Answer to Question 1
He was diagnosed with type 2 diabetes one year ago due to hyperglycemia; there were probably no antibodies present at that time, meaning he met only the type 2 criteria.
Now, the presence of antibodies GADA, IAA, and ICA indicates an autoimmune attack on the beta cells of the pancreas. The presence of antibodies makes a diagnosis of type 1 diabetes or LADA more appropriate.
His c-peptide is 0.6, which is very low, indicating that very little insulin is being produced due to the auto-destruction of the beta cells, further confirming a type 1 diagnosis.
Answer to Question 2
Type 1 diabetes:
Casual blood glucose above 200 mg/dL
Fasting blood glucose above 126 mg/dL
Oral glucose tolerance test >200 mg/dL (2-hr postprandial)
Presence of antibodies ICA, GADA, IA-2A, and IAA
Weight loss
Polydipsia, polyuria, polyphagia
C-peptide also used to help distinguish type 1 diabetes; low c-peptide indicates low or no insulin production
HbA1c >6.5
Type 2 diabetes:
Polydipsia, polyuria, polyphagia
Casual blood glucose above 200 mg/dL
Fasting blood glucose above 126 mg/dL
Oral glucose tolerance test >200 mg/dL (2-hr postprandial)
HbA1c >6.5
LADA: Generally, the most accepted diagnostic criteria for LADA includes the following: the presence of autoantibodies (e.g. ICA, GADA, and IA-2A), onset after age 30, and non-insulin dependent for at least six months past diagnosis
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