At the end of the day, the moniker you stick on your diabetes doesn’t really matter. Either you need (or probably should be on) exogenous insulin (IDDM), or your body is producing sufficient insulin for your needs, if you maintain proper diet and exercise (NIDDM). To some extent, any part of a treatment that works in IDDM to increase beta cell mass will help NIDDM patients, and, in theory (though it would probably be a piss-poor idea in practice) lowering insulin resistance in IDDM patients would be good as well, so that insulin dosages can be lowered. NIDDM can progress, for a number of reasons, to IDDM, though the reverse doesn’t seem to be the case.
The distinct separation into T1 and T2, classified based solely on antibodies, is a relatively meaningless distinction. As a very slowly progressing LADA/IDDM patient, I still have to worry about putting on weight and becoming insulin resistant; in fact, I postulate that my original dx was probably insulin resistance and stress, rather than solely autoimmune factors, based on duration of honeymoon. I’m almost a year into this ride, and if I go beyond 6-7 units of Lantus, I’ll get morning highs in the 140s that I absolutely can’t break and run higher sugars all day, as if though I’m dropping low and rebounding hard. My dx went from T1, to probable T2, to LADA/wtf? - and it hasn’t affected my treatment plan in the slightest.
The only time that there’s any reason to distinguish based on pancreatic function rather than on treatment is at diagnosis, since putting a T1 on oral meds won’t help, and, in the long run, can kill the honeymoon period but good and have long term deleterious effects.
The antibody/lack thereof distinction is important for research purposes, but for the “end user,” does it really matter? I’m still going to take those 5-6 units of Lantus either way. I’m still low carbing.
I guess my ultimate point is: treat the patient, not the disease. My lab numbers would indicate that my pancreas should be producing slightly less insulin than the sole of my shoe. A year later, it’s still sorta chugging along.
I also believe there have been some recent studies that show some other cross-over, but I may be misremembering.