Fifteen months ago, my 12 year old son was diagnosed with type�1 diabetes. He weighs 40 kilograms, his current total daily insulin requirement is 20 units, and his last hemoglobin A1c was 8.2%. I was told that an average total insulin need for a person like my son is 1.5 Units per kilogram of body weight per day. That would mean he should be taking 60 Units. Is 1.5 units per Kilogram correct? If so, are his beta cells producing more that 50% of his body’s needs?

I think that most children’s diabetes doctors would consider a total daily dose of insulin of 1.5 Units per kilogram of body weight per day to be quite high. A more usual figure would be between 0.8 and 1.0 Unit per kilogram of body weight per day, and your son is getting 0.5 Unit per kilogram of body weight per day. So you are correct in supposing that he is still making a significant proportion of his insulin needs.

To be doing so well 15 months from the onset is a little unusual, so you might think to talk to his doctor and see if it would be possible to get a serum C-peptide test which would confirm this. It might also be worth asking whether he had an antibody test at first diagnosis which would have confirmed that he has type�1A (autoimmune) in which insulin production is ultimately completely destroyed and not type�1B which has a similar acute onset, but in which, in about 50% of cases, insulin is gradually no longer required for a period of time.

DOB