My son still has occasional lows, in the 50s mg/dl [2.8 to 3.2 mmol/L], even though he is off insulin, in his honeymoon phase. Our endocrinologist says that it is normal, but we wanted a second opinion. We have found very little information, with the exception of one post on your web site back in 1999, where another family had a similar story. In your opinion, should he have additional testing? He hasn’t been tested for GAD antibodies or C-Peptide because his doctor said they wouldn’t help diagnostically. He was negative for celiac and thyroid antibodies.

It is unusual, but not abnormal, for a child with type 1 diabetes to have low blood sugars in the first few months of diabetes — when they occasionally are carefully treated with little or no insulin. It seems to me that the best option is to treat those low blood sugars and carefully observe to ensure that there is no significant recurrent hypoglycemia while off insulin. It would be appropriate to review this with your diabetes team, especially if it is recurrent, for additional advice. The testing for GAD antibodies and C-Peptide can be helpful for determining whether a child may have type 1 versus type 2 diabetes. Your physician would be in the best position to help you determine whether that testing might be of any value.

MSB