My 30 year old son, diagnosed with type 2 diabetes five years ago, is experiencing weight loss, and his sugar levels are higher. His doctor is now saying they weren’t sure what type he was. They think he has been in the honeymoon period of type 1 and now want to put him on Lantus (insulin glargine). I am concerned that they did not correctly diagnose his type and would like him to go to a center that specializes in diabetes for a second opinion before he goes on insulin. Is this a common occurrence in people with diabetes?

As medicine acquires better tools to evaluate patients with diabetes, there has been a graying of the classification of diabetes. Patients we thought had type�1 diabetes have an early form of type�2 diabetes and people we thought had type 2 diabetes turned out to have a more indolent slowly-progressing form of type 1 diabetes. The latter condition may be where your son is.

If type 1 is diagnosed, the treatment in almost all cases is insulin. Therefore, it is important to make the correct diagnosis. I would be more concerned about missing the diagnosis of type 1 diabetes and have him poorly treated with oral hypoglycemic agents. His physician should be able to indicate the tools that can be used to diagnose type 1 diabetes. If his physician is not familiar with these, I would recommend he see a physician who is.

JTL