If you have the antibodies it’s a sign of type 1. The antibodies destroy the cells that make insulin. There really is no official type 1.5 or official description of what that really means. There are a few variations of diabetes/subsets out there. One is MODY except that she has antibodies.
I’m pretty sure an A1c of 6.5 would not be a fluke either. A1c is an average of blood sugars over 3 months. A “normal” person would not have blood sugars raised over a 3 month period even if sitting around as insulin works properly to lower any blood sugar levels except in a diabetic or a brief time period, maybe because you are sick or some medications.
Type 2 is much more genetically inherited than a type 1, but type 1 is inherited too. Although some people don’t seem to have a relative that has it, a gene or genes inherited is where it almost always starts. (exceptions like pancreas trauma). They are working on identifying those genes now. 40% of type 1’s are misdiagnosed as a type 2 at first. My next question would also be on your husbands side is anyone on insulin? Being put on insulin within 3 years is a sign of type 1. I was misdiagnosed for over 8 years, mostly managed because I was put on insulin because medications made me sick. If people on you husbands side required insulin fairly early, within a few years, they could actually be misdiagnosed type 1’s and never tested. It turns out a lot of us are finally tested and diagnosed right when we switch doctors. As a type 1 you require insulin. But a type 1 can also end up being insulin resistant like a type 2.
A type 1 can be misdiagnosed for a long time because a type 1/LADA can make some insulin for quite a while before all the cells are destroyed, 8 years plus sometimes. As a younger person this usually occurs pretty fast. Weeks in children and it is more unusual to have slow onset as a young adult, but it does happen. One thing you learn fast is we can all be different in our responses.
But antibodies present mean that her cells are being destroyed and she will have full blown type 1 at some point. The prevailing theory is a type 1 inherits a gene that makes you susceptible to type 1 and at some point you are exposed to an unidentified virus that makes the process happen. Covid seems to be causing more cases right now.
Medications and lifestyle changes work at first because you still make insulin…that starts to change as you make less and less until you make none. There is no stopping it yet, but there has been rumors that early insulin helps your pancreas last longer or that some medications might do the same thing. That all will stop at some point. And no one can tell you whether it will be weeks, months or years.
Type 1 is a pain, but we have lots of technology nowadays to help and things are so much better and improving every year.
You will want a cgm for her, maybe not quite yet. But it will be one of the most powerful tools. It allows you to see your blood sugar levels 24/7 without testing constantly, you will still have to do some testing to verify levels, but it is a true blessing.
I’m sure some other people will come along with more input as some of us traveled this path in different ways. I got mine at 46 and a lot developed it when they were younger. 50% are diagnosed over the age of 30, which means 50% under the age of 30.