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October 10, 2001

Diagnosis and Symptoms

Question from New York, New York, USA:

A month ago, my seven year old daughter was diagnosed with type 1 diabetes, and since then her blood glucose has pretty much stabilized with twice daily insulin along with a low carb, no concentrated sweets diet. However, her doctor gave me the results of tests done at diagnosis, and while her C-peptide was less than 2, the ones for the antibodies were all negative. I don't understand. Obviously my daughter has some form of diabetes, but her doctor couldn't be specific with me. Is it necessary that she still be on insulin or could she benefit from taking a pill for to stimulate the pancreas to make insulin?

Answer:

Unless she is overweight, has acanthosis nigricans, hypertension and excess androgens, or some combination of these, she probably has type�1 diabetes but without positive antibodies that can be measured. The antibody tests are only positive in about 60-80% of such children because of problems with the antibody tests themselves. Statistically, she likely has type 1 and needs insulin not any pills. You should go back to your daughter’s diabetes team so that they can explain the specifics of the tests that they have already done.

SB