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November 22, 2000

Other Illnesses

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Question from Eugene, Oregon, USA:

My 17 year old son is and has had diabetes since the age of six. He is healthy, active, and his diabetes has been in good control. He is in the hospital at this time, the first hospitalization since diagnosis 11 years ago, for acute pancreatitis. Does the acute pancreatitis have anything to do with his diabetes? We have been told conflicting answers on this by the doctors attending to him. There is no gallstone causing blockage and no alcohol as a contributing factor. What caused this to happen? We also have an daughter, age 18, with diabetes. Should we be watching for this with her?

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Answer:

From: DTeam Staff

I think that it is almost certain that your son does not have type�1A or&nbspautoimmune diabetes which is by far the most common form of new onset diabetes in children in North America. You might ask his doctor whether he had an antibody test’ at the time of diagnosis because a negative test would have made this diagnosis unlikely. However this test was not widely used 11 years ago.

It seems more probable to me that he has one of the insulin resistant forms of diabetes where the islet cells are intact, but the receptor on the cell surface is changed. This could be detected even now by measuring C-peptide levels in blood, which should be normal or slightly elevated. What is particularly relevant to your question though is whether his blood lipid levels, particularly the triglycerides are elevated, a characteristic of syndromes like type A insulin resistance. These high blood triglyceride levels are in turn associated with episodes of acute pancreatitis, but are also subject to successful medical treatment.

DOB