My 19 year old daughter was diagnosed with Type 1 diabetes 3 months ago. She attends college 500 miles away from home and the internist that is treating her at college ordered an islet cell antibody test. The results were negative but I am unable to find out why they ran this test and what a negative result means.

Your daughter’s internist was absolutely correct to order an antibody test. I imagine that it had just been assumed that because she was only 19 her diabetes must be Type�1A or autoimmune which means that for all practical purposes she needs to be on insulin for the foreseeable future. A positive antibody test would confirm this assumption. However, it is now realised that there are other forms of diabetes which have a somewhat different prognoses and treatment priorities, notably Type�1B and Type 2 which could also present in someone of her age. Antibody positive diabetes in a 19 year old is sometimes called L.A.D.A. meaning Late Autoimmune Diabetes in Adults. First of all, the negative test in her case, may mean that she could have Type 1B diabetes. In this case, she would have about a 50% chance of coming off insulin at some time in the next six months. Long term, the prospects are that insulin will again be required. She might also be one of the increasing number of Type 2 diabetics that are now seen in young people and even in children. The problem in these cases is, at least initially, one of insulin resistance and not one of insulin insufficiency and again there is the probability that the disorder can be managed on oral medication with diet and exercise. Whatever the specific diagnosis, the aim of treatment has to be to keep blood sugars as near to normal as possible.

DOB