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May 23, 2005

Diagnosis and Symptoms

Question from Oak Forest, Illinois, USA:

My sister and I are married to brothers. My husband and two boys have type 1 diabetes. My nephew is now going through puberty and is showing some high blood sugars. He said he was urinating a lot and thirsty so, of course, with our experience we tested him and he was in the high 100s mg/dl [10.0 to 10.6 mmol/L]. Is this a part of puberty? Should we consult our endocrinologist? Could this turn into type 1 diabetes? My boys are still at a very young age and we haven't gone through puberty yet, so we don't know this question. He pretty much has the same genes as my kids. What should we do? Is he at a high risk for developing type 1 diabetes? Right now,we are testing him about three times a day. His blood sugars are in normal range except for one or two a day. Also, if you think that he is developing type 1 diabetes, should we consult someone about a clinical trial in which he could participate? He has not taken any insulin. If he has type 1, we have caught extremely early before any ketones or major symptoms. Please let us know what is out there for him as far as prolonging the delay of the disease as much as possible.


During puberty, there is some insulin resistant state that leads some to produce more insulin than usual, especially in the very hours of the day, but this does not mean that the adolescent has higher blood sugar levels than normal. Surely, type 1 diabetes run into your family so, I would consult your endocrinologist to have your nephew undergo some tests, such as autoantibodies against beta cells or insulin or GAD or IA2 and to undergo an oral glucose tolerance test in order to verify if his blood sugar levels are in the normal range, in the impaired glucose range, or in the diabetic range. If he has diabetes, the sooner he were to start insulin, the longer his honeymoon period.