Teen just diagnosed with T1D- No Symtoms

My son (19 years) was just diagnosed with T1D. On a regular blood test, the Avgglu level came at 350 with A1C at 14!. Repeated tests- similar results with no sysmptoms whatsoever. Internist was truly baffled. Urine test showed glucose too with some ketone. Sent to ER. ER staff could not beleive that he showed up in ER with no symptoms. They decided not to administer insulin as they were not sure if it is Type 1 or Type 2 or some other type. Have an appointment with endocrinology group later this week at one of the country’s finest hospital, which happens to be in my neigborhood.
More than likely, they will start insulin once we see the doctor later this week as all his blood reports ordered in ER should be back.

Question: Has anyone of your experiences matches mine?

t1/t2 is very hard to diagnose based on these inputs. one fact is this, something is causing very high blood glucose and it has been happening for months.

IN that case of t1 - the body does not make enough insulin due to antibody attacks on the insulin cells. insulin is injected to cover the requirements and blood sugar is maintained (diet exercise insulin)

in the case of t2 your body cant make enough insulin, or cant use the insulin it is making or both. treatments include insulin injections, and drugs to boost insulin production and drugs that help the body make use of available insulin.

When changes arrive slowly, as in MODY or LADA, diagnosis is even more difficult, and symptoms are very slow over long periods, giving the body time to adjust to increasing blood sugars, dehydration, etc. If his a1c was 14 and was walking around with a bs of 350, he has symptoms but they may manifest in a way that is just “blah, tired, fatigue, flu-like, malaise, etc.” and not typical of T1 with no insulin and a bs of 1400 on the verge of DKA.

hang in there, make sure you get to that appointment. they will give him what he needs right now to maintain blood sugar and he’ll feel “better” in a few weeks. IN the case of LADA or MODY, they will likely start him on T2 meds, esp if they do a c-peptide test and see that he can make a little of his own insulin.

other tests are available that can identify the GAD65 antibodies, which would help identify T1 versus T2 over something else that could elevate his blood sugar including stress hormone production.

There is a new language you will need to learn I put some if it below

DKA - Diabetic ketoacidosis - high blood sugar with no insulin available makes you very sick and dehydrated, requires IV fluids
LADA - Latent autoimmune diabetes of adults (LADA), often also late-onset autoimmune diabetes of adulthood or aging,[1] slow onset type 1 diabetes or diabetes type 1.5
MODY- Maturity-onset diabetes of the young (MODY) is a group of monogenic disorders characterized by autosomal dominantly inherited non-insulin dependent form of diabetes classically presenting in adolescence or young adults before the age of 25 years.
c-peptide - A C-peptide test measures the level of this peptide in the blood. It is generally found in amounts equal to insulin because insulin and C-peptide are linked when first made by the pancreas. Very useful when trying to determine if he can make insulin and how much.
GAD65 - antibody amongst diabetic patients. Insulin autoantibodies GAD65 also serve as a marker of susceptibility to type 1 diabetes

good luck and please let us know how you are doing.

Not sure what you mean by no symptoms. Not even in hindsight? My 11 year old was diagnosed at a well child visit. His ped was suspicious of some weight loss and upon inquirying learning our son was getting up 2x per night to pee. We chalked the weight loss up she - and he was hardly underweight. No ketones. He was diagnosed in September 2015 and we are lucky that he is still honeymooning.

My 20-year old was diagnosed in November. What a shock! What a crash course we’ve had in T1D! Is there another group on here that is just for parents of college kids with T1D? I could use some input from that age group of parents regarding pump choices, etc. Thanks.


Joe, thank you for your insight! At 21 my son was just diagnosed 2 weeks ago and my daughter (age 19) bs is high 150-170. We have a doctors apt tmrw am to review the results of her blood draw today. There is soo much misinformation out there, even from our medical professionals. How did you learn? Its a bit overwhelming and I’m not sure I am going to the right sources for info