Our son was diagnosed with type 1 after a routine pre-dental operation physical on December 2, 2003. He had absolutely no symptoms to speak of. We went on 2 shots of insulin a day and 4 glucose checks per day. After about 10 days his insulin was at “7 cloudy” only in the morning. We finally got the dental work done on December 23, and were told to not give the insulin because he would be fasting but to check over the next day to see where his levels were. Well, he has not had insulin since the morning on December 22, and his levels are within “normal range” anywhere from 75-140 mg/dl [4.2-7.8 mmol/L] he has gone as high as 170s [9.4 mmol/L] after a bedtime snack (but so did his father and I for comparison) but shows no signs of any problems. He also has congenital hypothyroidism, and when he had his blood tests, they also determined his thyroid levels were off and increased his dosage of Synthroid to.88. During that time is when his glucose levels became normal, and have since stayed that way. Could this be the miracle we asked for, and could the thyroid have caused the what we hope is a misdiagnosis? We are still checking his blood 4-5 times a day, and he seems to be doing great. Even now knowing what a “low” feels like to tell us, since he had no idea he was “sick” before this diagnosis in early December. Are there any tests or studies to look into?

I imagine that your son was diagnosed as having Type 1 Diabetes on the basis of an abnormal fasting blood sugar at a routine physical. If indeed he does have diabetes the most probable form is Type IA or Autoimmune Diabetes and that this was detected at the very end of the preclinical phase. After a short period on insulin he has become able to make enough on his own to have become insulin independent again. This story could fit either with the ‘honeymoon’ period after the onset of clinical diabetes or with a temporary restoration of islet cell function in someone who was still in the preclinical phase. The way to solve this is to ask the doctor about getting an antibody test. You need to make sure that this will look at the three standard antibodies, namely anti-insulin, anti GAD and anti ICA512 and that the laboratory reports the results as a definite +ve (>3SD above their mean) or as -ve. If these tests are all negative then it is possible that the high blood glucose was an indication of a very early stage in Type IB or Idiopathic Diabetes which occurs in >5% of Caucasian families; but in >50% of African American and Hispanic families. In about half the cases of this poorly understood entity there is an initial remission of the need for insulin; but these children do have evidence of underlying insulin insufficiency so that the need for exogenous insulin is likely to recur. There are some other possibilities like Type 2 Diabetes and other forms of insulin resistance and even of the very rare mitochondrial diabetes.

I am sorry not to favour the chance of a ‘miracle’; but there is always the small possibility that the diagnosis was based on a laboratory error.

DOB