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January 10, 2005

Diagnosis and Symptoms

Question from Swakopmund, Namibia:

My son was diagnosed with type 1 diabetes on October 7, 2004. When he was admitted to the hospital, his blood sugar level was 46 mmol/L [828 mg/dl]. He had pneumonia about two weeks before he was diagnosed. Our pediatrician put him on insulin and within three days we were back home. We were instructed about injections, needles, and insulin, but given no specific plan. I changed his diet to a "healthy diet" using a cookbook from Liesbet Delport, based on the glycemic index. After about one week, my son started to have one low after the other and we reduced the insulin injections. Previously on four injections (eight units of Protophane and four units of NovoRapid units in the morning/four units of NovoRapid dinnertime and six units of Protophane at night), he has taken NO Insulin for the last seven weeks. His A1c test for the last six weeks came back with an average of 4.3 and his liver tests and other tests came back 100% normal. My son is not encountering any problems with highs or lows and the pediatrician here tell us it might be the honeymoon phase. But, our family doctor says, it could have been pancreatitis due to the viral infection and we should see a diabetes specialist in South Africa. I need to know for sure! My son is very active and loves to go on camping trips with the boy scouts here in Namibia. For the last two weeks, we re-introduced "sweets" and he is having absolute normal levels. Of course, we are all still eating according to our "glycemic index food list," but is he really diabetic? Who could we see in Cape Town, South Africa? Is there anyone you can recommend? How can he be diagnosed with diabetes, without anyone checking to see if his pancreas is functioning normally or not?


This forum cannot “make” a diagnosis for you. The advice you have received seems very appropriate, other than “no plan” for insulin at home.

So, I would suggest that you continue your current diet, as long as the child is gaining weight and feeling well. If it is possible for you, I would encourage you to make the appointment with the diabetes specialist. A PEDIATRIC diabetes specialist would likely be even more helpful as, at least in the US, diabetes physicians who treat adults are often not as savvy about pediatric diabetes. The sub-specialist may make recommendations regarding special pancreatic antibody testing to help better confirm if the child has more typical, autoimmune-related type 1 diabetes.

Historical points that might, in fact, have caused a temporary diabetes due to pancreatitis is whether your child had SEVERE abdominal pain at presentation along with the results of blood tests that assess pancreatic efficacy (called “lipase”), and the A1c value at diagnosis.