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July 8, 1999

Diagnosis and Symptoms

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Question from Rock Hill, South Carolina, USA:

We recently admitted a nine year old new onset diabetic to our facility. Her admitting blood sugar was 323. The physician ordered an antipancreatic Islet Cell blood test which came back negative and also a serum insulin level which came back 48 (high). Please explain the significance of these tests. Any insight you can provide will be much appreciated.

Answer:

The absence of islet cell antibodies does not preclude Type 1 diabetes. You haven’t stated the measurement units of the insulin level but in any case this was probably not a fasting level and was not therefore high in relation to the prevailing blood sugar. Diabetes appears when there is a relative deficiency of insulin which does not have to be absolute.

KJR