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Re: [IP] Re: MODYs, LADAs and c-peptides

Sharon Spadaro wrote:
> I posed this question last week, but no one gave a response, so, I'll ask again - I > was diagnosed in 1990 at age 23. My doc called me a
> MODY - mature onset diabetes in youth and he said my c-peptide showed 
> that I was indeed a type 2 - however one month later
> (after trying to control on diet alone) I was put on insulin. Maybe I am really a 
> LADA instead of a MODY?

Did he tell you WHY he thought you were a MODY? Do you have a strong
family history of MODY? Were you overweight? Did he know what MODY and
LADA are? (A lot of docs haven't a clue!)

> Now, just recently my
> CDE said she thinks I am type 1 due to my ISF and my carb ratios. Can you tell > from these numbers? 

Again, has she told you why she thinks that? I don't know what ISF
stands for, but what are your carb ratios? How much insulin do you take
every day? 

MODYs can vary tremendously in how much insulin they make, and how much
insulin they need. That's because MODY is the result of a genetic error
in the cellular machinery that makes insulin, and so, while the beta
cells are still alive, they don't respond to blood glucose levels
appropriately. There are several different kinds of MODY, all due to
different genetic defects, but none of them are auto-immune, as Type 1

On top of the genetic beta cell defects in MODY, a person can also have
insulin resistance, which occurs in approximately 25% of the general
population (Type 1's can have insulin resistance, as well). So the
amount of insulin required, and the carb ratio will vary. 

> Can your c-peptide become lower as your islet cells fail?

Everyone's c-peptide becomes lower with age. But yes, if your islets are
failing, then one would expect the c-peptide to get lower.  Classic Type
2's who have had diabetes for many years also show lower C-peptides --
although we are told that Type 2's have higher than normal C-peptides,
that's only in the beginning of the disease; after many years the
C-peptides can decline to below-normal levels. The 0.5 cutoff of
Medicare is equivalent to virtually nothing; it's their way of excluding
Type 2's from getting the pump. 

> Should I ask my doc AGAIN to redo my c-peptide and reclassify me for 
> insurance purposes? I already
> have my pump and they pay for it 100%, but I see all these people posting 
> about their c-peptides being too high for coverage. I'm
> starting to get a little scared that if I lose my job I won't get insurance.

I can't answer that question -- but I would say that any diabetic should
always apply for COBRA if they lose their job. None of us can afford to
have an exclusion for pre-existing conditions if there were an insurance

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 Natalie A. Sera, with all her ducks in a row!
 Type Weird, pumping!
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