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Am I Type 1 or Type 2

D

Distroyer

Member
Messages
11
Hi All,

This is my first post in this forum. I've been diagnosed with Type 1 Diabetes in April 2021. My Hba1c was 120 at that time. It came to me as big shock and was just 1 week after my 40th birthday. I am very healthy and active person, played my sports and did gym at least 3 times a week.

During diagnostic they couldn't decide if I was Type 1 or 2 so prescribed me Metformin and also insulin. It was big shocker and just kept crying for a week at least thinking about rest of my life I have to inject myself with insulin and doing finger pricking. Later they did GAD test and said I was type 1.

Since then I am not taking any mealtime insulin (Repo), only take metformin (1 x tablet twice a day) and 6 unit of lantus every morning. I have also made big change to my lifestyle, cut down carbs by avoiding sugary food and bread/rice/pasta. I eat very healthy and still include 30-grams of carbs in my meal. This plus exercising and doing walks of meals. I have CGM so I can see how certain food affects my sugar levels but generally I am still able to keep my level within range. I do get after meal spikes sometimes depending on what I eat and the spike is upto 10-12 mmol/L. It does go down to 6 after 2-3 hours. Also when I do gym sessions I eat 40 - 50grams of carbs afterwards and level does not go up more then 10mmol/L

My Hba1c in April 2021 was 120
Sep 2021 was 45
and my last months report was 43.

This is makes me wonder is it diet and exercise that is helping me and if it is then its normally associated with Type 2 Diabetes. They told me I was Type 1 and will need insulin every time I eat carbs. In the beginning I got Hypos all the time so was advised to stop it and just take Lantus. My last appointment they said reason I am doing well is I could be still in my honeymoon period. When I read about it I found out that it is normally 2-3 month, surely it cant be this long.

I am just wonder if there is anyone out there with similar experience and can provide any advise.
Thanks
 
If they tested for antibodies they confirmed you have an autoimmune condition, this is different to type 2. The honeymoon period can be a significant time period. I suggest you do your best to retain some of your beta cell function as long as you can because it helps with blood glucose control - keeping blood glucose in range will help with that.
 
Thanks for reply Jonathan.
Currently not taking Bolus Insulin. Will the affect retaining beta cells? Worried if it will make it worse in the future.
 
Hi My nurse tells me the honeymoon period can often last 6 years. I am 4 years in and am still in honeymoon phase. It’s normal to see an initial improvement at the beginning when starting on insulin and I too have much better control when eating low carb. Walking and the weather really effect me too.
 
Distroyer said:
Thanks for reply Jonathan.
Currently not taking Bolus Insulin. Will the affect retaining beta cells? Worried if it will make it worse in the future.
Click to expand...
I too started on basal and bolus but had to drop the bolus due to many hypos but as time has gone on I had to gradually reintroduce the bolus. I think this is quite common. It’s early days for you, sounds like you are doing well. I too read up about beta cells I remember reading Dr Bernstein diabetes solution. Have you read this? He answers lots of questions. I am not sure of the answer regarding beta cells but at the moment if you took bolus insulin surely it would only give you hypos? You are replacing your basal though. There have been discussions on here about preserving beta cells that you could read through. Or maybe someone else might know a bit more?
 
Forgot to say congratulations on fantastic HbA1c ! You are obviously doing all the right things.
 
Thank you all

Thing is I’m currently taking metformin 1x500mg tablet with meal. On the advice of diabetic nurse I stopped it for couple of weeks because she said I am type 1 and don’t need to take it. It was only prescribed to me in the beginning because they were not sure if I was type 1 or 2.

During those 2 week period my sugar control was bad. I started getting big spikes after meals and level were staying high for more then 3 hours. So I started to take metformin again and controls are better again. This is the reason I posted this question and trying to understand what it could be.

Thanks
 
It sounds like you need something with meals I would guess the alternative to the metformin would be to take some bolus insulin with meals. Have you discussed this with your diabetic nurse?
 
Distroyer said:
This is the reason I posted this question and trying to understand what it could be.
Click to expand...

Some people call LADA T1.5 because it has some commonalities with T2 and metformin often helps its sufferers, at least for a while. Note that T1s can get prescribed metformin and I believe @Antje77 is currently taking it,
 
I see I've been tagged twice in this thread on different subjects.
I'll have a good read of it tomorrow to see if I can add any useful thoughts!
 
