My 13 year old son was diagnosed with type 2 diabetes three months ago, but I’ve been doing some reading, and I’m worried that he has type� 1. The doctor said the diabetes was because he is overweight. However, my son started having seizures of unknown origin when he was eight months old, was diagnosed with alpha-1 antitrypsin deficiency when he was five years old, and he has a hepatoma. I know seizures and hepatoma are sometimes caused by diabetes.

It is always difficult to tie together such a complex story within the limited compass of an e-mail and without any more detailed access to the medical records. However, in view of your son’s weight problem, I think that he almost certainly has type 2 diabetes and is probably being managed without insulin at the present.

Understanding the links to the other problems is more difficult. A rather rare genetic disorder called hemochromatosis, which is due to excessive iron storage in the tissues could explain the diabetes, the hepatoma and the seizures, but not the alpha-1 antitrypsin deficiency, which could or course be just another randomly associated genetic abnormality. It might be worth asking about a transferrin level, though. Alpha-1 antitrypsin deficiency is associated with diabetes, but the liver tumors are usually of a different kind.

Type 1A (autoimmune) diabetes seems very unlikely, and I would not feel an antibody test is justified, al though you might discuss it with the doctor. Some rare insulin deficient diabetes is a possibility even though there seems to be no present need of insulin, and its evaluation could waste resources without changing treatment.

DOB