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October 22, 2013

Diagnosis and Symptoms

Question from Canton, Michigan, USA:

When my then 7-year-old son was diagnosed with type 1 diabetes three years ago, he was well into DKA and was put on Levemir and Humalog. However, when I take him to his appointments, I see that his chart says his diagnosis was "Type 1.5 treated as type 1." They never said anything about that. What would this mean? I understand to stay the course of treatment, but what is 1.5? I thought that only referred to adults with late onset. He is on 22 units of levimir and a lot of Humalog.

Answer:

You are correct that type 1.5 is a bit odd for a young child unless he is very obese. Older teens and obese children/teens can have something that acts like classical type 1 diabetes – which is autoimmune with positive antibodies at diagnosis – but because of the obesity, have some clinical features of type 2 diabetes with insulin resistance at the same time. That can be called various names: type 1.5 and double diabetes are the most common tags attached. Either way, treatment is dictated by actual A1c and blood sugar values as evaluated by downloaded blood sugar data and office consultation visits, laboratory results etc. Perhaps it is just a computer error, so ask your diabetes team at your next visit.

SB