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December 30, 2000

Diagnosis and Symptoms, Medications: Pills for Diabetes

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Question from India:

My 12 year old son aged12 years was diagnosed with type 1 diabetes about six months ago. He is taking 9 units of 70/30 in the morning and 6 units of 70/30 in the evening. Can he be put on oral agents? How can we ascertain that he has type 1A and not type1B? At present, he is able to control his sugar level, but I am informed that during puberty period the insulin demand goes up. What other precautions should he take during that period?

Answer:

From: DTeam Staff

At this stage the only way to tell whether your son has type 1A (autoimmune) or type 1B diabetes is to get an antibody test done. I am sorry that I don’t have a list of suitable laboratories in India, but your son’s doctor should be able to help. Type 1A is much more likely, and it might be important to be able to distinguish between the peak of the honeymoon period in type 1A (I assume he is still in this based on the low insulin dose) when you would still want to continue insulin and the beginning of insulin independence, which is a feature of about 50% of type 1B cases, when you might be beginning to think of oral medication. If his present level of insulin need continues, however, it doesn’t really matter which type he has because the goal will be to keep blood sugars as near to normal as possible.

Puberty can be a difficult time, but the principles of good control are the same as at any other age. Details are rather beyond the scope of an e-mail.

DOB