Our 39 year old son was just diagnosed with type 1 diabetes in February 2004. He has been taking insulin injections twice a day. His blood sugars have been all over the place. First, they are way high and then, way too low. His doctor just started him on Glucophage. I thought this was for people with type 2 diabetes only. Why would they be using it with type 1? Will it cause harm with the type 1 diabetes? I understand the side effects of lactic acid build-up, but wonder if there is anything else to be concerned about. Should it really be used by people with type 1?

As you suggest, 39 years of age is older for a patient with newly diagnosed type 1 diabetes. It may be that he has a form of late-onset autoimmune diabetes of adulthood (also known as LADA) where there may be some early response to oral agents but relatively quickly has no ability to make insulin. When it occurs that no insulin is being made, the oral agent will not help a great deal. However, it will not hurt him. The lactic acid is a problem in the face of kidney failure, liver failure, or heart failure where the medication cannot be eliminated. The LADA is frequently diagnosed by the presence of autoantibodies, such as anti-GAD antibody. You may want to check if this was measured. If positive, it is a sign of LADA. It does sound like he responded to the insulin. If in doubt, the insulin will be effective.

JTL