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August 29, 2000

Diagnosis and Symptoms, Honeymoon

Question from America On-Line:

My 14 year old son was originally diagnosed seven years ago. His blood sugar was 300 mg/dl [16.6 mmol/L]. He has been on the same insulin dosage since his diagnosis and never had a blood sugar above 125 mg/dl [6.9 mmol/L]. His scores are always in the excellent range with an average of 70-80 mg/dl [3.9-4.4 mmol/L]. His doctor recently did a glucose tolerance test as well as an antibody test and they came back normal and negative. He now states that my son probably does not have diabetes. Could there be any damage from taking insulin for seven years? Could there be any other diagnosis? Are there people experiencing honeymoon periods of seven to ten years?


The most common form of diabetes in children in North America is now called Type 1A or autoimmune diabetes. These children are permanently insulin dependent and have positive antibody tests. However, in the last few years, it has been realised that about 5% of Caucasian children and a little over 50% of African American and Latino children with new onset diabetes are antibody negative. The basic pathology in this second group has not yet been fully explored, but what is important is that around 50% of them are able to come off insulin and a few can manage without oral hypoglycemics or special attention to exercise and diet. However, the evidence is that they do have diminished insulin reserves, and they may one day require insulin supplements again.

I think your son could well have this Type 1B diabetes, but he was first diagnosed before this group was recognised and before antibody tests became routine.