Thought I would give an update as to my case.
Short Summary: 33 year old Family Medicine physician Diagnosed in June 2014 with HgbA1c of 6.0 and Impaired Glucose Tolerance (with basically no Phase-I insulin response.. sugars go up to 200 with around 30g of carbs).
Since the last post, I have taken the advice of many here and got tested to rule out for Type 1 and the antibody tests have all come back negative.
(with the exception of the ZNT-8 test which my insurance did not have).
Here are my results:
GAD Antibody (-)
IA-2 Antibody (-)
Insulin Antibody (-)
Islet Cell Antigen 512 (IA-2) Antibody (-)
Islet Cell antibody (-)
Hemoglobin A1c = 6.0 (Still High Unfortunately)
Vitamin D = 44 (This I'm trying to get in a higher range).
Cholesterol Total =199
Triglycerides = 47
Cholesterol/HDL Ratio: 2.9
Fasting Insulin = 5 (Normal is 2-22)
Fasting C-Peptide =1.0 (Normal is 0.8-5.2)
Free T-3= 233 (Normal is 220-440)
Normal Iron Panel and Ferritin.
So yesterday, I went to see my Mom's Endocrinologist. My mom was diagnosed with Type 2 (She is also thin, Asian) with these results to get his opinion. My biggest question was what type of Diabetes do I have? Given all my antibodies were negative, I pretty much ruled out for Type 1, but he agree with me that based on my numbers with lowish C-Peptide levels, Low Triglycerides, High HDL and that I'm thin and weigh 105 lbs that I was not the typical "Insulin Resistance" Type 2. He said that he does not think I have insulin resistance at all. So I asked him if he felt like I could have MODY. He was pretty skeptical and said that usually onset is younger than 33 (which is my current age). Insurance of course does not cover for genetic testing, he states out of pocket price in california would be around $10,000.00 (I am actually contemplating this, my mom thinks I am insane). Regardless he feels like I'm still Type 2, but he thinks I'm not of the "insulin resistance" variety, but the lean more genetic Type 2 that he sees, that is characterized by being insulinopenic based on my low C-peptide level (in my mind when he said insulinopenic.. I was thinking.. well doesn't that mean my pancreas is kaput and how did it get that way if I'm not MODY or Type 1?) Anyhow, he felt like it was genetics and I was just dealt a bad hand because my mom whom is also thin was diagnosed with Diabetes at the age of 40.
His recommendation was to start Acarbose (which was not what I was expecting). He thinks because I have no signs of insulin resistance, metformin may not be that beneficial, but because I have a phase-2 response that Acarbose may keep my Postprandials under 140 for some time.
(How many here have taken Acarbose?)
So that's where I'm at. I'm probably going to get a 2nd opinion.
Everyone here has helped me immensely and I appreciate all the advice here. I restarted a LCHF diet with all the recommendations everyone here has given me and am giving it another go. I think if I follow everyone's recommendations here, I might be able to keep my Postprandials under 140 (Barely), but i'll have to be really strict with my diet and really up the fat content as everyone has recommended.
Hope everyone has a good Christmas and New Year's!