My five year old son was diagnosed with diabetes 5 months ago. They trained us to deal with type 1 since he is not overweight and is very active, but after testing his blood, they found no antibodies. I am very confused. Is there some other type besides type 1 and 2? Where can I find information regarding other types? What do you think he has?

In the last few years there has been a considerable increase in the understanding of the basic pathology of the various forms of diabetes. The early nomenclature of Type�1 and Type 2 is still applicable as a divider between those that do and don’t need insulin: but it isn’t much help in deciding what is basically wrong. One difficulty is that detailed tests are sometimes expensive and difficult to arrange and since outcome is primarily dependant on how well blood sugars are controlled, whatever the type, specific diagnoses are often not pursued.

The commonest form of new onset diabetes in childhood is due to a longstanding disorder of the immune system and is now called Type�1A. There is nearly always an acute onset requiring insulin and the insulin dependance is lifelong. In somewhere around 5% of cases in Caucasian children, the confirmatory antibody test is negative. Just exactly why has not yet been worked out. In a few instances antibodies have been present and then disappear before insulin is needed and in some the antibodies may disappear between the onset and the test. In a few there is a chromosomal alteration and in others it is thought possible that other antibodies that are not yet tested for may be present.

The situation however is quite different in Hispanic and African American children where just over 50% are antibody negative at onset. About half of these Type�1B diabetics are able to come off insulin after a few weeks; but it is not known for how long because they are basically insulin deficient and the expectation is that they will one day need insulin again.

I hope this helps; but you will have to wait a little before there is any literature on the subject.

DOB