My three year old son has been diagnosed with type 1 diabetes purely by chance because of his vast differences in blood glucose tests, which ranged from 2.6 mmol/L [47 mg/dl] to 27.7 mmol/L [499 mg/dl]. There doesn’t seem to be a reason for this. He has not eaten too much sweets and didn’t have any symptoms. The doctors are quite baffled by this. What is your opinion?

I’m sorry that I am unsure what input you need; I do not understand what is baffling to your physicians. By definition, diabetes is diagnosed when the fasting plasma glucose is confirmed to be great than 125 mg/dl [6.9 mmol/L] OR if a random plasma glucose is greater than 200 mg/dl (11.1 mmol/L) in the presence of classic symptoms such as increased urination, increased thirst, or weight loss OR if the glucose value at the two hour mark of a properly done oral glucose tolerance test is greater than 200 mg/dl (11.1 mmol/L).

The usual cause of type 1 diabetes is an autoimmune process whereby the person’s own immune system “attacks” the pancreas and its ability to produce insulin. This immune system issue is not the same as HIV/AIDS–in that situation the immune system is unable to fend off germs. In autoimmune diseases, the immune system fights against you. The consumption of “too much sweets” has nothing to do with the development of type 1 diabetes.

There are more causes of type 1 diabetes unrelated to the immune system. Sometimes this is referred to as type 1b diabetes. Certain chemotherapies and drugs are implicated; there remains data to support that pancreatic injury following certain viral infections may lead to diabetes as may pancreatic injury following trauma or pancreatitis.

DS