I was diagnosed as having T1 3 years ago. However, after a meeting with a new endocrinologist yesterday, she ordered antibody tests to see if my T1 diagnosis was wrong. She thought I might have MODY instead because I only take 2 units of Lantus a day and rarely have highs.

She said that we could try oral meds instead of insulin if the antibody tests are negative.

My question is - how tight control can I get on oral meds? With a low carb diet and low insulin doses I've had A1Cs in the mid 5s for the last 3 years. The only time injecting really bothers me is when I'm out with new people for the first time.

So, I'm wondering, if her guess is correct and I can switch to oral meds, can I expect my control to be as good?

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Please keep connected as to the test results.

How low carb of a diet are you following? The idea being that at a very low carb diet you could well be extending your honeymoon period. That is exactly where you would want to be. I am doing the same for my son diagnosed 2013, which keeps his numbers in a great place. As well as very little insulin.

I do not know about taking oral meds, but I know that they are being used more often.

What a great place to be! I imagine that if this is your future of Diabetes it will be like monitoring type 2 as opposed to type 1.

Best to you.

I'm having it done today. My doctor says the results typically take ~10 days to get in for these tests. I usually do around 60-75 grams of carbs a day. My mother told me my older brother, who was diagnosed with t1 at 16, didn't see his insulin requirements increase until after 4 years. He's now up to a much higher dose though and is definitely t1. The same could be true for me. I guess I'll know soon enough though.

Hi DanK,
I was diagnosed as a type 2 six years ago but when I met with a new endocrinologist, he strongly suspected that I was a MODY. A switch up on oral meds and I have been able to stay with them now for 6 years. I have had to up the dosage but I would prefer to do oral meds as long as I am able. I have kept my A1C in the 5's and once in a while I have been at 6. I also low-carb and have been doing so for the past 6 years, under 60 carbs per day. I am very active, rarely get ill and teach yoga and pilates classes. See what your endo has to say, the only problem with a MODY diagnosis is that you really need to get genetic testing to determine if you truly are a MODY. Expensive and not covered by insurance. The MODY diagnosis made more sense to me when the endo strongly felt that I was and using meds that work for MODY including glimiperide and prandin. Good luck with your test and it looks like you are doing exceptionally well.

Hi, thanks for the reply. It's good to see it's possible to achieve such low A1Cs with the oral meds instead of insulin. Are you concerned though that long term the medication could wear out your pancreas? Do you know the reason why your dosage had to increase?

Also, if the antibody test is negative, why would I need the genetic testing to confirm MODY? I have clear t1 symptoms (A1C of over 11 at diagnosis), but still have low levels of c-peptide and very high insulin sensitivity (usually 1:12 insulin to carb ratio at meals).

Yes, I do get concerned about the oral meds but I do take a low dosage and my endo says those are the best for MODY's. I have reviewed other options for med's with him but he says these will work the best and the other meds won't be as effective. According to my endo and an article http://www.phlaunt.com/diabetes/14047009.php on diabetes, the only confirmation of MODY is by genetic testing which is expensive. Its a very good article. Even though I haven't been tested my endo did an extensive history on me and is convinced that I am a Mody. Sometimes I do get low's, its hard for me to tell because I do not get any physical response but am mindful to check my blood sugar levels. I often hike/run in the woods but I usually eat a Quest bar (available at GNC) before I run, keeps things in check. I avoid sugar and use bars (made with stevia or sucralose, prefer stevia). My endo is not concerned about low's in the 70's or even a bit lower for me as I am very active and many athletes sugar levels can dip into the 40's. That being said, low's are something my endo always tells me to watch! I see you are a surfer. So is my son. He is 21 and has been surfing for about 9 years now, just was out in the recent storm, 13 foot waves in RI. When you live in NE, you gotta get them when you can. Unless of course, he gets to CA once in a while. So, a very strenuous workout, good that you are eating more carbs! You seem to be on the right track, good to explore all options and my endo spends an hour with me each visit, answers all my questions and research I find. I find that snacking lightly during the day also helps. Nuts are a great choice, carb and protein!

Also, do you have to worry about lows when exercising when you're on the oral meds? Right now I have to bring a sugary drink with me when I go out for walks, and I go through a few hundred grams of carbs on days when I go surfing, just to prevent lows.

Yes, Dan hypos ARE A BIG DEAL with the oral meds. For me, the reason I like insulin - and soecifically the pump, is that I micro manage my dosing. But I am also very sensitive to fluctuations in my BG. I feel sick with a big rise and going hypo has issues. Obviously.
Hello - I need to reintroduce myself to this group. I have been absent for a couple of years - but I would be happy to try to answer your question.

My Name is Gracie - formerly known in this space to Old Timers like BSC and Natalie as April. I was diagnosed in Dec 2010 as an "Insulin Deficient T2" - meaning my high BG was due to insufficient insulin production - vs Insulin Resistant (so common in T2).

In theory, MODY's do very well on oral meds and many of us can go off insulin and throw away our syringes. Unfortunately I am not an example.

I think it does not hurt to give it a try so long as you ask her what all the options are, and make it very clear that what you are doing now seems to be working - you are always interested in investigating a better solution - but if it doesn't work out - you'll be going back to your current regimen.

My Endo started me on Onglyza - a DPP-4 inhibitor. Initially my a Internist did not believe I was diabetic bc my fasting BG was so low - only 105-110. But my post-prandial readings at 60-90 minutes were over 200 if I ate 35-50 carbs per meal.

Onglyza did very Little and I was leery of trying to get meds to make my poor pancreas do something it didn't want to do. But my Endo wanted to try again, so she gave me Prandin. Whatever the lowest dose was, she gave it to me and told me to take one half an hour before I ate. I became sick: nausea, headache, shakes and hypoglycemia. She told me to try half a pill. Same thing. At that point we tried Levemir, which worked great. Later, I clearly needed a bolus and I ended up on a pump that could give me tiny does of short acting Novolog because I am so insulin sensitive I usually need a dose of less than 1/2 unit.

I hope this helps and was not too confusing. Best wishes, Gracie




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