The doctors said my three year old grandson has type 1 diabetes but he does not need insulin yet. They did the antibody test and said he has the antibodies for type 1. He has fasting blood sugars of 165 to 211 mg/dl [9.2 to 11.7 mmol/L]. The doctor said, unless he has sugar in his urine, there is no need to worry or do anything yet. He has also started to wet his bed. The diabetic educator said it would be about six month and he would need insulin. Please help me to understand what is going on.

I am not sure that I understand either. Your grandson has fasting hyperglycemia (by definition, diabetes occurs when there is fasting serum glucose more than 125 mg/dL [6.9 mmol/L]); he apparently has antibodies against the pancreas; he has increased urination (typically the blood glucose is more than 180 mg/dL 10.0 mmol/L] to cause increased urination.)

This sounds like classic, albeit perhaps early diagnosed, type 1 diabetes. I do not know why your pediatric endocrinologist has not prescribed at least SOME insulin at this point. A good dialogue to understand people’s rationale for not starting insulin seemingly is warranted. Might you want a second opinion from another pediatric endocrinologist in your region?

DS