Results Update

[elaine77]

So! I finally got my blood results (numerical) back from my consultant today and needless to say I am more baffled than I was before!!

When I was diagnosed in December results were as follows:

HBA1C = 83
GAD antibodies = 323
C-Peptide = 395

When I had my second bloods done 6 months after diagnosis (June) the results were as follows:

HBA1C = 45
GAD antibodies = 539.4
C-Peptide = 750

So my GAD antibodies has gone up but so has my insulin production? Quite significantly?? Didn't understand this at all so I asked the consultant and he said that its not unusual for c-peptide to go up once people are diagnosed and having treatment for their diabetes.... I pointed out to him that I do not take sulfonylureas nor have I ever taken any exogenous insulin and as far as I was aware Metformin did not make the body produce any more insulin.

He said oh yes that's right you're just on Metformin aren't you and then confirmed that Metformin does not stimulate any insulin production but apparently can stimulate some beta cell regeneration!! Did anyone else know this?? If that's the case everyone who is insulin deficient should be taking it!

I'm still unsure as to how it could have almost DOUBLED my insulin production though? Anyone have any ideas??



Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

 

[hale710]

Crazy results, but not bad results! Your insulin production is up, so you can be insulin free for a little longer

 

[dib]

This is the tricky thing about managing type 1.5 diabetes.
Your pancreas will switch on or off insulin production quite randomly. I can only suggest you monitor your bloods regularly and try and be very aware of hypos. I can go for days eating the same breakfast and doing the same exercise with good readings then suddenly go either high or low for no apparent reason, except that my pancreas has either kicked in or not.
I just juggle doses and accept that I won't always get it right, I don't think you can predict when it will happen.
The important thing is not to give yourself a hard time about it, stress doesn't help and the occasional high or low will not do much harm.
Good luck with it.
PS I am not medically trained but do have four years of living with this condition and politely suggest that you press your GP for insulin medication, it does make things easier to control if you are ok with injections.

 

[SpaceChick]

Fascinating results

I'd say, keep monitoring and don't knock it! But I was also of the understanding that insulin production would just keep failing (but then my Health Board won't give me GAD and C peptide tests as the funding has been withdrawn, they just think I'm 1.5 so only a HBA1C for me!)

 

[elaine77]

Hi all,

I'm not ok with injections AT ALL unfortunately but I'm not allowed to go onto insulin anyway because consultant says my levels are not high enough, the amount of insulin needed will be negligible and I would be risking constant hypos! So Metformin it is I guess....

I'm not sure it does mean I'm insulin free for longer I was thinking maybe the fact my insulin is up but so is my antibodies that one is cancelling out the other so I'm no further forward or backwards?

More antibodies means more destruction? Consultant says not. He says the number of antibodies bears no reflection upon the number of beta cell destruction.... Duno how he figures that out though?

I was having a think and thought that maybe my insulin was so much lower at diagnosis because I had used it all up as I didn't know I was diabetic and so was eating whatever I liked but since diagnosis I've went low GI carb so maybe I'm not using all my insulin up so maybe the is more of it in circulation? Does that make sense?

I didn't think u could just regenerate beta cells but I guess maybe u can when ur type 1.5 because they won't be immediately killed like they would in full type 1? I also wonder if type 1.5s ever DON'T become full type 1 and always have some sort of insulin production because of how slow and unpredictable the beta cell attack is?

These results have given me more questions not less! :-(


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

 

[dib]

i don't think it works like that, I have come to understand that my insulin production will be quite random for some years until it ceases altogether. So the task is to manage the yo yo with regular monitoring and very minor adjustments of insulin and carbs. i used to fear the injections before when I was on oral meds (which by the way did not help in anyway) but now I am very used to them, the needle is tiny, only 4mm and the dosage very small only around 8 units twice a day but the effect on levels was dramatic, they came down almost immediately. Your consultant's concerns about hypos are valid but as long as your are hypo aware and always have something sugary to hand you will be ok. You will develop a second nature about when things are right or not, believe me, life is actually alot easier now I am on insulin, so I would keep pressing him to prescribe it, you will most likely have to go on it anyway at some point and with type 1.5 my view is that earlier is better than later.

Good luck :thumbup:

 

[elaine77]

I asked him about that and he said there is no evidence to support the fact that early insulin introduction preserves any beta cells at all or makes a difference to anything other than current BG levels.

I am currently between 4mmol and 8.5mmol all the time unless I eat something I KNOW is not going to agree with me and another member on here started a thread about how awful a time he is having at the moment with constant hypos and so I think the longer I can keep insulin away the better. Is not just the injections its the DVLA palarva, the insurance malarky, the hypos and everything else.

I technically don't think I have hypo awareness at the minute because I don't take meds that can cause hypos so the lowest level I have ever had was 3.9 mmol.

If I was eating a 'normal' diet then without a doubt I would have no choice but to use insulin as I don't produce enough of it to manage a normal diet and many people might want to go onto insulin so they don't have to change what they eat but I actually don't mind a low GI diet.... Sometimes I wish I was type 2 because I would rather be on a low GI restricted diet forever than have to ever inject myself with insulin....

Unless my levels were consistently in an unsafe range I don't see the need to take insulin either.. If its not broke don't fix it right? *wishful thinking*


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

 

[dib]

Fair enough you must go with what suits you best. Personally speaking I have very little or no resistance to insulin so metformin did nothing for me at all.
I would question your consultants assertion that there is no evidence early introduction of insulin helps preserve cell production, it seems contrary to everything I have read and been told by those in the profession, still there you go, there is obviously still much to learn about diabetes and type 1.5 in particular.

Best of luck with it :thumbup:

 

[elaine77]

I've searched for research myself and asked on the forum if anyone has came across actual carried out research showing that early insulin injecting preserves beta cells but no one has been able to provide any other than HCPs 'believing' it happens. They 'believe' a lot of things like starchy foods should be eaten at every meal etc etc.. Mostly they are wrong.

I too have no resistance to insulin either but Metformin still helps because it utilises what I do produce a lot better and quicker which is good for me because I'm not producing enough so it needs all the little kick starts it can get lol.


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

 

[dib]

I guess it can take a long time for proper research to validate what is sensed by those who live and work with this condition and many other conditions too.
I take the view that the jury is out, nobody really knows.
I was caught out with the starchy carbs advice in the early days after my diagnosis and tried low carbing for a while which brought my levels down but really didn't suit me. Small doses of insulin does suit me, we are all different.
GP's will often generalise, there are some who still don't even know what type 1.5 is, in their eyes if you are not type 1 you must be type 2. Hey ho!
In the meantime we must find our own way to manage it and do what ever seems to work for us.
Research may well catch up with how we individually manage, one day.

 

[elaine77]

There was a piece of research on it. I've had a look but I can't find it ATM but basically they followed a number of slow-onset type 1s, half had been given insulin immediately and half just diet and oral meds and they monitored them for 18 months and after 18 months the people who went onto insulin immediately were not producing anymore insulin than those who didn't and the difference in how their diabetes had progressed was also no different.. I'll keep looking for the link. Obviously that was only 18 months long, there doesn't seem to be any research that goes longer than that so it has its limitations....


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.