I shadowed an endocrinologist this morning. He's actually a diabetes specialist. He's AMAZING!!!
We spoke about my own history with diabetes for a couple of minutes. (I don't remember how it came up.) Even though he sees adults, the first thing he asked me was if I'd been tested for GAD65. I told him I was, and also ICA, but it was two years ago and my blood sugar has become much harder to manage since then. He immediately said that I should be tested again. (And then I brought up the zinc transporter antibody, and I was shocked that he'd heard of it and insisted that I get tested for that one, too.) Though I had already intended to get re-tested, I was very happy to hear that someone else thought I should, too.
Later, we were talking about a patient of his who presented with ketoacidosis but no antibodies and a normal-ish c-peptide. He said she's skinny and she her blood pressure, triglycerides, and cholesterol are all normal. He said he's sure she really has T1. I said (and he HAPPILY agreed with me) that the initial tests could be wrong, or the labs don't detect antibody levels low enough, or that her islet cells are more sensitive to autoimmune attack than the average person, so lower antibody levels could make a larger difference. He AGREED! (Have I mentioned I liked him?)
Anyway, if anyone in the tri-state area ends up as an inpatient, if you have a choice, I'd go to Hackensack University Medical Center in NJ. He specifically takes care of inpatients with T1 and T2 diabetes--that's his only job. All of the patients he saw were in for other reasons, but he was specifically overseeing their diabetes care.
Unfortunately, the only way to become his patient is to be referred by someone (or if he sees you in the hospital first). He reminds me of my endocrinologist in many ways, but I think his diagnostic skills might be a little sharper than my endocrinologist's.
