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December 18, 2000

Diagnosis and Symptoms, Insulin

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Question from India:

My 12 year old son was diagnosed with type 1 diabetes about six months ago. How do I ascertain whether he has type�1A or type�1B?

He is taking 15 units a day of Mixtard insulin. He is exercising a lot and generally keeps a good control of his sugar. Is there any chance that he can be put on oral medications? Is there any chance of getting him off insulin in near future?

What are the safe sugar levels he should maintain? At present, his fasting is around 110 mg/dl [6.1 mmol/L] and two hours after lunch it varies between 130-160 mg/dl [7.2-8.9 mmol/L.

Answer:

I think that your son, already diagnosed as type�1, actually has type�1A (autoimmune) diabetes, but I’d check him for autoantibodies first in order to confirm the diagnosis. He needs to stick to insulin therapy, and I don’t see any chance to be switched to oral therapy. Blood sugar levels you report are quite fine even though good metabolic control, whatever it is obtained are better judged from HbA1c, and this is his best insurance towards a normal life free from complications.

MS