My seven year old nephew was diagnosed with type 1 diabetes with an initial blood sugar reading of 560 mg/dl [31.1 mmol/L]. He was in ketoacidosis and required hospitalization. Now, his blood sugar is very well controlled and he requires less than five units of insulin once daily. Could he be type 1b? Can he ever be taken off insulin?

There is no good way to know this for sure. If blood is available for (expensive) antibody tests (islet cell, GAD-65, for example) and if he is positive, then this would be unlikely. If negative, then he could have some other type of childhood diabetes. You should discuss this in detail with his diabetes team since they will be able to give you more specific rather than such general answers to these questions. Family history is important. Ethnic background is also important.

SB

[Editor’s comment: Keep in mind that most people diagnosed with type 1 go through a honeymoon period during which they need little or no insulin because their pancreas is still producing some insulin. This period can last for days, weeks, or months. See our previous questions on the Honeymoon.

BH]