"High insulin levels" is very relative.
It could be high compared to ZERO, but still way below NORMAL.
C-Peptide, rather than actual insulin levels, is the most common measurement.
Language wise is it possible you or the endo is conflating "high bg" with "high insulin levels"?
Similarly... Are you in the US or somewhere else? "Pancreatic insufficiency" is not a term I've ever heard from any of my endos and I've been T1 for 30 years, I know that it has more to do with pancreatis (often as a result of CF/SDS). Pancreas makes a lot of stuff other than insulin too. Is your endo talking about that too?
Pancreatic insufficiency is a term used to more generally describe the failure of the pancreas to produce "digestive" enzymes, and as you note suggests acute pancreatitis or some other condition.
As Tim says, most people who are diagnosed with LADA have high blood sugars and are found to have some level of lowered insulin levels. Basically, your insulin production starts to fail and your body becomes less and less able to maintain normal blood sugar levels.
If you don't understand the things your doctor has said, it is always important to ask questions, so I'm glad you came here. The tests for LADA/T1 (many people consider LADA to just be slow onset T1) are to measure for autoantibodies (GAD, ICA and IAA) which detects an autoimmune problem attacking your pancreas and as Tim notes the c-peptide which suggests your insulin levels.
There are some people who suffer from acute pancreatitis who end up with a form of T1 called ideopathic T1, or T1b. But this is not the same as LADA or autoimmune T1.
Being autoimmune type 1 involves having autoantibodies "and" having problems with your blood sugar. It turns out that perhaps 20% of type 2 diabetics are also positive for antibodies, and a significant percentage of non-diabetics also test positive. I know it can be confusing, but hopefully the second endo and the additional tests will help you figure out what is going on.
I sent a reply to Linnette yesterday, but would be interested in your "take" on my situation while I anxiously await my antibody tests.
I just joined this forum too, and in the diagnosis stage of possible LADA. My insulin is very very LOW -- 3.2 out of 24. I'm also definitely NOT insulin resistant, not obese, no type 2's in the family, and the kicker is that I had another serious autoimmune disease, Graves Disease, and as a result have no thyroid left. I've been on a low carb diet (Bernstein or less) for 3 months, and before that was only a bit higher carb, but my BG shoots up to 115 or more if I have even 20 grams of carb. It takes 3-4 hours to come back down into the 80's. Also exercise jacks it up. And after taking my BG for weeks it feels like my pancreas is "sputtering," doing all kinds of weird stuff. My thyroid did the same thing before it finally burned out.
'shoots up to 115' that's a normal number for even non-diabetes after meals. we, as type 1's have numbers that go up into the 200's, 300's if we eat any carbs, somestimes even if we take insulin and don't match our I:CR correctly.
Mine would go up over 200 (and has) if I eat more than 15-20 carbs. If I ate the 130g recommended by the ADA it would get up there and stay there. I'm basing my concern on Bernstein's position that your sugar shouldn't go out of the 80-90 range, no matter what you eat, as this is a normal non-diabetic insulin pattern. Also, even if it could be considered "normal" to go to 115 on 15g of carb, mine doesn't come back down into the 80's for several hours, which I understand is Type I pattern, though on an early scale. I'm hoping that if I do have the antibodies and LADA I am catching it early enough to have some level of control through diet alone for awhile, at least, as Bernstein and the various websites indicate may be possible.
As a Type 1, I'm sure glad I didn't absorb the information that my blood sugar shouldn't go out of the 80-90 range, because I'd sure spend a lot of time feeling like a failure! I think I have pretty good management, but for most of us, Type 1 is about aiming for targets and correcting promptly when we inevitably go higher or lower than those ideals.
Yeah, the phrase "shoot up to 115" gives me a definite chuckle. Since I'm LADA, I spent my first 15 months doing fine on oral meds until my numbers started to climb and I realized I'd been misdiagnosed. So I never experienced a honeymoon in the classic sense. If I'm 115 two hours after eating I am very happy.
ha, me too...i would have freaked out and would have made myself scary low, especially when first starting out.