Are you sure its type 1 doc?

Engcricket

Member
Messages
7
Hey guys.

Help would be appreciated. I was diagnosed itch T1 DMin Aug 2011. At the age of 23.

My dads type two. I was expecting to be type two ( I am overweight and not particularly) however I was admitted to hospital with DKA Bm was 46 and I started on insulin.

The question still remains in the back of my mind I was never tested for GAD antibodies but I was deemed type 1 because I'd the ketosis however rarely type 2 diabetics can also have ketosis. Unusual but can happen for which theyll require a insulin for a while and then no more.

Reason I'm skeptical is no official tests and I am on small amounts of insulin (in terms of my body's weight) 10 unit of novo rapid with evening meal and 9 units of lantus. Don't know whether I should speak to my endocrinologist.

My hba1c at diagnosis was13

My HbA1C now is 6.3 yeah I changed diet but I'm still oversight. Need to excercise more and that good a control with such low doses confuses me even more.

Help.
 

phoenix

Expert
Messages
5,671
Type of diabetes
Type 1
Treatment type
Pump
With an HbA1c of 13%, your average glucose levels were about 18.1mmol/l. This is high , you also had DKA which suggests at least a relative lack of insulin.
Personally, I'm positive that T1 and T2 both cover a variety of conditions and have varying amounts of insulin resistance and or deficiency and a variety of 'causes'.
Officially there is T1a which is autoimmune and can be caused by a variety of antibodies, not just GAD but there is also, Type 1b which is idiopathic ie no known cause.
If you need insulin supplementation/replacement from diagnosis and are susceptible to DKA, then according to present day definitions you have T1.
There are conditions that aren't really covered by the normal 2 boxes.
These include MODY, a genetic condition http://www.diabetesgenes.org/
and ketosis prone T2 http://www.uptodate.com/contents/syndro ... s-mellitus (if you think this may be relevant google Michael Barker, Ketosis prone T2)
Ultimately though, what matters is that you are on the right treatment; if you are insulin deficient that is insulin.
 

Ambersilva

Well-Known Member
Messages
715
Type of diabetes
Type 1
Treatment type
Insulin
Hello,

Well... I was diagnosed T1 at the age of 63 with had DKA and HBAic 13.8%. GAD and C-peptide tests confirmed T1.
I have not put on weight since diagnosis and could do with losing 20 lbs to be a desirable weight.

We are all different and some T1s need much more insulin than others. I am currently on 12 uits of Lantus per day and 3 - 6 units of fast acting insulin at meals. At one stage I was injecting 10 units of Lantus.

Today my total daily dose of insulin is 21 units - the variation being in the meal time injections.

If I forget to inject the fast acting insulin my BS can soon reach the high teens even with a meal low in carbohydrate.
 

donnellysdogs

Master
Messages
13,233
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
People that can't listen to other people's opinions.
People that can't say sorry.
I personally am T1.. And never really understood why people are worried whether they are t1 or t3...

PersonallyI wld rather be T1 than T2...as I believe T 1 a lot more flexible snd less restriting nowadays than T2.
I eat same as any other non diabetic person..i remain with hba of 6.6 and a size 10. I do not have to low carb or high carb.. Just whatever suits me.. Yep I eat meat and 6 veg for my dinners.. No potatoes... But when I do my job gardening I dont worry about hsving a jam doughnut once a week either...i dont think that now I'm on a pump that strangers sitting next to me in a restaurant would think I had D....

Why do people, especially non diabetic people see type 1 as significantly worse disease than type 2??. I will be a bit contentious here... But pretty much my thoughts..

I got type 1 through my genes.
(not all) but a lot of people hinder themselves through their lifestyles and weight problems to get type 2...
I would far rather blame my D on bad genes than bad lifestyle...i do know some type 2's are reslly heslthy, thin, sporty etc... But I do not know why people see T1 as a bigger issue...
 

AMBrennan

Well-Known Member
Messages
826
Reason I'm skeptical is no official tests and I am on small amounts of insulin
With all due respect, but I cannot follow that line of thought at all. T2s tend to be insulin resistant and require a lot of insulin, so small doses would suggest that the T1 diagnosis is, in fact, correct.

As for the GAD test, I take it that you're not a statistician? The vast majority of people diagnosed with diabetes when they are in DKA are T1s (yes, exceptions do exist), so even with a negative GAD test I'd still bet on T1; I'd go as far as saying that this is probably the textbook illustration for Bayes theorem (GAD negative = positive for T2).

Personally, I am fairly happy to be T1; its onset is fast enough to be diagnosed before getting any complications and the finality of the diagnosis leaves one less vulnerable to snake oil salesmen that exploit desperate people e.g. looking to avoid having to to go on the dreaded insulin.
What's more, as I understand it we can more or less fix T1: The body produces no insulin, so you inject the amount you should be producing. T2 is more complicated, and the solution to "insulin not working properly" is just "use more insulin" (insulin secretagogue and insulin), which is hardly ideal - e.g. at the maximally tolerated dose of Metformin, liver glucogenesis is still above normal... so you use more insulin to move the rest out of the bloodstream and store it as fat?
 

Engcricket

Member
Messages
7
Thank you everyone for all your comments.
I certainly didn't mean to imply any type is worse than the other. To be honest with you I'd rather not be diabetic but hey that's life.
I agree with the above post type one has advantages mainly the earlier diagnosis of it rather than presenting with target organ damage as type 2 do.
My query was simply whether I had been misdiagnosed or further tests were needed at the end of the day I am diabetic and will be for the rest if my natural life. I have accepted that fact but was confused as to how it was "definitely" type 1.

Ps I am not a statistician your comments always enlighten me ambrenner

Thank you again everyone.