We are Americans living in Italy. Our Italian is not good enough to understand everything the doctor tells us. However, yesterday an endocrinologist told us our son’s pancreas is still functioning 50%. He was diagnosed October 20, 2004 with a blood sugar of 619 mg/dl [34.4 mmol/L] and an A1c was 10.7. As of December 6, his A1c was 7.3. His C-peptide measured 0.50 ng/ml with his “insulinemia minore di 2.0 mcU/ml”(I don’t know what this is in English.) Did we understand this information correctly based on his information upon diagnosis?

I don’t think it is really possible to assess residual endogenous insulin production from only one basal parameter with the C-peptide even as low as 0.5 mg/ml. Much more indicative would be the stimulated C-peptide test. Moreover, it’s also quite difficult to quantify precisely how much of insulin is still produced from that given pancreas, e.g. 50% of the normal secretion. I think that my colleague might have tried to let you understand, in simple words, that your son is still producing some insulin as part of his honeymoon period, but not more than this. Remember that this “happy” period is not permanent and, in children, it usually lasts no longer than few months.

“Insulinemia minore di 2.0 mcU/ml” means insulin level lower than 2.0 mcU/ml and it parallels the low C-peptide level, which is common in type 1 diabetes.

MS