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Cant Figure out my diagnosis--may be a unique case

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xaini29

Member
Messages
10
Location
pakistan
Type of diabetes
Other
Treatment type
Tablets (oral)
hey guys

so i am in limbo of diagnose, kindly help me..i am 32 years old male, obsese with a father who is type 2..

in december 2016 my hba1c was 4.7%, in January i was having sudden severe thirst issues with frequent urination, in march mid i went to the doctor who told me that it was DKA(unknown to me at that time) , i had low PH value with no symptoms at all except thirst and frequent urination. i was admitted and later discharge from hospital 3 days later with metformin and insulin(lantus and rapid) course, i was diagnosed as type 1, my hb1ac came back as 14% in march as compare to 4.7% in december with weight lost of 7 kg in 2 months and tested +++ for ketones initially with +++ sugar as DKA

now i got tested for anti gad <0.16 and anti islet cell negative with Random Cpeptide value of 4 with bloodsugar 139 mg(same time test as cpeptide)

I went to two endo and both are confused with my diagnosis ,i am using 8 points lantus(started with 30 points) in night and dropped rapid insulin(use to be 8 points before every meal) all together , with walk and exercise my BG are now under 120 mostly and fasting 110-120, carb intake (upto 100-120 gms per day)

my endo said all the clinical signs are towards type 1, however test indicates type 2 dka prone...i am confused as to what i am..type 1 or 2 or something else, specially when cpeptide is also normal along with negative anti gad and anti islet

do i need more tests?

any input would be appreciated and excuse my english as its not my first language
 
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It is possible to have both at the same time. I am not saying that is what is happening to you just that it is possible.
 
Sounds like you may be able to get off insulin with diet and exercise and just could be very IR.

Cut carbs, walk and see how it goes. Initial insulin may help andnifnyou change your diet you may be able to get off it.

What is your diet like now?
 
Perhaps you have one of the rarer type of diabetes?... eg. MODY. Have they thought of that? I wish you the best. :)
 
Hi and welcome!

I appreciate that not knowing is very frustrating! But there are a number of different types of diabetes as well as 1 and 2, although they are much rarer. And even T2 can be divided into many different groups (age onset, fatty liver, beta cell death...) although no one really bothers to make the distinction :) )

There is also the possibility of false positives or negatives on your tests, which do happen occasionally.

But the important thing is that you are getting appropriate treatment - and it sounds like you are. :)

Are you testing both blood glucose and ketones regularly?

Oh, and your English is GREAT!
 
There is such a thing as Ketosis Prone t2, perhaps that is what your consultant was referring to.
Have a look at my answer about Ketosis Prone type 2 (aka flatbush diabetes or idiopathic T1) on this thread http://www.diabetes.co.uk/forum/threads/type-1-cured.63416/#post-618081 I think that there are some other posts mentioning it as well.Google it, there are now quite a few articles and papers discussing it. Also there is a blogger with this type of diabetes http://ketosisprone.blogspot.co.uk/p/blog-page_1355.html?m=1
 
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Kristin251 said:
Sounds like you may be able to get off insulin with diet and exercise and just could be very IR.

Cut carbs, walk and see how it goes. Initial insulin may help andnifnyou change your diet you may be able to get off it.

What is your diet like now?
Click to expand...

Even 10 minutes walk drop my bg by 20-30 points which is strange to me but may be after 4 years if sitting in a chair to go walk does that to one :)

I am on like 1000-1200 cals per day with 100-120 gms carb per day
I need to loose 28 kg out of which i have lost 6 kg in last 20 days :)
 
Mep said:
Perhaps you have one of the rarer type of diabetes?... eg. MODY. Have they thought of that? I wish you the best. :)
Click to expand...

My endo says its now between t1 and dka prone t2..i need to read about mody possibility as well i guess
 
Contralto said:
]I see what you mean. You sound a lot like a type 2 but you are on type 1 drugs but that doesn't mean that some type 2s don't also use insulin. I was first put on insulin for a week and then on metformin various doses.

