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Question:

From Traverse City, Michigan, USA:

I was diagnosed as a Type 1 diabetic 7 years ago at age 24. At the time of diagnosis I had a C-peptide test and islet-antibody test performed. The C-peptide came back normal and the anti-islet test came back negative (no islet antibodies). I had the tests repeated again 3 years later and finally last month. The results from Mayo clinic are identical. C-peptide in the normal range and negative on the islet antibodies test. My question is what am I? Type 1 or Type 2 or MODY? I have gone to 3 different endocrinologists and received 3 different answers. Currently I am 31, 6 foot 2 inches, and 200 pounds. My A1c are always in the non-diabetic range. I am currently on 15U of lispro and 15U Ultralente taken twice daily, caloric intake is approximately 3500 calories per day. No history of diabetes on either side of the family.

Answer:

From the story you give you seem to be an insulin dependant antibody negative diabetic. Nowadays you might be termed a Type 1B diabetic as opposed to the Type 1A which have antibodies. This is a group which is common in Hispanic and African American groups; but occurs, albeit much less frequently, in Caucasian families. The fact that you are still needing significant amounts of insulin five years after diagnosis does not exclude this diagnosis; but does make it less probable. Without other clinical features like deafness and a history involving the maternal line, mitochondrial diabetes is unlikely. Finally you could be a MODY3 who may require continuing insulin like a Type 1A.

Unless it irritates you very much, I would concentrate on maintaining the best possible control and try to live without a specific answer. So far you cant get this for Type 1B and it will be a frustrating organising it for MODY3. there are also some very small print indeed possibilities like genetic defects of beta cell function or nutritional damage to the islet cells.

I rather hope that in a few years time there will be a central laboratory that will set up many of these complex diagnostic procedures.

DO'B

Original posting 17 Mar 1998
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:08:56
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