Type 1 MODY or LADA

Hi,
I have recently been diagnosed as a diabetic but they are not sure which type I've got. Four month ago I had to stay at hospital for a night with a blood Glucose level (BGL) of 27.5 mmol/L. Before that, I had been taken two Metformin per day with a fast blood sugar of 6 or less for around one year. I have been measuring the BGL for four months and the levels are between 5-7 mmol/L in the morning and 6-7 mmo/L before going to bed. Postprandial (after breakfast and lunch) levels are 6-7.5 mol/L. My last blood analysis showed a C-peptid level of 0.68 nmol/L (while it was 0.64 when staying at hospital) and HbA1C level of 40 mmol/mc (48 at hospital). I am a little confused why I am Type 1 while I don't take any insulin? I take 3 Metformin (500) plus 1 Sitagliptin (100). Any one knows how they decide which type a patient is?

catapillar said:

If they have any sense they will do a GAD test to see if you have antibodies associated with type 1, which is an autoimmune disease.

At the same time they will consider:-

• How old are you?
• What's your BMI?
• How did you present when you were diagnosed with diabetes? Did you have high blood sugar (>30) did you have ketones? Had you had dramatic untried for weight loss pre diagnosis?

Reference range for c-peptide is 0.26-1.03 nmol/L, so you are producing plenty of your own insulin.

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I am 37 years old with BMI of 29.7 (30.9 when diagnosed) 177 cm height and 93 kilogram.
Yes, they did GAD and it was 162 but the BGL was never above 30. It was more than 20 just for 1-2 days and then it reduced to around 12 with taking the above mentioned pills plus one Repaglinide and more reduced to below 7 with three Repaglinide. Then my doctor removed Repiglinide one by one have a stable levels below 8.
I was diagnosed when my wife smelled acetone in my breath so I had ketones when diagnosed.
I lost weight quickly in 4 kilos in a month.
However, the thing is my pancreas is producing insulin (as you said), that's why I wonder be a Type 2 instead Type 1.

Good point to know!!

MGhM said:

Good point to know!!

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catapillar said:

If you had a positive GAD test, that strongly suggests type 1.

Type 1 is an autoimmune disease. Your immune system is killing off your insulin producing beta cells. That wipe out doesn't happen in one fell swoop - it can take quite a significant period, particularly in an adult.

The period when a newly diagnosed type 1 diabetic is producing their own insulin is known as the honeymoon period. Sounds like you are having a nicely robust honeymoon period. But do continue to keep a close eye on blood sugar so you are aware of whether there are any spikes and indications to consider commencing insulin.

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maybe interesting!

We should therefore pause to consider the significance of a ‘positive’ test for GAD antibodies. This does not, to begin with, mean that these antibodies are either present or absent. They are in fact continuously distributed through the healthy population, and one might as well talk of positivity for plasma glucose or blood pressure. Since ‘positivity’ refers to a selected cut-off point, it is important to appreciate how this is defined.
http://link.springer.com/article/10.1007/s00125-005-1954-5