Majaz Ahmad (Undergraduate Student) needs a second opinion on this medical case.
A 35 year old male, diagnosed as diabetes 3 years ago. He has oculocutaneous albinism with history easy bruising and gum bleedinf and nhe was tested throroughly with normal blood coagulation profile and normal platelet function test, ?hermansky pudlak syndrome.
On examination he is alright except for decreased visual acuity 6/36 in both eyes and congential horizontal nystagmus.
He has two more siblings with oculocutaneous albinism and history of distant consanguinity is there. He has father who is a known diabetic.
He started losing weight and was initially on doctor's advice he started life style modification, with exercise and MNT.
His current fasting blood glucose remained around 180 mg/dl the report I am attaching here has 1.8 mg/dl and HbA1c of 9.5.
I sent his C peptide level to rule out any possibility of LADA. His fasting c peptide level has been reported as 0.85 ng/ml.
I am attaching relevant reports here.
His main concern with which he has presented is now is diabetes and I need to confirm if the screening result from fasting c peptide points towards possibility of LADA. And how to start treatment , with insulin or OHA.