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Question:

From Phoenix, Arizona, USA:

I am 35, 5 feet, 3 inches, 100 pounds and recently found out that I am insulin resistant. In January, I had sugar show up twice in urine dipsticks but not on the urine culture or during a normal fasting glucose test. However, a friend who is a physician pushed me to have an oral glucose tolerance test (OGTT).

My fasting insulin and glucose levels were normal, however, the GTT showed an insulin value of 81 and a glucose level of 157 mg/dl [8.7 mmol/L] at two hours. Honestly, I've had the worst diet with high carbohydrates and three or four Cokes per day for years and didn't really exercise. My A1c came back normal at 4.6 and the two family physicians told me to change my diet and exercise. They are going to monitor my level in one month.

In the meantime, I've been reading about type 1.5 and the anti-GAD antibody test. The doctors didn't run it because they said I fell under type 2 and insulin resistance. Should I have an anti-GAD test run? Can type 1.5 mask like this since I am thin? Or, does type 1.5 always show up as true diabetes first? I have been thinking of having a child in the next year, but I want to know what type of situation I am dealing with before I stress my body any further! No one in my family has type 1. An uncle has type 2 and is overweight. If I do happen to have type 1.5, would it be worth it to try and get the injection of the experimental drug C3 which can slow beta cell destruction?

Answer:

At this point, it appears that it is more in the insulin resistance category. If things do not improve, and especially if they progress, you can get it later. Even if it was positive, with a normal A1c, it does not sound like the time to start insulin therapy. I do not think you need to panic at this point. A month or so more of monitoring will help determine if things improve or not. You do not have diabetes. The specific diagnosis is impaired glucose tolerance. Because you are not overweight, I think it is reasonable to think about autoimmune destruction. However, your insulin levels are not low.

JTL

DTQ-20050702023925
Original posting 2 Aug 2005
Posted to Diagnosis and Symptoms and Type 2

  
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Last Updated: Tuesday April 06, 2010 15:10:04
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