Two months ago, my eight year old son was diagnosed with type 1 diabetes. He only had flu symptoms and dehydration from vomiting, and his blood sugar was 475 mg/dl [26.4 mmol/L]. He takes 3 units of NPH in the morning and 1/2 unit of NPH before bed. His counts are usually in the 50s to 140s mg/dl [2.8 to 7.8 mmol/L} with an occasional 240 mg/dl [13.3 mmol/L] after a ball game. Up to a year ago, he was overweight, but now he is on thin side. Could he have type 1B or type 2 diabetes? Do you feel a total of 3.5 units a day is a very small amount for a 63 pound child?

3.5 units total per day for a 63 lb child is not a lot, but your son likely does not have type�2 diabetes, and, on occasion, a child with type�1 is diagnosed “very early” due to a sporadically high glucose reading or during an unrelated illness that does not provide the classic symptoms of increased urination and thirst. They then go into an easy (and sometimes prolonged) honeymoon during which diabetes management is easier, insulin requirements drop way down, and the diagnosis is questioned. However, an illness with “flu symptoms and dehydration from vomiting” is a common presentation of uncontrolled diabetes with DKA [diabetic ketoacidosis]. Is this what you were told at the time of his diagnosis?

To help distinguish type 1 from type 2, a simple blood test can be requested to measure for special pancreatic antibodies. These are most often analyzed in specialty reference laboratories and are often abbreviated: GAD65, islet cell antibodies (ICA512), and Insulin autoantibody.”

DS