Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
September 13, 2001
Diagnosis and Symptoms
Question from New York, New York, USA:
I have always been skinny, I was diagnosed with polycystic ovaries at age 19 (on the basis of my hormone levels), and, when I was 23, I was diagnosed with diabetes (with all the typically symptoms -- excessive thirst, urination, significant weight loss and a blood sugar over 600 mg/dl [33.3 mmol/L], which was originally treated with oral medication. However, this did not lower my blood sugar so, after meeting with an endocrinologist, I went on insulin shortly thereafter. For the last five years, I have never had to take more than 16 units of insulin per day and my hemoglobin A1cs are around 5-6%. Recent visits to new endocrinologist made me concerned that perhaps I do not have type 1 diabetes and do not need to be on insulin. He did a C-peptide test which was 1.5, but I had already taken my insulin the morning of the test. Does the test detect the injected insulin? I did test positive for the GAD antibody. Do you think it is possible that I could go on an oral medication? Can you please explain the relationships between PCOS and diabetes? I have heard many conflicting explanations.
C-peptide does not directly measure insulin. C-peptide is a peptide which is cleaved when insulin is secreted from the beta cells. Injected insulin may decrease C-peptide levels, however. It is best to measure C-peptide in response to a glucose challenge or when the blood sugar is greater than 200 mg/dl [11.1mmol/L]. The level of 1.5 is not high. However, it is unclear whether the result can be relied on.
The positive anti-GAD antibody is a significant finding and consistent with type 1 diabetes. Your case sounds like you have type 1 diabetes. However, individuals with type 1 diabetes may have some resumption of insulin secretion after blood sugars are brought down into the near-normal range. I would not try to get to oral agents and sacrifice good control.
Polycystic Ovary Syndrome is a clinical syndrome and is not a specific diagnosis. However, it is associated with insulin resistance and type 2 diabetes.