Adult Onset T1 - Interview

[Alexandra100]

http://www.diabetesincontrol.com/kathleen-wyne-complete-interview/

You can watch a series of videos of this interview with Dr Kathleen Wyne, or read the complete transcript. I was especially interested in what she has to say about diagnosing adult onset T1. She says exactly the same as Dr Bernstein, that the C-peptide test is useless without a simultaneous glucose test. I have just been listening to one of Dr B's Teleseminars, where he explains that a person with a normal response to carbs would test low for C-peptide if they had not eaten any/many carbs, as they would then have no reason to produce a lot of insulin. Dr K.W says,

"... most people think you diagnose type 1 by doing a C-peptide and if the C-peptide is undetectable, then by definition, they have type 1. That’s not true. First of all, someone who has had type 2 for many years could have an undetectable C-peptide. Second of all, any time you measure C-peptide, it must have a simultaneous glucose. You need a context. So, this person who is an adult onset type 1, may have a C-peptide that’s reported in the normal range. But if the simultaneous glucose is 410, then it’s inappropriately low which is not what you would see in a newly diagnosed type 2 where it would be inappropriately high. So, first of all, your C-peptide needs to be in a context."

 

[Diakat]

That's why there are instructions about eating a meal containing carbs before the test. At least there were in my bit of the UK.

 

[Flora123]

Does that mean you should test your levels at the same time you take the urine sample?

 

[notria]

I read Bernstein but can remember him saying less fat? (as per your signature "less fat à la Bernstein"). Perhaps you should have more fat and less protein.

 

[Alexandra100]

I read Bernstein but can remember him saying less fat? (as per your signature "less fat à la Bernstein"). Perhaps you should have more fat and less protein.

I am pretty lavish with the fat, certainly consuming far more than before I began LC. However if I eat too much fat I start to feel sick. I am perhaps even more lavish with the protein. Dr B recommends restricting carbs and then filling up (but of course not stuffing) with protein, and accepting the fat that comes naturally with the protein. It is possible that older people (I'm 76) and active people need more protein than others. Having involuntarily lost a lot of weight over the winter, I am very keen to rebuild as much muscle as possible. I know protein raises bg, but less and more slowly than carbs. IMO I have to accept whatever bg rises come after eating protein in order not to waste away!

I listen to Dr B's Teleseminars every month, and he often emphasises his concern that in the current enthusiasm for LCHF people, and especially children, are eating too little protein. In the case of child diabetics this can be disastrous, as their growth is slowed / stopped. This is something he sees in his patients.

 

[phoenix]

Instructions for c peptide requested by UK consultant. I've been using insulin (now a pump) for 13 years and originally diagnosed in hospital as LADA: T1.

Its to see how much, if any insulin still produced... ( and whatever the result new pump ordered as it 'obviously gives you good control')

Continue with basal insulin, fast overnight. Eat at least 60+gcarbs with no bolus insulin. Blood drawn exactly 90 minutes after eating.
Warned glucose level may reach 30mml/l .

 

[Circuspony]

I had C-peptide test done in hospital as part of a trial on adults with late onset T1. Bloods drawn every 15 mins for first hour and they track glucose against c-peptide in the results.

I was still producing some insulin - but it took nearly an hour for my pancreas to wake up and start to chug out insulin. Does mean I'm now careful at night not to go to bed lower than 8 in case it decides to start helping out.