Question from Houston, Texas, USA:

My five year old son was diagnosed with type 1 diabetes about nine months ago, presenting classic symptoms of excessive thirst and urination, small to moderate ketones, and a blood sugar level of around 600 mg/dl [33.3 mmol/L]. He was released from the hospital within a couple of hours and placed on insulin therapy. His A1c was 14% at onset. Three months later, his A1c was 6.4%. Six months after diagnosis it was 6.5% and, now, nine months later it is 6.3%.

Ten days ago, he became ill with a virus. The illness, vomiting and diarrhea, unfortunately, started an hour after his regular insulin morning dosage of 6 units of NPH and 1 unit of Humalog. We tried to keep his numbers up, but after three mini-doses of Glucagon we took him into the hospital, where he recovered quickly. For the week following, we expected a change in insulin requirements, but this seems drastic. His normal insulin requirements prior to the illness were 6 units of NPH and 1 unit of Humalog before breakfast and 3 1/2 units of NPH and 1 unit of Humalog before dinner. Also, three to four times a week, he required an additional unit of Humalog during the afternoon. For the week following the virus, he has been taking 1 unit of NPH in the morning, no Humalog, and 1/2 unit of NPH before dinner with no Humalog. For that week, he could eat and drink ANYTHING (Gatorade, cookies, candy), and most readings were in the 90s mg/dl [5.0 to 5.6 mmol/L] but a few up to 150 mg/dl [8.3 mmol/L].

Now, his insulin requirements are climbing slowly. I expect his units required will be back to where they were within a few weeks. He went to his endocrinologist a few days ago, and the doctor informed us that all three antibody tests performed at onset were negative. I cannot tell you specifically the names of those tests. My question to the doctor that day was whether this could be 1B, and if oral medication could be a possibility. He said ‘no’ to the medication question and didn’t answer the 1B question. He did order a repeat of the three antibody tests.

Do you think this could be 1B? Do you see any significance to the condition of my child’s body post-virus, post-Glucagon that could shed light on his obvious surge in insulin production? Is there some harm possible to my child’s body by taking oral medication as his doctor thinks? Is this simply honeymoon?