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Am i diabetic?

Jamie1991Stables said:
Is it possible to get DKA and not be diabetic? Isn't it possible that the pneumonia I had damaged my pancreas and it has now repaired itself?
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These questions should really be answered by a doctor, not an idiot like me:)

DKA as the name implies, is ketoacidosis caused by a lack of insulin (hence the diabetic pre-fix in the acronym). It's possible that you developed ketoacidosis of sorts due to an underlying issue - but that's all purely hypothetical and speculative on my part, I really don't know.

As for the damage to your pancreas, again - I have no idea. Typically the pancreas is damaged by the body's own immune system, that's certainly true for us T1's. What you may find interesting is that there is a type of diabetes called "type 3c" which is basically T1D as a result of pancreatic damage caused by things like pancreatitis, pancreatic cancer, etc. The causes of type 3c are usually permanent and non reversible though...
 
GrantGam said:
How much carbs (weight) are you eating per day?
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A typical food day for me is:

Breakfast
2 shredded wheat or 3 weetabix or 2 sachets Quaker Oats. All with 330ml of semi skimmed milk.

Whey Protein Shake with 500ml water and a banana as a snack

Lunch
1 chicken breast with a full packet of uncle bens spicy Mexican rice

Dinner
220g of tuna and 1 large jacket potato with cheese

Houmous and breadsticks or
Grapes or strawberries as a snack

Supper

Casein protein shake with 330ml of semi skimmed milk
 
Jamie1991Stables said:
A typical food day for me is:

Breakfast
2 shredded wheat or 3 weetabix or 2 sachets Quaker Oats. All with 330ml of semi skimmed milk.

Whey Protein Shake with 500ml water and a banana as a snack

Lunch
1 chicken breast with a full packet of uncle bens spicy Mexican rice

Dinner
220g of tuna and 1 large jacket potato with cheese

Houmous and breadsticks or
Grapes or strawberries as a snack

Supper

Casein protein shake with 330ml of semi skimmed milk
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You're eating a moderate amount of carbohydrates then, so it's not like you're HbA1c is lowered by your following of an ultra low carb diet or the like...

This is all very strange, I'm on tenterhooks waiting to find out what the verdict is:)
 
Jamie1991Stables said:
How do I get a second opinion?
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You would go back to your doctor(s) who have allocated you with your current diagnosis and request that other medical professionals put forward alternative diagnoses and/or theories as to what your ailment actually is.

You may also request to be sent to a specialist however - I think you're already dealing with them?
 
Jamie1991Stables said:
I could accept it if the diagnosis was unanimous but different people have different views. I'm being told by my GP that it could've just been a 'blip' caused by the pneumonia. The diabetic nurse theorises that I'm not diabetic, she's seen nothing like it. But the specialist says I definitely am and I'm in the honeymoon phase. I just don't know what to think.
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To be frank, I'd only go by what specialists say. It's definitely not impossible you're in your honeymoon period. In some people it can last more than a year. There are people with LADA here who came off insulin for quite a while eg @wiserkurtious

When I was diagnosed, the first HbA1C I had done wasn't as high as others have mentioned here. i think that's because it was caught early.

A misdiagnosis is never impossible, but if it was me I'd wait to see how things go, keep testing regularly - and keep your mind open to either possibility.
 
My understanding is it's not that unusual for a type 1.5 to be totally off insulin for a long period while honeymooning.

There is no definitive test to confirm whether a type 1 diagnosis is correct. A cpeptide test will tell you if you are producing insulin, but you already know you are and that would be expected in a honeymooning type 1.

You could ask for repeat antibody/GAD testing. A positive GAD test will confirm you are type 1, but a negative GAD test doesn't rule it out - about 25% of type 1 diabetics are GAD negative.

A hba1c of 66 on diagnosis is unusually low. But perhaps treatment for pneumonia meant you were diagnosed very early on in type 1 development. Diagnosis early in development can also help with the strength of the honeymoon period.

I don't see pneumonia being a cause of dka. Dka needs insufficient insulin.pneumonia doesn't damage the pancreas or stop insulin production.

If you are currently diagnosed as a honeymooning type 1, youre under care of diabetic specialists and keeping a close eye on blood sugar levels but not currently taking any diabetic medication I would say just enjoy the honeymoon. If you're not satisfied with the diagnosis ask for a second opinion but as a definitive test is not possible and a presentation in DKA is in your history I wouldn't expect you'll get much out of a second opinion.
 
