My 13 year old daughter was diagnosed with type 1 at the age of seven. After one episode of ketoacidosis, the doctor put her on 2 units of NPH every morning. After three years, we moved out of state and were unable to get a doctor specializing in diabetes. Her regular physician said to discontinue the insulin. After years of fighting lows, we did stop it. Now, several years later, she continues to test her sugars on a regular basis. Her highest sugar was about 155 mg/dl [8.6 mmol/L]. Her doctor never would perform an antibody test to determine her exact type. I have read this forum for years and no concrete answers are available to explain her type. What damage do the 120-150 mg/dl [6.7-8.3 mmol/L] readings do to her body, if any?

Her aunt died of type 1 diabetes complications at the age of 26. She had gastroparesis as well as other neuropathies. Recently, my husband was informed of an irregular glucose reading after two work-required physicals, leading me to believe my daughter’s condition could possibly be inherited.

The most common form of new-onset diabetes in children in North America is due to a disorder of the immune system and is now called type 1A (autoimmune). In about 5% of Caucasian families and in more than half the new onset cases in African Americans or Hispanics, there doesn’t appear to be an autoimmune problem and the antibody tests are negative. In these type 1B cases, there is acute insulin dependence to start with, but, after a few weeks or months insulin, may no longer be required. There is not much known so far as to the underlying cause of type 1B. Some are linked to chromosomal abnormalities, but it is thought that there is an underlying insulin deficiency in many, if not all, cases so that insulin may be again required at some time later in life.

If the blood sugar levels that you report were taken fasting then they are abnormal, and it is quite possible that your daughter does have this mild type 1B form of diabetes. Even though she doesn’t require insulin, she may still need to control her blood sugars with diet and exercise or even with the help of drugs like Glucophage [metformin]. You should ask her doctor about this. Meticulous control of blood sugars can go a long way in forestalling long-term complications.

DOB