Diagnosed by GP at 49yo as DT2M in Apr '19 with A1C ~15. Over the next year I tried a variety of insulin sensitivity meds while at the same time making huge changes in lifestyle and diet. Metformin, pioglitazone, glipizide, The meds never seemed to act the way I thought they should – BG trending did not follow med dose changes, etc. GP saw A1C improvements as evidence of meds working but I believe it was primarily diet and exercise.
I went to an Endo in July '20 and was started on Lantus long acting. Current is 22U Lantus and 1000mg Metformin, each 1x/day and that seems to work reasonably well (time in range ~90%). The Metformin is a holdover from the GP timeframe and I don’t believe it is doing anything but the endo doesn’t want to discontinue it for some reason. I do not use any short-acting insulin. I probably should, but so far I manage by eating low carbs.
My peptide-C test was very near the bottom of the normal range and my GAD was normal. I understand T2 would typically have a high c-peptide.
I was told 30 years ago and a few times since that I was pre-diabetic but always opted out of treatment, being “bullet proof” at the time.
I had cancer when I was 4yo and subsequent abdominal (at least) radiation, chemo therapy, and surgery to remove one kidney. My current theory is that the radiation affected my pancreas and my insulin output has been low my entire life and is just now over the “tipping point”. The normal GAD test and the fact that I make some insulin suggest to me it is not auto-immune / LADA and not “traditional” type 1.
Anybody have any insights or references as to other “types”? Does it make a difference what the diagnosis actually is? I worry about going to doctors of other specialties that may assume all T1’s (or T1.5, T2) are the same and apply the same recipe or make inappropriate assumptions.