So, there is a type 1 forum here and a type 1,5j type 2m type 3, etc,. Go to tye top bar and after the word Home, check out the various options under the next word, FORUMS

http://www.diabetes.co.uk/forum/

check out the various kinds. Then you will feel more confident when you say to a new doc that you would rather not take insulin any kind if you can take other drugs in case you are a type 2. Then you might get tested again but so what?

Meanwhile, low carb diets work for everyone who is obese, if you are really obese. To know if you are really obese, know your SBMI, i.e. Smart Body Mass Index. For this you will need your age, height and weight. If you are east Asian, you have to list it to make the calculator more accurate.

http://www.smartbmicalculator.com/

Skip all of the Optional questions.

You might not be as obese as you think.

Also important is your waist circumference according to your height and build. A heavy boned man will naturally have a wider wast measurement than a thin boned woman

In diabetes, we are always warned about central obesity, il.e. a waistline measurement and the % of waist to hip measurement.

According to the International Diabetes Federation central obesity =

Waist circumference Women: > 80 cm (31.5 inches)

Waist circumference Men: > 90 cm (35.5 inches with different cut-points for different ethnic groups

And according to the World Health Organization the Waist-to-hip ratio should =\

Women: > 0.85

Men: > 0.9

According to the above, I pass the BMI and SBMI tests but should not lose more weight. According the the central obesity I flunk, i.e. I have central obesity which is a characteristic of diabetes and puts me at heart disease risk.

What languages do you speak more than English?

Oh, and welcome to the forum. It has been helpful to me and after it has helped you, you can help others.
Click to expand...


Thanks for the kind detailed reply


I checked my bmi on smartbme one and my bmi is 34

Sbmi =56/70

Waist is 42 inch on jeans and i have to calculate waist to hip ratio , it may give me a good indication with 6'4 as my height


I would love to join any specific forum but unless i can be diagnosed for sure, no idea which forum to join :d and i do speak couple other native languages :)
 
Brunneria said:
Hi and welcome!

I appreciate that not knowing is very frustrating! But there are a number of different types of diabetes as well as 1 and 2, although they are much rarer. And even T2 can be divided into many different groups (age onset, fatty liver, beta cell death...) although no one really bothers to make the distinction :) )

There is also the possibility of false positives or negatives on your tests, which do happen occasionally.

But the important thing is that you are getting appropriate treatment - and it sounds like you are. :)

Are you testing both blood glucose and ketones regularly?

Oh, and your English is GREAT!
Click to expand...

i am testing blood sugar like 10-12 times a day ,pre meal post meal pre exercise post exercise and what not :) i am yet to test ketones as i thought ketones only are bothersome when bg goes over 250 while mine is 110-130 mostly, correct me if i am wrong. its giving me a good idea of how my body reacts to different things , for e.g high carb in bf will spike my BG as compare to whatever i eat in lunch or dinner wont do anything much to my BG

shall i repeat the tests to make sure? not a problem to repeat tests to rule out false negative, but its highly unlikely to get three test as false neg
anti gad, anti islet both negative and c peptide 4 (tested twice)

and i had fatty liver for a while
 
phoenix said:
There is such a thing as Ketosis Prone t2, perhaps that is what your consultant was referring to.
Have a look at my answer about Ketosis Prone type 2 (aka flatbush diabetes or idiopathic T1) on this thread http://www.diabetes.co.uk/forum/threads/type-1-cured.63416/#post-618081 I think that there are some other posts mentioning it as well.Google it, there are now quite a few articles and papers discussing it. Also there is a blogger with this type of diabetes http://ketosisprone.blogspot.co.uk/p/blog-page_1355.html?m=1
Click to expand...

my both endo says i am most likely dka prone type 2 but they both also says that all the clinical signs are of type 1 hence they can't confirm anything for now
 
Then keep walking and keep low carbing!!! You're going the right way.

