I have recently heard of a 16 month old who was diagnosed as having type 2 diabetes. I am aware that this diagnosis is now being made more often in children, but isn’t this a little young for such a diagnosis?

I think that the first step would be to find out exactly on what basis the diagnosis of type 2 was made. In all probability it was because of a negative antibody test in which case it would be important to know if this was just the immunofluorescent screening test which can yield false negatives or it was a test for GAD antibody alone which was negative and that no test for the first appearing anti-insulin antibodies was done.

The age of 16 months would be really too young for conventional type 2 diabetes in childhood and for related conditions like the insulin resistance syndrome so that less common conditions like type 1B diabetes should be thought of or even much rarer ones like one of the Maturity Onset Diabetes of the Young (MODY) variants or IGF-1 (Insulin like Growth Factor) deficiency should be considered.

The problem, as always, with reaching for a precise diagnosis is that it is expensive, and it seldom makes much difference to management.

DOB
Additional comments from Dr. John Schulga:

I don’t believe the child can have type 2 diabetes. If she does, it is a first.

JS
Additional comments from Dr. Stuart Brink:

I don’t know how this diagnosis could be made. Antibodies are not always positive so perhaps somebody has mixed up antibody-negative infantile diabetes (rather common especially if antibodies are not done in a research lab). MODY would also be a possibility and, of course, MODY is a type of type 2 diabetes but this would depend upon family history and perhaps also genetic determinations of family members and the child.

SB