August 29, 2000
Diagnosis and Symptoms
Question from Beijing, China:
Our child had the following tests at the Beijing Children’s Hospital: Test / Results CT test – C-P: < 0.2, Insulin test - 4.0, Anti DNA antibody - negative, IF-ANA antibody - negative. Our child stayed in Europe in summer and was brought to the China hospital with diabetes ketoacidosis, but quite quickly was feeling well for a week (HbA1c - 9%). Then, he got a flu and, unfortunately, doctors could not adjust the insulin needed. When we asked if he is type 1 or 2 doctors said that he should be type 1 (like all kids) and ketoacidosis never developed in child type 2 diabetes and hence no other tests are necessary. Would you, please, tell us what tests are done in USA for the exact determination of diabetes type (1 or 2) and what is the difference of Type 1A (is it only in Asian kids or any foreign child changing climate from Europe to Asia with a family strong history of diabetes type 2) can develop this disease?
Answer:
Let me say that none of the tests you have had done will tell the difference between Type�1A (autoimmune) diabetes and other forms of diabetes in childhood. The tests routinely used in the U.S. are for antiinsulin antibodies, anti glutamic acid decarboxylase antibodies and a less specific test for anti islet cell antibodies. Both Type 1a, which is the most common form of diabetes in childhood and Type�1B often present with an acute need for insulin. In Type 1A the antibody tests are positive and in Type 1B and Type 2 they are negative. In Type 2 diabetes, which is rare at this age, the serum insulin levels are higher than in Type 1B; but an exact distinction requires more elaborate testing.
In any case, the treatment is the same irrespective of the specific variety of the diabetes.
I have not seen population figures for Type 1B in Asian children.
DOB
