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July 8, 2010

Diagnosis and Symptoms, Research: Causes and Prevention

Question from Tucson, Arizona, USA:

Through a routine blood test, it appears that my son is developing type 1 diabetes, which my husband already has. We are in a very unusual situation in that my son is not sick yet, but has impaired blood glucose levels, high trigylcerides of 185 and low HDLs. We eat an extremely healthy, low fat diet at home. My son is thin and active. The only thing unusual, is that at 11, he is in well into puberty and has grown very quickly the last few months. Is there anything we can do, anywhere we can go, in order to stop the progression of the "pre-diabetes" into full blown diabetes? We will go and/or do whatever it takes to save his pancreas. We prefer not to go into a study where he might have to take a placebo. I would think that researchers would be very interested in our case because we are discovering the diabetes so early. We hate to just sit back and wait for his insulin producing cells to be destroyed. We are searching for answers.


You ask a difficult question since it involves personal, family and medical ethics. We do not yet have a safe and proven, as well as reliable, way to stopping type 1 diabetes although there are clearly major advances in our knowledge about such efforts. It is best for you to discuss this with your pediatric endocrinologist and perhaps also with your husband’s diabetologists. They can they answer your specific questions and point you to some researchers in the area, as well as in other parts of the USA and elsewhere around the world. The key problem is that the interventions are not proven, are not reliable and have some degree of risks in that they interfere with immune system functioning. How much cancer risk, how much infectious disease risks and how much unknown risk might you and your child be willing to consider – critical and sometimes unanswerable questions. Without going into a research study, whether or not with a placebo arm or not, cutting back on simple carbohydrates may help save a damaged pancreas; this has little risks except for hassles. Some might say to maximize antioxidants especially vitamin D levels (that means a simple blood test and perhaps trying to achieve vitamin D level around 50 ng/ml in some studies). Some might also include going gluten free as also a nonspecific benefit to the immune battle you have identified so early with positive antibodies but not yet abnormal glucose readings. Sorry to be so nonspecific and noncommittal, but I am not sure that such interventions are yet ready for anything but clinical research studies with high level informed consent documentation for all involved.