March 25, 2003
Daily Care
Question from Lyndhurst, New Jersey, USA:
My 17 year old son, diagnosed with type 1 diabetes four years ago, and using a insulin pump, has had a few C-peptide tests done. Last year, his level was 0.8, and at his last checkup, it was 1.0 (normal:0.4-3.3). His A1c was 7.5% (the highest he has ever had) because he switched to the insulin pump, and we were having a little bit of a hard time getting the right basal rate since he is very active in high school sports.Is it possible after almost four years of type 1 diabetes for my son’s pancreas to still be making insulin? Can he try oral hypoglycemic agents instead if he is still producing insulin on his own?
Answer:
With a C-peptide of 1.0 and a hemoglobin A1c of 7.5%, he isn’t making much insulin. I wouldn’t switch.
That said — Is he overweight? Is there a lots of type 2 in the family with the other diseases of insulin resistance (hypertension and cholesterol). If so, you might ask the doctor about using a thiazolidinedione too. This is controversial and there is no real literature yet as far as I know, but worth the discussion in the right kids. I haven’t personally been too impressed yet. Is he making some insulin? Yes, but not much.
LD
