C-Peptite Test

[alimar77]

As a type 2 for 18 years with severe insulin resistance, I keep wondering whether I can ask for a C-Peptide Test to see how much insulin, if any my body is making.

On Metformin and Alogliptin even when I eat well and avoid carbs my BGs are always high, and when on insulin I’m injecting massive doses which gives control but still it remains higher than I would like.

If I knew how much insulin I was producing it might make me understand what I can and can’t eat?

Is it possible to really reverse T2 diabetes after 18-years?

 

[In Response]

If I knew how much insulin I was producing it might make me understand what I can and can’t eat?

I was not aware you can work it out that way. Are there graphs showing “if your body is producing x amount of insulin, you can eat y amount of carbs a day”?
My understanding was that we are so different that two people maybe about to eat the same amount of carbs but one can eat porridge and the other finds porridge sends their levels soaring.
Do you test your levels before eating and 2 hours later to see if your body can cope with each meal based upon the rise (a rise of no more than 2mmol/l 2 hours after eating means your body can cope).

 

[alimar77]

I was not aware you can work it out that way. Are there graphs showing “if your body is producing x amount of insulin, you can eat y amount of carbs a day”?
My understanding was that we are so different that two people maybe about to eat the same amount of carbs but one can eat porridge and the other finds porridge sends their levels soaring.
Do you test your levels before eating and 2 hours later to see if your body can cope with each meal based upon the rise (a rise of no more than 2mmol/l 2 hours after eating means your body can cope).

I test before and after meals but it seems no matter what I eat, even on insulin my levels rise rapidly.

I was under the impression a C-Peptide test can tell you whether your own pancreas is still producing insulin and how much. I think they use this test to distinguish from type 1.5 and type 2 diabetes.

 

[EllieM]

Is it possible to really reverse T2 diabetes after 18-years?

It's certainly harder the longer you have been diabetic

What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss | BMJ Nutrition, Prevention & Health

But that doesn't mean you can't reduce your insulin and (possibly) lose weight by reducing carbs,

Personally, as a T1 with some insulin resistance (thanks T2 dad) I have found my weight tends to gradually increase unless I watch my carbs. I've finally lose some weight this last year (down from borderline obese to a bit overweight), a combination of lowish carb and a bit of care with calories (moderation on cheese and alcohol) works for me.

But I stress that I am cross posting here, so what works for me may not work for you.

In your position I would be interested in a cpeptide test, just to see how much insulin I was still producing, but am also not sure whether T2 endogenous insulin production can improve if bg levels reduce (my understanding is that high sugar levels damage insulin producing cells). I suspect your doctor's attitude may be that it doesn't matter how much insulin you are producing because it doesn't affect the amount of insulin you need now?

And if you do try reducing carbs to reduce your levels then please be careful - insulin needs are likely to change and if you aren't confident to deal with those changes you'll need to consult with your team.

Good luck, whatever you decide to do.

 

[Antje77]

As a type 2 for 18 years with severe insulin resistance, I keep wondering whether I can ask for a C-Peptide Test to see how much insulin, if any my body is making.

You can definitely ask for it.

I was under the impression a C-Peptide test can tell you whether your own pancreas is still producing insulin and how much. I think they use this test to distinguish from type 1.5 and type 2 diabetes.

Correct.
And I was wondering if you've ever had tests to see if you might be something else than a T2.
You were diagnosed in your twenties, which is very young, and you also developed DKA on flozins, which is well possible with T2 but more common with other types.

Are you being treated for your diabetes by a GP or are you under hospital care with an endocrinologist?

 

[alimar77]

You can definitely ask for it.

Correct.
And I was wondering if you've ever had tests to see if you might be something else than a T2.
You were diagnosed in your twenties, which is very young, and you also developed DKA on flozins, which is well possible with T2 but more common with other types.

Are you being treated for your diabetes by a GP or are you under hospital care with an endocrinologist?

I am guessing you mean Type 1.5 … I have wondered this myself many times. I think the reason I got the type 2 label was because I was overweight so an automatic assumption was made by the NHS.

I am under the main diabetes team via a stand alone clinic, but barely see anyone and it’s always telephone appointments. I do intend to call to have a chat with a diabetic nurse about the C-Peptide Test.

What’s more bizarre is my mum was a type 2 or was diagnosed as a type 2 in her 50s but she went straight onto insulin, and she was of normal weight, but had renal failure and was on dialysis. I was told they blamed her diabetes on the sugar in her CAPD dialysis bags for the cause of her late onset diabetes. I have often wondered if she did in fact have Type 1.5, and if she knew and just referred to it as Type 2 because it was easier than explaining Type 1.5.

Her death certificate blames her renal failure and diabetes, she was 61 and had excellent control with insulin.

 

[alimar77]

It's certainly harder the longer you have been diabetic

What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss | BMJ Nutrition, Prevention & Health

But that doesn't mean you can't reduce your insulin and (possibly) lose weight by reducing carbs,

Personally, as a T1 with some insulin resistance (thanks T2 dad) I have found my weight tends to gradually increase unless I watch my carbs. I've finally lose some weight this last year (down from borderline obese to a bit overweight), a combination of lowish carb and a bit of care with calories (moderation on cheese and alcohol) works for me.

