Am I Type 1 or Type 2?

robertwt

Active Member
Messages
42
Type of diabetes
Type 1
Dislikes
Rudeness, bad driving, incautious use of English
Sorry for the 'age old' question. Whenever it gets answered, I get confused!

My history:
diagnosed in 1996. Treatment followed a well known path -
diet (about as much use as a chocolate fireguard :shock:)
then metformin (a little better :wink: )
then mixtard 30,
then novorapid,
then novorapid plus levemir.
then novorapid plus levemir plus metformin.
My current regime is novorapid 6 i/u three times a day; levemir 62 i/u morning and evening.
Plus metformin 850mg (3 times a day, although graduating this week onto 1000mg twice a day)
So am I said to be insulin resistant or insulin dependant.

But am I a Type 1 or Type 2?

:wave:

Robert wt
 

Mileana

Well-Known Member
Messages
553
If your pancreas produces insulin, that insulin will be bonded with a c-peptide. The insulin gets spent, so that cannot be measured easily, but the c-peptide stays alive for much longer. If your c-peptide is around 1, you produce a normal amount of insulin. If it's below, this indicates type 1. If it's higher, it indicates Type 2 (upping the insulin production because of resistance, not keeping up anyway - blood sugars go up.)

If your c-pep test comes back low or normal, have a GAD-antibody test done, GAD is the most common antibody that tends to kill beta cells. If that comes back out of range (30-50 depending on lab), this indicates you have an autoimmune form of diabetes, - those are classified as Type 1s. It may then be Type 1, plain; or it might be Type 1.5, LADA. In the latter case, your GAD should be high, and c-pep low to normal. LADA is when your pancreas slowly dies off. Type 1 often happens quickly.

I cannot tell which category you belong to, but either your pancreas is not keeping up with insulin resistance or you might be 1.5 LADA.

How is your weight? If you were to eat and forget to inject your novorapid, what would your blood sugar do? Rise a lot, then fall slowly, or rise and stay up there?

A lot of Type 2s will eventually need insulin, so being on insulin does not mean you are Type 1. It may have to do with the degree of insulin resistance, it may have to do with weight or dietary choices or it may be lacking insulin production.

However if you would have very high blood sugars without insulin, you are insulin dependant - that's fairly simple :) If you're not Type 1, the trouble may be less immidiate if you don't get the injected insulin as you can cope some of the way yourself, but there is a nasty condition called HyperOsmolar HyperGlycaemic State that somewhat corresponds the Type 1 DKA, so one is not really less important to treat with insulin when needed than the other.

Go ask your GP for a check.
 

phoenix

Expert
Messages
5,671
Type of diabetes
Type 1
Treatment type
Pump
I don't think a c peptide test would demonstrate anything. It's value as a diagnostic test in in the fairly recently diagnosed, not someone who has had diabetes for 16 years.
A person with new type 2 diabetes often has a normal or high level of C-peptide in the blood. Over time, a person with type 2 may lose beta cells ( their number reduce as we age in any case) A person with long standing T2 diabetes may develop quite low levels of C-peptide.
http://labtestsonline.org/understanding ... e/tab/test

Insulin resistance isn't really a have it or you don't have it. It's a continuum, some people are more insulin resistant than others and it can vary according to what we're doing/eating but it is one of the characteristics of T2 diabetes.
On the face of it , the amount of insulin you need plus the metformin you take would suggest that you are more insulin resistant rather than sensitive so (and I'm not a doctor and don't know your history ie when you first went onto insulin and why) I would guess that you are a T2 who now has insufficient of your own insulin so need to supplement it.

I think the confusion about insulin dependence and non insulin dependence comes from the older and confusing names for T1 and T2
Type 1 used to be called IDDM (insulin dependent diabetes melitus) and what is now called T2 was called NIDDM (non..)
even when the person went onto insulin
Heres what was written in a 1990 paper
Non-insulin-dependent diabetes mellitus (NIDDM) is a common disorder occurring in 3–6% of adults in most western populations. In the United States, 29% of patients with diabetes take insulin; of these, 76% have NIDDM. Insulin therapy is usually required at some time in NIDDM.

But as Mileana says someone who is T2 and needs to take insulin to keep their levels down really needs it and neglected/untreated diabetes can lead to the HHNS she mentions It just takes longer to get into that condition than it does for someone with T1 to develop DKA. In the sense of keeping yourself healthy and preventing the damage from high glucose , you are dependent on insulin .
 

robertwt

Active Member
Messages
42
Type of diabetes
Type 1
Dislikes
Rudeness, bad driving, incautious use of English
Hi,
Although no closer an answer, those wise words of advice have certainly given me something to think about, and something to do.
Thank you for taking the time to spell it out.
Regards

Robert wt