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June 5, 2003

Research: Causes and Prevention

Question from the US Army in Germany, USA:

My seven year old son and my oldest brother both have type 1 diabetes, and I am concerned about my four year old son. We recently noted that he began to drink and use the bathroom often, but this lasted only a week. During this time, I did a random blood sugar check approximately one hour after her had eaten which was 183 mg/dl [10.2 mmol/L], but I have since checked some random blood sugars and noted normal values. He is no longer using the bathroom and drinking like he was. I know that other things can cause polyuria and polydipsia, and I guess that I am concerned that he may be starting to display some early signs of diabetes. Is there any way to check to see if he is developing diabetes before it actually full manifests? I read some journals that have talked about using low dose insulin in siblings of people with diabetes who may be at risk. Is there any therapy that may delay the full onset of diabetes if he is at risk for developing diabetes?

Answer:

With blood sugar tests that were within normal limits and the polyuria evanescent, I don’t think that your small son shows any evidence of prediabetes. Anyway, his chances of ever becoming insulin dependant are only about 5%. At the same time, I understand your concern so perhaps a negative antibody test would be a reassurance. I rather doubt though that this test would be available through the army medical services, but you could ask.

Unfortunately, even if the test were positive, there is no way at the present for delaying the need for insulin. Unhappily two big studies, one in Europe called ENDIT (using nicotinamide ), and another in the U.S. and Canada called DPT-1, (using very small doses of subcutaneous insulin) were both recently shown to be unsuccessful. Despite these disappointments, active research is continuing both on preventing type 1A (autoimmune) diabetes and on maintaining insulin production and even regenerating it.

DOB