I can't comment on the DKA but sounds like you're regaining insulin sensativity which of course is a good thing.

I used to take a slow to moderate 15-20 min walk after meals and it would always lower me. Not anymore but that's a different story.

Breakfast is usually the hardest meal to get right. And if we don't get it right it can set the tone/ pace for The Whole day. Many of us are better with a lower carb fattier bf and saving the carbs for later in the day as we become more sensitive then.

Congrats on taking the bull by the horn!
 
you are absolutely right, high carb breakfast meal makes it harder for me to control bg whole day, i had bread today in breakfast and now (post meal 1 hour in 140s instead of 110s) however 10 minutes easy walk just bring my BG down to 95 from 145..weird for me atleast or may be walk just solve my insulin resistance

i read hard exercise can cause high BG, but after breakfast , one hour gym also bring my BG down by 60-70 points around

why walk doesn't bring your BG down anymore?

Kristin251 said:
Then keep walking and keep low carbing!!! You're going the right way.

I can't comment on the DKA but sounds like you're regaining insulin sensativity which of course is a good thing.

I used to take a slow to moderate 15-20 min walk after meals and it would always lower me. Not anymore but that's a different story.

Breakfast is usually the hardest meal to get right. And if we don't get it right it can set the tone/ pace for The Whole day. Many of us are better with a lower carb fattier bf and saving the carbs for later in the day as we become more sensitive then.

Congrats on taking the bull by the horn!
Click to expand...
 
Walking ( and exercise in general) can make us more insulin sensativity. I'm type 1 one requiring insulin and walking and all forms of exercise including washing the floors raises me and I would require extra injections. We are all different but many type 1's find the same as me and many go lower. The morning is especially bad. I need to take it easy for the first two hours or so after I get up. This is when cortisol and adrenaline are waking up. When I do anything that raises my heart rate which in turn raises my cortisol and adrenaline I go higher.

I haven't eaten bread in forever. Avocado/ guacamole with celery has been my breakfast for years and I look forward to it every day :).

If my fasting is high I stay high all day. I can bring it down with insulin butnit just pops right back up.

I'm happy you're doing so well and are taking it seriously and testing testing testing as well as adjusting your diet. I couldn't function on that many carbs but some can. If you want your numbers lower at any point you know where to look. Knowledge is power !!
 
Kristin251 said:
Walking ( and exercise in general) can make us more insulin sensativity. I'm type 1 one requiring insulin and walking and all forms of exercise including washing the floors raises me and I would require extra injections. We are all different but many type 1's find the same as me and many go lower. !!
Click to expand...

I'm one that goes lower the more activity I do. So I have to plan my activity by taking less insulin. If I do unplanned activity that's when I get in trouble. I basically find myself having to eat more to keep my sugar level up.
 
Mep said:
I'm one that goes lower the more activity I do. So I have to plan my activity by taking less insulin. If I do unplanned activity that's when I get in trouble. I basically find myself having to eat more to keep my sugar level up.
Click to expand...

I am loosing like 30 bg points for a 15 minutes walk

If i am doing gym, i loose around 60-70 points, however it doesn't go below 85 for last 15 days i am checking
If i eat high carb it will go around 80-90( post workout)
If i eat low carb it will stay in 105-110(post workout)
 
hey guys--first of all accept my thanks for helping me when i was panic
smile.png
...so after some time my doctor confirm my diagnose as type 2 DKA prone. my Hba1c is now 5.8% with very normal eating habits and i am sure i can manage it to 5.2-5.4% in my next test
Exercise does worked well with me and freestyle libre helped me a lot to understand that what food effects me and how does my overall body works with diabetics..

Raw apple cider vinegar and Organic Cinnamon Ceylon also work wonders on BG

i also found that R lipoic Acid is a great supplement to add as well, i am going in cycles with good supplements

thank you again
 
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