October 4, 2007
Diagnosis and Symptoms, Other
Question from Seattle, Washington, USA:
My son is now five years old and was diagnosed with diabetes at 17 months of age. The type was undetermined when first diagnosed. The pediatric endocrinologist is determined that my son must have type 1 diabetes, but is puzzled at my son being able to make insulin. His A1c test early this year was 8.1. He currently weighs 39 pounds, takes three units of Lantus each morning and 0.5 units of NovoLog for every 20 grams of carbohydrates. His correction factor is 0.25:100 (or 1:400). On average, he takes eight units of insulin daily. Can a person with type 1 diabetes continue to make insulin throughout their life? Is it possible that my thin, healthy, active son has type 2 diabetes, not type 1?
Answer:
With an A1c of 8.0, his average glucose is about 180 mg/dl [10.0 mmol/L], which mean he certainly has diabetes and he certainly needs treatment. A C-Peptide test will tell how much insulin he can make. Your pediatric endocrinologist could order one after a standard meal. The diabetes research community uses the canned meal replacement drinks and tests C-Peptide afterwards.
Although 17 months is really late for the infant diabetes which is caused by a rare gene, it, too, can be tested.
LD
[Editor’s comment: For more information on “infant diabetes,” see Switching from Insulin to Oral Sulfonylureas in Patients with Diabetes Due to Kir6.2 Mutations.
BH]
