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July 25, 2006

Diagnosis and Symptoms

Question from Minneapolis, Minnesota, USA:

My nine year old son had a GAD-65 screening in May 2005. We'd taken him to the endocrinologist after a few tests revealed numbers of 140 to 160 mg/dl [7.8 to 8.9 mmol/L] two hours after eating and a fasting of 111 mg/dl [6.2 mmol/L] one morning. The endocrinologist called and said the GAD-65 was elevated and there was "significant activity taking place." We were instructed to take occasional blood glucose tests and return for laboratory work when his numbers were over 200 mg/dl [11.1 mmol/L] two hours after eating, with symptoms. In addition to avoiding high carbohydrate foods, isn't there anything else I can do as a parent to delay the onset of type 1 diabetes other than wait for his pancreas to be destroyed to the point we can clinically diagnose type 1 diabetes? His four year old brother was diagnosed with type 1 in November 2004 and I'm having a hard time coming to grips with the prospect of both of our children being diabetics. Caring for two diabetic children is going to be difficult, but it's the anxiety of waiting for my older son to be "sick enough" to be diagnosed that's bothering me more than anything.

Answer:

There is not much that definitely works in preventing type 1 diabetes. Positive antibodies remain a marker for this future development and, as you said, cause a lot of angst with the waiting. Staying away from obviously high sugar foods is a common sense approach, but likely only a temporizer. There are some experimental protocols run under the auspices of the National Institute of Diabetes & Digestive & Kidney Diseases of the National Institute of Health and the Diabetes Prevention Trials, so you may want to discuss these with your endocrinologist. Not all parents and kids are wiling to participate in such experimental trials, but at least you could learn about the options.

SB