But I stress that I am cross posting here, so what works for me may not work for you.

In your position I would be interested in a cpeptide test, just to see how much insulin I was still producing, but am also not sure whether T2 endogenous insulin production can improve if bg levels reduce (my understanding is that high sugar levels damage insulin producing cells). I suspect your doctor's attitude may be that it doesn't matter how much insulin you are producing because it doesn't affect the amount of insulin you need now?

And if you do try reducing carbs to reduce your levels then please be careful - insulin needs are likely to change and if you aren't confident to deal with those changes you'll need to consult with your team.

Good luck, whatever you decide to do.

Thank you for sharing this.

I’m going to reduce carbs and monitor more often, I’m using Libre. I am pretty confident on playing around with insulin. I didn’t do any yesterday, naughty me.

Having lost 50kg I’m terrified of gaining weight back, yeah I’m still overweight and could do with losing another 30kg, so maybe finally giving up the carbs especially potatoes and bread is the way to go, and ensuring others don’t try and control what I eat!

I also need to get back out and go for walks, I’m barely getting any exercise now since losing my dog earlier this year.

 

[EllieM]

I also need to get back out and go for walks, I’m barely getting any exercise now since losing my dog earlier this year.

I forgot to mention exercise on my weight loss comment. It definitely helps me. We lost our last dog last year and still greatly miss her. It's so much easier to take regular exercise when a furry friend relies on you for your daily walk or walks.
I know it's the nature of human and dog lifespans that you tend to outlive your pets, but it still hurts. My commiserations for your loss.

 

[LonelyFatGuy]

I was on the Randox website the other day for unrelated reasons, but I noticed that as part of some of their tests they do C-Peptide. Might be worth keeping that in mind if your doctor says no to performing the test.

They have a test called 'Discovery' that includes a bunch of stuff, and costs £195, and specific to diabetes they list:

Glucose
HbA1c
Insulin
C-Peptide

 

[alimar77]

I was on the Randox website the other day for unrelated reasons, but I noticed that as part of some of their tests they do C-Peptide. Might be worth keeping that in mind if your doctor says no to performing the test.

They have a test called 'Discovery' that includes a bunch of stuff, and costs £195, and specific to diabetes they list:

Glucose
HbA1c
Insulin
C-Peptide

Good to know, thanks for that!

 

[alimar77]

I forgot to mention exercise on my weight loss comment. It definitely helps me. We lost our last dog last year and still greatly miss her. It's so much easier to take regular exercise when a furry friend relies on you for your daily walk or walks.
I know it's the nature of human and dog lifespans that you tend to outlive your pets, but it still hurts. My commiserations for your loss.

He was our rescue and with us for 11 years, he was my reason for getting out, even on bad days those eyes and waggy tail dragged me out!

 

[Outlier]

My last dog died just over a year ago, and like everyone else who has been through this, it still hurts. But I walk every day, sometimes where we used to walk, sometimes in nice places where it wouldn't be safe to take a dog. I thought it would be hard to meet other dogs, but in fact it is a comfort. This morning for instance I met five 'regulars' who all gave me dog snuggles.

 

[Antje77]

I am guessing you mean Type 1.5 … I have wondered this myself many times. I think the reason I got the type 2 label was because I was overweight so an
automatic assumption was made by the NHS.

Type 1.5 or LADA is T1 (an autoimmune condition), it just comes on slower so it tends to look like T2 at first, especially if you're overweight.
Being overweight also means there is a fair chance of insulin resistance as well, which is a trait of T2, but this doesn't change a T1 diagnosis in T1's.

I'm fat and got diagnosed with T2 at 39. I asked for a referral to look into the possibility of T1 after 2 years. The practice nurse didn't understand why I thought I might be anything but a straightforward T2, but she was happy to refer me.
For me, the change of diagnosis didn't change my treatment, I was on insulin after a month of my original diagnosis.

What’s more bizarre is my mum was a type 2 or was diagnosed as a type 2 in her 50s but she went straight onto insulin, and she was of normal weight

There are more types than only T1 or T2, and with a family history of diabetes presenting in a somewhat unusual way, it can be worth thinking about MODY as well.

I agree with everyone on the loss of a dog. I lost my first dog 3 years ago, and the grief is still strong, and not unlike the grief I feel over my parents. I still have two little dogs and I love them a lot, but I don't have the same relationship with them as I had with that first dog.

 

[In Response]

Type 1.5 or LADA is T1 (an autoimmune condition), it just comes on slower so it tends to look like T2 at first, especially if you're overweight.

There have been a few discussions about this recently.
It seems there is no official definition.
Some say diagnosis with Type 1 as an adult is LADA. Some say Type 1 with insulin resistance is Type 1.5.

This is probably why some doctors don't bother with either terms and just call it Type 1.