I was never officially diagnosed with 1.5, but I did spend a stretch being called a T2 (before my antibody testing came back wildly positive)… honestly insulin is WAY easier to manage than oral meds. Your failing pancreas will continue to do just that - FAIL. You may have some success at first, but it usually doesn’t last long… plus with Oral meds you must rely on your doctor to make appropriate changes in dosage to manage your BG. On insulin, YOU have that control… and the ability to make any changes on the fly. If you need less, you take less, if you need more, you take more. You don’t have that flexibility on oral meds.
I honestly feel that insulin helps preserve what beta cell function you do have, because your pancreas is only needed to take up the slack, it’s NOT trying to provide a full physiologic level of insulin for your body. Oral meds might make your pancreas do that for a while well enough for a while, but if you do have T1 it won’t last… why stress it further? Wouldn’t you want it to keep working in the background as long as possible?
I went several months between a pregnancy where I was on insulin, to to seeing a doctor who allowed me to insulin and gave me scripts for Humalog and Lantus (I started on Lantus about one month after it hit the market here in the US)… during a majority of the time inbetween I was self-medicating myself with R and N. I know I would have ended up in DKA if I hadn’t been. My antibody tests came back wildly positive maybe a month or so after I started seeing a doctor that knew what they were doing.
It was a full 18 months from the time I was initially diagnosed during my first pregnancy to when I was certain I was “done” honeymooning. I think a large part of why my honeymoon lasted so long as because I was on insulin… if I’d been on oral meds, and relying only on that while I was able, I think my pancreas could have burned out much sooner. I went from rarely having numbers much above 200 to suddenly seeing 400’s if any little thing went wrong. It happened relatively quick… it’s like I had a safety net if I snacked more than I thought, or miscalculated a bolus, or had a bad infusion site, and then it was just gone. A high for me during my honeymoon was pretty much anything over 150… after, well, lets just say the meter has greeted me with a “HI” more than once and not always because I did something completely stupid. Most are in the 300’s… even with a CGM sometimes it happens faster than I can do anything about it.
My thoughts are… it will take no more than 48-72 hours to know if you really “need” insulin if you did stop taking it. In my case, back when I was being told to take oral meds, my BG would not skyrocket immediately, but I’d work all day to do things to bring it down, and it would fluctuate some, but overall would just steadily climb… it would take a few days to really get out of control to where I was spilling ketones. At first I was only correcting highs over 300 (or any time I had ketones) with R, despite my doctor telling me NOT to. After a while I started taking some N again to help prevent the gradual rise… I was a new mom, and I felt completely lousy at 300, so in my mind it was necessary, even though my doctor at the time kept telling me to “give the oral meds a chance to work” and completely dismissing the fact that I often had ketones. It was not long after that when I switched doctors to one who wasn’t trying to kill me (I lost 35-40lbs in that time, and that was ON TOP of the baby weight I lost from my pregnancy). I was only taking tiny doses of insulin at that point… 2-3u was enough to bring me down from a 300. Over time I needed more, and I plateaued at a TDD of 18-20u for a very long time.
That said, I really do think your Doctor is doing the right thing… it is confusing and I know it’s frustrating to feel stick in the middle while they try to figure out what’s going on, but in the meantime the only thing that really matters is glucose control… it’s really your choice on how to do that at this point, as long as what you choose is working for you. That holds true for now, as well as in the future… there are a lot of T1’s who use insulin and certain oral meds (like metformin) and there are T2’s who could probably do okay on just oral meds, who also take insulin too - it’s not a right/wrong scenario, it’s very much a “what works for you” kind of thing… if it’s working, don’t change it, if it’s not, then look into other options