of ketosis, but it can happen. The ketosis that can occur with Type 2 diabetes generally is not as severe as the kind that typically occurs in type 1 and can lead to DKA [diabetic ketoacidosis]. Of course, in children, type 2 diabetes is not as common as type 1 diabetes.

So do many children with type 2 diabetes present with ketosis? No. Can type 2 diabetes look like type 1 when there is weight loss, ketoacidosis, and extremely high glucose levels. Yes, but not typically.

Type 1 diabetes is most often caused by one’s own immune system developing antibody proteins which “attack” the pancreas and its ability to manufacture insulin. This is typical, Type 1 “ketosis-prone” diabetes. It is easy to measure for the antibodies with a blood test. There is also the confusing picture of type 1B diabetes, which is less ketosis-prone and in which the antibodies are not present. This is found a bit more commonly in African-American and Latino individuals, compared to Caucasians. It is to be distinguished from type 2 diabetes in which there is insulin resistance.

DS