May 11, 2014
Diagnosis and Symptoms
Question from Boulder, Colorado, USA:
My nine-year-old son appears to be getting close to a “prediabetes” diagnosis. We have his A1c checked every year and his latest result was 5.7, which is the lower borderline. His fasting blood glucose reading this morning was 109 mg/dl [6.1 mmol/L]. I am his parent and have had type 1 diabetes for the past 21 years, which is why we are diligent about keeping an eye on his readings. His pediatrician is not knowledgeable about diabetes, so not very helpful. My endocrinologist is at the Barbara Davis Center in Denver and they will not see him until he is diagnosed with diabetes. I am trying to find some information about doing what we can to keep the disease from progressing. I really want to be proactive here and realize that a lot of this that is out of our control. He is not overweight and is pretty active kid with sports. We, as a family, adhere to a fairly low carbohydrate diet, especially me. I have read online that there may be some medication treatments and, also, I have read of some doctors using insulin therapy, like low doses of long acting insulin. I just need some advice.
Fasting glucose levels above 100 mg/dl [5.6 mmol/L] are in the early diabetes or prediabetes realm. It may be important to have pancreatic islet antibodies checked – islet cell antibody, ZnT8 antibodies, insulin antibodies and IA2 antibodies are the four that are currently available. Positive antibodies would indicate higher risk while negative antibodies don’t always stay negative but are a “good” finding. You may also want to consult with the pediatric diabetes group at the Barbara Davis Center since they may offer a consultation that could answer your specific questions. They may even have some research studies available for more detailed genetic counseling.
Not being overweight, being active physically, avoiding gluten and minimizing rapid acting carbohydrates are about the only things that seem to make some difference in postponing type 1 diabetes in some research studies and it sounds like you are doing most of this already.