About two years ago, I noticed my 11-year-old son was becoming a bit sluggish. At that point, I used his older sibling’s meter (since my older son has type 1) to check his blood sugars, which ranged from 120 mg/dl [6.7 mmol/L] to 180 mg/dl [10.0 mmol/L]. We confirmed these readings through blood work at the clinic. In addition, his A1c was in the normal range. During that two year span, I periodically checked his blood sugars with little change in range. Then, this Thanksgiving, my son’s reading was 597 mg/dl [33.2 mmol/L] and he was diagnosed with type 1. Do you have any experience of a delayed onset such as this? What are the chances of a sibling becoming diabetic without any other diabetes in the family? I have two additional sons and wonder about the benefit of having them tested for antibodies. Also, with my son being newly diagnosed, is there anything out there to slow down the honeymoon stage?

It is not so rare to have a period of time when the pancreas is “failing,” but in a partial sense. Thus, there is some intermittent hyperglycemia. There could also be some intermittent hypoglycemia as well. Then, whatever damages the susceptible pancreas islets continues and, finally, there is sufficient absence of insulin production to produce more consistent hyperglycemia and symptoms. Presumably, if there were antibodies measured, they would change from negative to positive during that time period. But, antibodies are not present 100% of the time in anyone so they are more helpful for research predictions than for an individual. Actual risk is around 2 to 5% of a sibling developing type 1 diabetes when another child has already been so diagnosed. You should discuss antibody testing in your other children with your diabetes team since they will know what is available, costs, etc. There are also some research/prevention trials ongoing that also may be of interest to you and your other children.

SB

[Editor’s comment:

For information on clinical trials in which your son(s) could participate, see the NIKKD page Opportunities to Participate in Clinical Trials
BH]