Jamie1991Stables said:
Is it possible to get DKA and not be diabetic? Isn't it possible that the pneumonia I had damaged my pancreas and it has now repaired itself?
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It's possible to get DKA with diabetes which isn't Type 1. It's just pretty rare. It can happen with genetic (MODY) cases, depending on which gene is involved. There's also other 1.5 cases ("Flatbush diabetes", etc) which can usually produce insulin and don't have auto-antibodies, but will sometimes present with DKA at diagnosis or if discontinuing the oral meds that they needed, such as Gliclazide.

It's a bit weird that you don't have autoantibodies at all, yet got diagnosed as LADA. In LADA there usually are autoantibodies at diagnosis, but the destruction of insulin-producing cells is slow enough that insulin isn't needed during the extended honeymoon phase. But there are other autoantibodies (ICA, IA-2, ZnT8) which can cause it, so being negative for GAD wouldn't entirely rule out LADA.

It might be worthwhile to get more testing if you can - all of the autoantibodies, and c-peptide. Obviously you still have c-peptide activity going on, but higher levels could suggest Type 2.
 
Jamie1991Stables said:
Hi, I was admitted to hospital exactly a year ago and was diagnosed as type 1. I was told I had DKA and began taking novo rapid throughout the day and lantus before bed. But i kept having a hypo, even when only injecting 1 unit. I came off of my injections altogether and haven't taken any injections for 10 months now. I'm being told by one specialist that I'm in the honeymoon phase, but then my diabetic nurse gets my hopes up and theorises that I may not be diabetic at all (I should point out I had pneumonia at the time I was diagnosed type 1).
I'm 6 foot 4 and 14 stone so they ruled out type 2. I guess I'm just hoping I'm not diabetic after all and wondered if anyone could offer an opinion.
Any would be appreciated
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Hi I was in a very similar situation to yourself was committed with dka in july of 2015 and diagnosed type 1 given insulin on release but shortly after had to come off of insulin due to having hypo's on very little insulin.I'm now in the stage of my hooneymoon breakdown so to speak,sugars have been a lot higher than I'm used to over the past 4 months and I'm at diabetic clinic tuesday to have a glucose tolerant test and hopefully after i ll be on insulin,i ve lost about a stone in the past month but no signs of keytones just a lack of insulin i suspect but ya excited for tuesday and all the best bud and diabetes isn t the end of the world :) peace
 
GrantGam said:
C-peptide and GAD antibody tests seem to go hand in hand for accurate diagnosis of T1D. But, because you initially presented with DKA, the doctors will be "certain" that you have T1D because they also go hand in hand as a positive marker of T1D.

There's also genetic testing of sorts for MODY. I don't know (off the top of my head) of any MODY diabetics on the forum to tag here...
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This is all very interesting reading. I have recently been diagnosed with T1D (10 weeks!). No DKA but noticed weigh loss, thirst and tested my own BG to find 30 mmol/l! Had some ketones, but highest reading was 2.9. V.long story after this but basically I was diagnosed by the local Diabetes Specialist as T1D 4 days later - my HbA1C was 70. I started having 12 units of long acting and 20g carbs:1 unit rapid acting, however over the following weeks since diagnosis I've arrived at the point where I can't have any rapid and only take 2 units long lasting morning and night, I actually think I don't need any insulin as I'm drifting quite low and may need to stop the long lasting.

The only way for you to be sure you have T1D (which I know from my recent experience) is for you to be tested for the antibodies that your own immune system has created which will/are attacking the beta cells in your pancreas. GAD antibodies are not the only type of antibody that turn on the pancreas, I believe only 85% of T1Ds have the GAD type. It'll be worth having your blood tested for Anti-Islet cell, ZnT8, IA-2 antibodies also, these are common in newly diagnosed T1Ds.

The c peptide test will be interesting to tell you how much function your are getting from you pancreas, but doesn't really tell you you are diabetic, basically gives a good indication of honeymoon status. My c peptide was 1.17 ug/l a few weeks back, this is at the bottom end of the normal range, and I'd expect this reading to be higher since having to reduce my insulin dose to practically nothing.

I know all this and have all this info blood test as I've been getting involved in clinical trials. Not taking experimental drugs, just trying to do my bit to find a cure - unexpected benefit from this has been lots of info and the chance to speak with the top Diabetes experts in the country.

Good look! Enjoy the honeymoon, that's if you really do have them antibodies in there somewhere!

I'm love the honeymoon - 15 mile runs without hypo risk is a luxury I'm going to enjoy for as long as I can!
 
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