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November 6, 2002

Daily Care, Diagnosis and Symptoms

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Question from Short Hills, New Jersey, USA:

About a year ago, at the age of 63, I was diagnosed with type 1 diabetes. My blood sugar was 526 mg/dl [29.2 mmol/L], my C-peptide level was 1.1, I responded favorably response to mixed insulin therapy, and for the last six months, my A1c has stayed around 7.7 to 7.8%.

I had been obese since the fourth grade, going up and down like a yo-yo, until the last 25 or more years, during which time there has been a gradual weight increase. Prior to my diabetes diagnosis, I began losing weight rapidly along with having the classic symptoms of frequent urination, excessive thirst, and blurred vision. I don’t know how high my weight was up to, but it is now down to about 150 pounds. It’s more than likely I’ve lost 100 pounds due to ketosis initially, and the lifestyle changes resultant from my diabetes diagnosis. I also have a family history of type 2 diabetes.

During my last appointment, my doctor said he thought I might actually have type 1.5 or MODY and plans to repeat the C-peptide test at my next appointment in three months. This is in response to my questioning that my pancreas may sometimes be producing insulin, due to the strange low sugar episodes I’ve experienced.

Before discovering this website, I was looking up type 1.5 and MODY on the Internet and found that both appear to be associated with lean adults. Everyone who knows anything about diabetes, and who hears my story, comments how on unusual it is for me to be diagnosed with insulin-dependent diabetes at my age. With my weight and family history, type 2 was more likely for me. What are your comments on my case? What type of diabetes do I have?

Answer:

From: DTeam Staff

It sounds to me like you have type 2 diabetes. The fairly low C-peptide level may have improved once your initial high blood sugar was treated. It would be very uncommon to have Late-onset Autoimmune Diabetes of Adulthood (LADA) at age 63, so your skepticism is warranted.

That being said, you still have to work with your physician regarding the appropriate medication for you to be taking. If you do not have type 1 diabetes, it does allow the possibility of using oral hypoglycemic agents.

JTL