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Question:

From Mumbai, India:

I'm 18 years old and recently diagnosed with diabetes after ketoacidosis. According to laboratory reports, my GAD, ANA, and microsomal antibodies test were negative initially. After taking insulin and oral medication for about a month, I was told to stop taking insulin, to take the medication only. My C-Peptide is improving (current level-1.95; earlier-0.28 normal being 1.0-4.0). Do I have type 2 or type 1 or 1.5, considering that I have a family history of type 2?

Answer:

The diagnosis of type 1 versus type 2 diabetes is largely a clinical diagnosis. You can rely somewhat on generalizations about your presentation. For instance, type 1 diabetes is favored by an onset with diabetic ketoacidosis, a low C-peptide, a positive anti-GAD antibody, lack of obesity, and a lack of family history in each generation of your family. However, a positive anti-GAD titer or low C-peptide is not absolutely required for type 1 diabetes. Some patients still have residual insulin secretion after blood sugars improve with insulin. A positive anti-GAD helps, but a negative result does not rule out type 1 diabetes.

I am not sure what type of diabetes you have. Your doctor may not be able to tell clearly. At 18, if you are not obese, I would still be concerned you may have type 1 diabetes. Time will tell. If you have type 1 diabetes, you should not continue to respond favorably to the oral medications. The important thing is to keep close follow-up with your doctor.

JTL

DTQ-20070622041231
Original posting 30 Jun 2007
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:10:12
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