We would be very grateful if you could help us regarding the problem my daughter is having. We had her first lab test done when her body weight dropped 4kgs. We had her do three lab tests from which the local pediatrician confirmed that she had diabetes.

Judging from third lab test it says that endocrinology test re: c-peptide shows a result of <0.5 during fasting and according to local pediatrician with result of <0.5 they cannot detect the pancreas accurately. The minimum requirement for accurate detection should be above 0.5 to enable them detect if the pancreas is functioning or not! The report shows: c islet cell autoantibodies (cf-ica), ifa: complement-fixing islet cell autoantibodies (cf-ica) are useful markers for the prediction of insulin-dependent diabetes. These autoantibodies correlate with active insulinitis in individuals susceptible to insulin-dependent diabetes mellitus and are often present before the stage of insulin dependence and even before glucose intolerance. After the third test doctor said to undergo daily insulin every morning 15 units and every night 8 units, both the times before meals. She had her fourth lab test done a month after having undergone the insulin treatment. The 4th test result shows as follows: Amylase 66.00 u/l (normal 25-125) Lipase 39.00 u/l (normal <190) Glucose fasting 137 mg/dl (normal 65-110) Glucose 2 hours after meal 206 mg/dl A month before this problem occurred this child had an early menstruation warning. Do you think due to the above early menstruation the child's hormone underwent changes, which could have caused damage of the pancreas? According to a local pediatrician, this child has been attacked by some kind of virus which looks similar or have characteristic shapes which is similar to pancreas which produces insulin. Therefore, the autoantibody of this child attacked the pancreas due to the said virus? Is there any kind of medication/method which can activate this child's pancreas again without having to undergo daily insulin?

I am assuming that the diagnosis of diabetes is correct and based on finding several fasting blood sugar levels that were above normal together with the presence of glucose and perhaps ketone bodies in the urine. I was not clear however as to whether she had actually the test for antibodies that you described or not. If it is possible to have this test done I would suggest that you arrange it because it will tell you whether or not your daughter has what is called Type 1A diabetes. This is the commonest form of diabetes in childhood and is due to a disorder of the immune system that destroys the insulin producing capacity of the islet cells in the pancreas over a period of a number of years. If the test is positive then your daughter needs to be treated with insulin, at least for the time being.

It may turn out however that your daughter will have negative antibody test. And in this case too there is a good chance that despite the initial insulin requiring stage of the disorder that she will be able to control her blood sugar without insulin in the months to come. This type of diabetes is called Type 1B and there are some other rare possibilities.

The other laboratory tests (e.g. the amylase and lipase levels) are not relevant to the diagnosis. The C-peptide levels appear to be very low; but since you don’t give the units it is not possible to be quite sure.

It is very unlikely that a virus infection or the onset of menstruation actually caused the diabetes although it is possible that the stress of either event might have precipitated the final need for insulin in an already extensively damaged pancreas.

Although there is some possibility that your daughter may be able to control her diabetes without insulin in a few months time, I would counsel you against using any Ayurvedic, herbal or alternative medicine remedies at this time. They may have placebo value for the family; but are otherwise inappropriate for any form of Type 1 Diabetes.

Finally, you may be greatly helped if you use the Internet to download (without charge) a book by Peter Chase called Understanding Insulin-Dependent Diabetes

I hope this gives you some help; but you and your daughter would benefit from going to an experienced child diabetes team that has not only a physician but a nurse educator and a nutritionist available; I realise though that this may not be available to you.

DOB