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August 18, 2003

Daily Care, Diagnosis and Symptoms

Question from Panama, Republic of Panama:

Recently, my two year old daughter had an A1c of 7.5%, postprandial glucose levels of around 180 mg/dl [10 mmol/L], and negative antibodies. Our doctor in Panama believes she has Maturity Onset Diabetes of the Young (MODY) because the mother, maternal grandfather and three aunts all have type 2 diabetes. Can such a small child be placed in oral agents? If she does not have not type 1 diabetes, how can her sugars levels be controlled (given that she does not need insulin)?

Answer:

If your child is significantly overweight/obese, then it is a possibility that, even at her young age, this is early type 2 diabetes. Otherwise, it is likely that she will need insulin treatment. Many, if not most younger children, do not show positive antibodies and so the antibody tests, if positive, confirm classical type 1A (autoimmune) diabetes. If the tests are negative, they do not help classification at all, and one must always go by blood glucose readings for insulin requirements.

SB