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Anthony Osula
Anthony Osula, Doctor
Category: Endocrinology
Satisfied Customers: 1306
Experience:  MB ChB DRCOG
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My eldest daughter was diagnosed as type 1 diabetic a year

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Hi, my eldest daughter was diagnosed as type 1 diabetic a year ago when she was 12 years old. I have been puzzled by 2 things over the last year that I'm not getting questions on from our medical team. They may be connected, I don't know. The first is that even though i suspect she was diabetic for months before diagnosis, & that her blood sugar levels were very high & difficult to get down, she was gaining weight. I don't understand why as usually a sign of type 1 is weight loss. secondly, even when her blood sugar levels are very high, her ketones never go high. Again, I don't understand. We're a year in, her blood sugar levels are generally in a better range (7-17), but that's still high & yet she is still struggling with weight gain & her ketones are always fine. I welcome your answers, thanks.

Hi, thanks for your query

There is a 3rd category of diabetes most Drs actually forget exist This is like mixed diabetes, where you can have both type 1 and 2 diabetes existing together. Hence, you might find wieght gain in some type 1 diabetics and some would respond to oral medication and insulin, whereas strictly type 1 would only respod to insulin.

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Customer: replied 1 year ago.
thanks Anthony. it did take them longer than they thought to diagnose her. initially they thought she was type 2 (although she isn't that big & actually eats a healthy diet), but the oral medicine wasn't making a difference, so they tried her on insulin, which seemed to be more effective in bringing her levels under control. do you have any suggestions on what we should be doing? also is there a name for this 3rd category? thanks.

There's no name as such as not officially diagnosed,

How was she diagnosed as type 1?

Customer: replied 1 year ago.
I think it was a process of elimination. Very high blood sugar levels & the medication for type 2 (metformin) not making a difference.
Customer: replied 1 year ago.
We tried metformin prob for 4 weeks, then they said it’s probably type 1 & switched her to insulin.

so no ketones found in her urine?

Customer: replied 1 year ago.
No, she does daily ketone tests & they’re always fine, even when her blood sugar levels are high.

so they have not actually proved she's type 1 which points more to a mixed picture

But due to her age, you'll expect her to be more type 1 than type 2 as you tend to get this in children, while type 2 more in adults

Customer: replied 1 year ago.
Exactly. And whilst she is overweight, its not excessive.
Customer: replied 1 year ago.
I’ve raised these questions with her medical team, but have not gotten any answers. Do you think I need to escalate? At the moment she is only being treated for type 1.

This puts her at risk of metabolic syndrome in the future which include high blood pressure, and cholesterol.

She's the type that needs to be seen by a professor who specialises in children with diabetes, maybe even privately

Customer: replied 1 year ago.
Ok. She is under the supervision of the paediatric consultant, but I have private healthcare & am happy to use it, within C-19 constraints. Do you think they could do a remote consultation?

Yes they can do remote or face to face, but if you have private then use it, as the care would be much better

Customer: replied 1 year ago.
Ok, thanks for your help Anthony.

no worries