What should be done at the time of diabetes diagnosis to determine the type of diabetes?
It's important to determine which type of diabetes is present at the time a child or teenager is diagnosed with diabetes. In lean, pre-teen children, it's probably correct to assume that the young child has type 1 diabetes. However, in overweight teenagers, it may be hard to tell type 1 diabetes from type 2 diabetes.
Who is at greater risk for type 1 or type 2 diabetes?
Those more likely to have type 1 diabetes include younger children, Caucasian children, leaner children people with a short course of symptoms; and those who had diabetic ketoacidosis.
Those more likely to have type 2 diabetes include older children, heavy children, people of African American, Hispanic, Asian American, or Native American descent; people with a longer course of symptoms of diabetes, a family history of diabetes occurring at an older age; and people with high blood pressure, high lipid levels or acanthosis nigricans.
The diagnosis of type 1 versus type 2 is usually made on this clinical basis. However, for research studies, blood tests are often done to determine which kind of diabetes a child has. This is done because if a study is conducted on children with diabetes, the research team needs to know if there are any elements of double diabetes, which might distort the results of the study. The main blood tests taken by researchers are used to:
- Determine if the beta cell has been attacked by the immune system – the key feature of type 1 diabetes. This is done by measuring antibodies that act against the pancreatic beta cells as hallmarks of the autoimmune process.
- Determine how much insulin the person with diabetes is able to produce. A key feature of type 2 diabetes is that the body can still produce some insulin. Assessment of the amount of insulin a person can produce is done by measuring C-peptide levels in the blood.
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