My 10 year old daughter has been type 1 for about one-and-one-half years. Last year, I was tested for the DPT trial and tested positive for Islet Cell Antibodies. Six months ago, I had the IVGTT and was told that it was fine. From time to time, I check my blood sugar with my daughter’s meter. Lately, my readings have been in the 140 ml/dl [7.8 mmol/l] range about two hours after eating. Previous readings have always been normal. Could this be the beginning of type 1 for me?

You have to accept that, with a first degree relative with autoimmune diabetes, you have about a 5% chance of developing insulin dependence. Clearly, the presence of islet cell antibodies means that the immunological process has begun. At the same time, I assume that you have no anti-GAD (Glutamic Acid Decarboxylase) or anti-insulin antibodies and the insulin response in the IVGTT must have been normal. All of these indicate that the path to actual clinical diabetes is going to be a long one, even an indefinite one, although you will always be a candidate for LADA (Late Autoimmune Diabetes in Adults). Incidentally, you should ask your doctor whether the positive ICA test was based on the old fluorescence technic or on the much more reliable and newer ICA512 immunoassay.

The random blood glucose levels after an unspecified meal are still within normal limits and the rise could, in fact, be due to anxiety over a possible higher figure. The only way you could predict insulin dependence more accurately would be to carry out detailed HLA typing and, of course, with serial repetitions of the antibody and IVGTT tests.

DOB