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May 22, 2001

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Question from Tetovo, Macedonia:

My seven year old has had type 1 diabetes for a year, his hemoglobin A1c's have ranged from 4.4-7.0%, and his blood sugars 4 to 8 mmol/L [72- 144 mg/dl] on twice daily Mixtard. Nobody in our family has diabetes. Is there any possibility my son is cured? If so, for how long?

Answer:

Your son has of a form of type 1 diabetes (young age, abrupt onset, negative family history). I don’t think antibody testing is easily available in your country, and their eventual presence doesn’t change the current clinical approach. On this, basis I think insulin, even at low dosage during the current partial remission (honeymoon) phase, will be his only therapy for the coming years.

Regarding the future, gene therapy and islet cell transplants might restore endogenous insulin secretion and make patients free from the shots. We have a long way to go, though.

MS