My 13 year old son who is very thin was diagnosed with diabetes which his regular doctor and I think is type 1, but the specialist is unsure and thinks it’s type 2, even though my son does not fit the criteria. He is taking Starlix along with Glucophage [pills for type 2 diabetes], and his sugars are still very erratic. He was sleeping all the time, tired, and hungry, but he is losing weight which is why I took him to the doctor in the first place. Please tell me what you think. Why would the specialist think this?

It can sometimes be difficult to specify what kind of diabetes a child or a teenager has on purely clinical grounds without the help of ancillary laboratory studies. The great majority of new onset cases in Caucasian children and teenagers are due to type 1A (autoimmune) diabetes, but to make sure of the diagnosis, it is necessary to have antibody studies. To provide a clear answer these should include anti-insulin, anti-GAD and ICA 512. Your doctor can explain what these symbols mean, and the test should be done in a laboratory like Quest Diagnostics which reports the results as positive or negative and not as some number which may be hard to interpret. Only if all three of these tests are negative would it be appropriate to consider alternatives such as type 1B diabetes, Maturity Onset Diabetes of the Young, and type 2 diabetes. This is important because people with type 1 diabetes need to be treated with insulin even though only small doses may be required.

DOB