September 24, 2008
Diagnosis and Symptoms, LADA and MODY
Question from Pennsylvania, USA:
I was diagnosed with diabetes when I was 14 years old. I had none of the typical signs or symptoms. My endocrinologist could not tell me what type I had, so he just told me I had type 2. I weighed only 98 pounds! Even he didn’t believe it. I was put on pills for type 2 about a month after I was diagnosed. My doses were always changing, nothing ever worked. About a year and a half, or so, after I was diagnosed I was told I had MODY. They never tested me for it. I was put on insulin a little more than two years after diagnosis, just Lantus. They started me on three units. Right now, I’m 17 years old and was put on Humalog about a month ago after going up to 485 mg/dl [26.9 mmol/L]. I now take about 35 units of insulin daily, including 18 units of Lantus. I was tested for MODY about a month ago also, but haven’t gotten the results back yet. Also, my last A1c was 8.2 which is my highest ever. My C-Peptide came back at 3.1, which baffles me a little bit. I’m even looking at pumps! My friend has MODY and she was on four or five units daily, but she had to stop insulin because she was having lows. I am on a lot more than four units! So, does this sound like MODY or could it be type 1 with a really long honeymoon? I have had diabetes for almost three years and still have no definite answer and it is really starting to bug me. So, what do you think?
Answer:
It is pretty rare to have type 1 diabetes with such a long honeymoon, but not impossible. With a positive C-Peptide, certainly you are making some insulin. There are specific genetic tests that can be done to see if you have one of several types of MODY. Also, it would be important to know if anybody ever checked you for pancreatic antibodies since, if positive, this would suggest autoimmune type 1 diabetes and not type 2 or some other variant. It is best to go back to your diabetes team and ask these questions since they would have much more specific information about you and could answer this without so much generalization.
SB
