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Am I type 1 or Type 2 ?

S

Spirit of Eden

Well-Known Member
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I was just about to create a signature for the forum (which i'm really pleased to be part of) and to be honest I don't actually know what "type" I am. I've asked my health pros and they never give me a straight answer.

So what do you think ? Your thoughts would be much appreciated for the next time I bring the subject up. Psychologically its good to know exactly what you are suffering from and I can also fill in my sig ! The evidence is ...

I was first diagnosed over 4 years ago after complaining of blurred vision, tingly feet etc. It was a bit of a shock (even to my GP) as I wasn't overweight and do a lot of sport. Was started on Metformin, then Glicazide was added. More Metformin was added until I was on max dose. On this regime I never really got the numbers under control.

Earlier this year I dropped a load of weight. The concensus was that there wasn't enough insulin being produced. Stopped Oral meds and moved on to Insulin only. Numbers are much better now and gaining weight.

As I understand it, Type 2's have plently of insulin but cant use it, type 1's dont have enough insulin to clear glucose. Since taking insulin I have hypo'ed a few times which suggests my body appreciates the extra insulin.

Thanks in advance for your thoughts
Paul
 
I would guess you are type 2 however your healthcare team can run a blood test which will determine for sure your not type 1.5 only they can really answer this question.
 
Hi Paul!

There are lots of misdiagnosed LADA diabetics. The medical world doesn't believe it matters to have an accurate diagnosis as the early treatment is the same. Personally, I think that is rubbish! The tests you need are:

GAD antibody test - checks for antibodies. Positive test usually indicates an autoimmune form of diabetes i.e. Type 1/1.5
C-Peptide test - tests how much insulin you are producing. This test is used in preference to the insulin test because injected insulin contains no c-peptide and so it can effectively differentiate between the insulin you are injecting and that which you are producing.

Together these tests help to differentiate between autoimmune (Type 1/1.5) and metabolic (Type 2) forms of diabetes.

Smidge
 
From what you describe above it sounds like you've started off being diagnosed and treated as a Type 2 until they can tell whether you're actually producing sufficient insulin yourself, but then when your numbers weren't much better they've decided you're not producing enough insulin and so they've changed your treatment to administering insulin.

I would say that makes you a Type 1 and from what I've gathered from other forum members when I've asked questions about hypos, I've heard that hypos generally only occur if you're a Type 1 on insulin.

I hasten to add I'm no expert, but am speaking from what I've learned whilst being on the forum. :)
 
Hi. It certainly sounds like you are a late onset T1 (LADA). Are you also fairly young? Insulin is the right treatment. As others have said the C-peptide and GAD tests would prove the T1 but I think you would need to do the c-peptide without having any insulin injections at the time as it measures your natural level of insulin. As you will see on the forum the NHS is really bad at diagnosing LADA. GPs like mine just assume there are only two diabetes types i.e. T1 at birth and T2
 
Hey Guys

Daibell said:
As others have said the C-peptide and GAD tests would prove the T1 but I think you would need to do the c-peptide without having any insulin injections at the time as it measures your natural level of insulin.
Click to expand...

Injected insulin makes no difference to the c-peptide test. When the body forms insulin, it is in two parts which split into 1 insulin part and 1 c-peptide part. Injected insulin has no c-peptide attached to it. Hence by measuring c-peptide levels instead of insulin levels, they only count the natural insulin. This is one of the reasons that c-peptide is measured in preference to insulin.

Smidge
 
Hey Grace!

GraceK said:
I would say that makes you a Type 1 and from what I've gathered from other forum members when I've asked questions about hypos, I've heard that hypos generally only occur if you're a Type 1 on insulin.
Click to expand...

Not quite. Poorly-controlled Type 2s will also progress to needing insulin because constantly-high BGs will cause the death of the pancreatic beta-cells. So in progressed Type 2s, they will not produce enough insulin and they will need to inject insulin - usually large doses of it because they will also probably be insulin-resistant. This doesn't make them Type 1. Once a Type 2 is on insulin, they are also at risk of hypos.

Hope that explains!

Smidge
 
Testing for "Which type" costs money and makes little difference to treatment, so it's rarely done. Much diagnosis in this field is done by Assumption. I.E. if you are middle aged and oveweight, you MUST be T2 if you are a child, you MUST be T1. this is now known to be wrong. However, since it makes so little differnce to treatment protocols, It's just not cost effective to test. Oral medication usually only works in T2. Insulin works for all types of DM.
Hana
 
I wouldn't have thought it was cost effective for a type 1.5 to go through the whole gamut of oral meds only to find that none of them work. Surely a saner and cheaper solution would be to test inconclusive diagnoses and go straight on to the correct medication ie: insulin, in however small doses that may be required in the early days?
Just a thought after 2 years of trial and error and virtually uncontrolled levels along with the anxiety that accompanies it. I am now on insulin and back in control. :thumbup:
 
Hey Dib!

dib said:
I wouldn't have thought it was cost effective for a type 1.5 to go through the whole gamut of oral meds only to find that none of them work. Surely a saner and cheaper solution would be to test inconclusive diagnoses and go straight on to the correct medication ie: insulin, in however small doses that may be required in the early days?
Just a thought after 2 years of trial and error and virtually uncontrolled levels along with the anxiety that accompanies it. I am now on insulin and back in control. :thumbup:
Click to expand...

Yes, I couldn't agree more! Especially as Type 2s are left to get on with it and are actively discouraged from testing - as are misdiagnosed LADAs. LADA can get way out of control on an NHS carb-rich diet with no testing - as I know to my cost :roll: Also, we all need an accurate diagnosis so that we can make informed decisions about our treatment and we all deserve an accurate prognosis so that we can plan our lives! It makes me really mad to see more and more people coming through the forum without those basic rights fulfilled.

Smidge
 
This issue keeps coming round -- is there a case for having a separate section of the forum for non-T1/T2, so that people can find it? It's understandable and proper that the forum has separate sections for T1 and T2, but that does send an inadvertent message that you must be one or the other.
 
I would say there is a case for a type 1.5 subsection, this was mooted quite some time ago but nothing came of it. I do get a bit fed up reading about so many weightloss successes (all power to you that need to none the less) - Weight has NEVER been a problem for me and did not play a part in my diagnosis as I am sure it hasn't for many other member's of this forum.
 
Thanks so much for your thoughts and advice.

I can see that an outright test (which I was unaware of) would settle the matter. The disappointing thing is that despite being quizzed my condition, my GP never even mentioned this as a possibility and yes discouraged me from testing etc. He even said "i've no idea why you are Diabetic. you shouldn't be" !

I'm aged 50 (46 at diagnosis) BMI of 23 and active in several sports and seemingly quite sensitive to insulin, so the profile that best describes me is LADA 1.5. So thats whats going on my sig :)

Sort of looking forward to my next appointment now to "have it out" with the Doc.


Thanks for the Ammo !
Paul
 
Hello tizzy.
LADA stands for latent autoimmune diabetes (in) adults...
Basically it is classed as a slow onset Type1 .
Hope this helps.
Anna.
 
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