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November 30, 2002

Diagnosis and Symptoms

Question from Williamston, Michigan, USA:

I have had type 1 diabetes since age 23, and my daughter has positive antibodies for islet cell antibody, insulin autoantibody, and GAD. However, her pediatric endocrinologist says she does not have diabetes even though she has failed two glucose tolerance tests with a final blood sugar of 396 mg/dl [22 mmol/L]. How would you explain these abnormal results?

Answer:

I have no other explanation for a history of three positive antibody tests, a random blood sugar of 396 mg/dl [22 mmol/L], two abnormal glucose tolerance tests and a positive family history other than a diagnosis of type 1A (autoimmune) diabetes, unless there has been some major problem of communication. It is possible that your daughter is in the so-called honeymoon period and that the doctor doesn’t think that she needs insulin. Perhaps you have interpreted this as implying she does not have diabetes. Whatever the truth, I suggest that you talk this over with the pediatric endocrinologist, and if this is not satisfactory, then you should get a second opinion.

DOB