My insurance just approved the full MODY panel of genetic testing for me, I think the list price is $6K, performed by Athena Diagnostics. I'm posting here to solicit feedback on any readings I should do or questions/issues I should raise with my endo when I go in to talk with him about the results.
I was diagnosed in 2002 with a fasting BG of 124, OGTT peaking in the mid-200s, A1c of 5.6. An OGTT with insulin levels suggested I had substantially impaired Phase 1 post-prandial endogenous insulin response, but decent Phase 2 response. My c-peptides have consistently been modestly below reference range, but just a little below, e.g. 0.4 ng/mL-ish or even a bit higher.
I tested negative for the antibodies for which I've been tested (and I was just tested recently, a dozen years post-diagnosis, my prior docs didn't seem too concerned about doing the tests, though I might have had one antibody tested way back when, not sure), but my endo only ordered two tests, ISLET CELL AB SCREEN W/RFX TO TITER and GLUTAMIC ACID DECARBOXYLASE-65 AB. My impression is there's another antibody test that only works if you haven't been taking exogenous insulin, and maybe yet another one that's not widely available?
I was initially briefly put on a sulphonylurea, within months on basal insulin (Lantus), within a few more months also bolus insulin (Humalog, these days Novolog). I used MDI until two months ago when I started my first pump. My doses have always been modest, e.g. I was using 12 units/day of Lantus on MDI, 9/day on the pump.
Over the years things have declined a little, but not much, my highest A1c ever was 6.2, normally I'm 5.8ish these days. I still make enough endogenous insulin that I can (and must, to avoid hypos) go without basal and bolus insulin during periods of intense physical activity, like alpine climbing or intense trekking trips (I still take some basal with dinner in camp, but otherwise no exogenous insulin at all).
But during my day-to-day life, I need both basal and bolus to keep things in check. During morning runs I keep the basal flowing, and BGs actually rise a bit, during other times of the day I kill the basal a few hours in advance of a workout and BGs stay relatively stable. My I:C ratio seems to be between 1:15 and 1:20, my correction factor, which I still need to dial in more precisely, about 1:75. I'm pretty lean, but not severely so, and less so than I was in my 20s, have both more muscle mass and a little more fat, too.
I think that about covers it, are there any other key parts of the history/presentation that I'm missing?