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January 25, 2001

Diagnosis and Symptoms

Question from New York, USA:

My 10 year old son was diagnosed a month ago. At the time, his HbA1c was 8%, and now it is 6.8%. He had a negative antibody test last week. He is taking a small dose of insulin twice a day. Does this mean he does not have diabetes?

Answer:

The hemoglobin A1c was only mildly elevated so this usually means, at diagnosis, that he has not had high sugars for a very long time. The fact that the A1c has shown a nice decrease to almost normal range means that you are doing a good job giving him food and insulin, and you should be seeing mostly normal blood glucose levels. You will want to check the A1c at least every three months. Your diabetes team should have a protocol and let you know how often this is done. We do the test every six to eight weeks.

Antibody tests are only positive about 60-80% of the time so a negative test only means that there were no antibodies detected. Diabetes is diagnosed by symptoms and blood glucose levels, not by antibodies. Also, sometimes antibodies are negative at diagnosis and then become positive later on. Interesting for research purposes but does not help your treatment.

Have you seen Insulin-Dependent Diabetes in Children, Adolescents and Adults, the teaching manual by Dr. Ragnar Hanas? It might provide you some interesting information, and it sounds like you are ready for it.

SB