Diagnosis of Type I vs. Type II

[utahmomma]

My 15 year old son's doctor confirmed my son had diabetes yesterday.  I'm waiting for a consult with an endocrinologist however the pediatrician was confused about my son's diabetes and I am too.

Here's the issue.  HUGE family history of Type II diabetes.  My son is a tall (5'10"), slender (128lbs), athletic boy.  He has recently been having symptoms of dizziness and fatigue (which we chalked up to all-night video game playing), eats and drinks like a horse (he's grown 6" this year), no excessive urination, and is gaining weight (8lbs in 2 months).  He doesn't really fit the text-book profile of Type II (his age and he's so young and slender) or Type I (gaining 8lbs in 2 months).

How do doctors determine if a teenager has Type I or Type II diabetes?

As a side note, his blood sugar (checked on two different meters to ensure the readings weren't off) has bounced between 68 and 266 over the past few days.  Even though he's really limited carbs today he bounced up to 185 after water, salisbury steak, and an orange at school.  The doctor suggested this could be rapid onset of diabetes that we caught very early and his A1C today of 4.9 confirms that may be the case.

Thank you, I appreciate the advice. I can manage my diabetes fine and my son is taking all of this in stride along with the diet change and hourly glucose readings (the pediatrician asked him to log them for the endocrinologist) but we're confused if he's headed towards insulin or metformin.

[JDRF-Team-CDB]

Hi Utahmomma,
I'm a momma, too, not a doc, so let the docs call it-- you definitely need to see a good endocrinologist. That said, I have a type-1 daughter and a type-2 husband, and type-2 is rampant in his family, so I'm pretty familiar with both.

You're right that it makes no sense for him to have Type 2. I have heard of a couple of non-overweight people getting type 2 when there's a strong genetic history, but they don't usually get it until well into middle age. In general, you don't see it in skinny people like your son.

It does sound like type 1 that was caught very early, and he could have gained weight because he could be in the middle of a big growth spurt-- maybe he would have gained 15 pounds if it weren't for the blood-sugar issues. If it is type 1, he's headed for insulin.

If it is type-1, it's good news if it was caught very early. My daughter was caught fairly early, though her BG was 450 on diagnosis. She has been excellent about controlling it, and the result was that her honeymoon period went on for what seemed to be a record time. Catching it earlier means a better chance to keep the pancreas producing at least some insulin for a long time, which helps them feel good and stay in control without too much effort. It makes the transition to living with this disease much less stressful.

Good luck, and let us know what happens.