Distroyer said:
Thanks for reply Jonathan.
Currently not taking Bolus Insulin. Will the affect retaining beta cells? Worried if it will make it worse in the future.
Click to expand...
Dr Bernstein's approach is to restore normal blood glucose levels which includes a low carbohydrate dietary approach. I suggest you watch some of his videos on youtube and read his book Diabetes solution. Reducing the blood glucose swings and then reducing the level at which you control blood glucose will help retain beta cell function because high blood glucose is toxic to beta cells and damages many proteins in the body.
Dr Bernstein recommends treating hypos with glucose tablets as this gives a more predictable rise in blood glucose without the need for digestion.
My blood glucose control is improving but I have still not achieved the very tight targets he uses for both himself and his patients - so think of it as a continuous improvement journey rather than something you can necessarily achieve in a very short timescale.

I also initially started on basal insulin only but as the beta cells are killed off I needed to both increase the basal dose and start with bolus doses for both carbs and protein. You will also need a more rapid acting insulin for treating high blood glucose readings for example when you are ill.
 
Hertfordshiremum said:
@Antje77 Any links to info on preserving beta cells ?
Click to expand...
I have looked into this a couple of years ago.
From what I could find, there are quite a few people who believe taking gliclazide hastens the process, but I haven't been able to find conclusive literature on that.
I've also found the belief that insulin will slow the process, but again, couldn't find conclusive literature on it.
Another school of thought is that eating LCHF or even keto can prolong the honeymoon.
I don't know if that's correct, but it obviously means you need less insulin so it makes sense you'll be able to hold out longer as your beta cells decrease. This seems to be your approach at the moment, @Distroyer , and it apparently works well for you at the moment.

Then there is the question of if preserving beta cells is beneficial.
For some, the honeymoon period is great, as their pancreas is helping out and seems to be smoothing dosing errors.
For others, the honeymoon period is a nightmare, with the pancreas spluttering out insulin on and off in a most unpredictable way, making it impossible to find rhyme or reason in the amount of insulin you need.

For myself, I decided that there is simply not enough known about both the best method or the benefit of trying to preserve beta cells for as long as possible.
So I just left my beta cells to do whatever they pleased, and I concentrated on keeping my blood glucose as stable as I could. I'm very happy I can adjust my insulin to my food, even though I eat lowish carb usually.
EllieM said:
Some people call LADA T1.5 because it has some commonalities with T2 and metformin often helps its sufferers, at least for a while. Note that T1s can get prescribed metformin and I believe @Antje77 is currently taking it,
Click to expand...
Glad to say I'm not a 'sufferer', I'm just a diabetic!
But yes, I've been on metformin for the past 3 months. I think it helps me, but things are a bit muddled because I got a 2 week illness a few weeks after starting the metformin (either covid or a very strange cold) which definitely didn't help with BG control.
Distroyer said:
So I started to take metformin again and controls are better again. This is the reason I posted this question and trying to understand what it could be.
Click to expand...
If it helps, it helps, so that's a good thing!
Metformin doesn't do anything to make your beta cells do anything different, so it helping isn't in any way indicative of not having T1.
Sounds like a normal T1 honeymoon to me.
 
Thanks Antje for useful info. I find taking insulin shot bit stressful and easier to control BG with current regime. Just wish if it stays like this.
 

I was in a similar boat.. except was told T2

They have told you t1 so that is more likely what you have... the trouble when getting t1 at the age of 25plus is normally a slower onset t1.. so you can be producing some insulin for many years... just not enough to keep BG low enough... and over time that insulin production will stop/almost stop

But until you insulin ceases it's easer to control your diabetes as your insulin production help provide a buffer for dose errors.. if you take slightly too much insulin you body will produce less.. making control easier

I went for spells where I stopped insulin for many weeks.. then all of a sudden massive increase in bg when my pancreas couldn't keep up
 
Distroyer said:
Thing is I’m currently taking metformin 1x500mg tablet with meal.
Click to expand...

Just checking that you know that Metformin can help your body by reducing insulin resistance and glucose take up from the gut, but that it is a long term medication and won't make a difference immediately after taking.
Taking with food generally helps with any side effects such as dodgy guts.
 
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