Our now 27 month old son was diagnosed a year ago at 15 months of age with type 1. What tests are performed to determine that he was actually type 1? Can a child that young be type 2? Our doctors seem to not answer our questions.

He has been honeymooning for almost that whole year, and we have many unexplained moments (severe lows, strong reactions even a quarter unit of Humalog, lows during the night without any insulin given since 8 am, etc.). His sugar was 465 mg/dl [25.8 mmol/L] when brought in, and he was misdiagnosed for two weeks prior. He was in intensive care for three days and spent two more days in the pediatric unit.

Until quite recently, any child who developed diabetes in an acute insulin dependent form was diagnosed as type 1. Recently, however, this category has been divided. type 1A, or (autoimmune) diabetes is characterised by a positive antibody test and requires insulin supplementation, in some form or another, life. Whereas, in type 1B, the antibody test is negative. The underlying pathology is not yet worked out, although some are linked to chromosomal changes. Of more practical importance, about half of this group can be managed without insulin after a few months, although they may still need oral agentsType 2 diabetes.

Extreme sensitivity to Humalog and a prolonged honeymoon period are not all that unusual in your son’s age group, but I think you should talk to his doctor about the possibility of type 1B, particularly because of his proneness to hypoglycemia.

DOB