Consultant unsure which type despite positive GAD result

[searley]

If the consultant expects the metformin to have much of an effect with the insulin then he does not know much about diabetes and the way metformin works. I would expect you to be T1. A Positive GAD and low insulin thru C-peptide for most medics would 'prove' T1.

My dad T1 for many year was recently put on metformin and it massively improved his control.. and in the time he has been on it his hba1c has dropped significantly

so while it may have little effect for some/most there are some that it helps greatly... its important to remember everyone is different so what 1 person experiences may be completely different to the next.. personally i had major issues with metformin and they could pay me enough to take it again...

 

[searley]

I think this is the main stressor as having an official diagnosis can open up different doors. I know with both types that diet and exercise are important but more so to get into remission with T2 so it’s a little frustrating but I’m just going to do the best I can

I’d love a continuous monitor, my fingers hate me right now lol I’ve already got hyperthyroidism so that’s being checked every 3 months anyway. Misery loves company ay lol

Thank you so much, virtual hugs back to you I appreciate your time and support x

in the short term it doesn't matter but as you state it become more important if you wish to get back to diet control only so T2 may allow that.... on the other hand an official T1 opens thing up a little in treatment choices.. so yes you will want to know.. but somethings can't be rushed its not always clear cut in the early stages

 

[HSSS]

Yes I agree it definitely makes sense towards T1 but she said because I only had 1 positive GAD test instead of 2 or 3 and the family history of T2 on my dads side she just can’t give an answer

With gad antibodies, weight loss, low insulin what else does she want for goodness sake? A second opinion could be in order here to get the official diagnosis to open up the full range of management options (pumps/cgm etc)

The only thing for type 2 would be your dad and that is nowhere near as strong as the rest of it.

 

[BethJo]

My dad T1 for many year was recently put on metformin and it massively improved his control.. and in the time he has been on it his hba1c has dropped significantly

so while it may have little effect for some/most there are some that it helps greatly... its important to remember everyone is different so what 1 person experiences may be completely different to the next.. personally i had major issues with metformin and they could pay me enough to take it again...

Completely agree with this. I had no idea there’s actually more types of diabetes than just T1 and T2, there’s so many misconceptions and confusion around it all in general but now I know the basics I think the metformin is a good step to take for me. Like you said, everyone’s different

 

[BethJo]

in the short term it doesn't matter but as you state it become more important if you wish to get back to diet control only so T2 may allow that.... on the other hand an official T1 opens thing up a little in treatment choices.. so yes you will want to know.. but somethings can't be rushed its not always clear cut in the early stages

Yea definitely it would be more clear on the treatments etc I need to go through. I think the unsurity (not a word I know lol) is certainly because I’m so early on. Unfortunately it seems the insulin isn’t helping much, I reached a highest level of 22.6 yesterday evening. I feel the effects of it all though, literally falling asleep here there and everywhere lol

 

[searley]

Yea definitely it would be more clear on the treatments etc I need to go through. I think the unsurity (not a word I know lol) is certainly because I’m so early on. Unfortunately it seems the insulin isn’t helping much, I reached a highest level of 22.6 yesterday evening. I feel the effects of it all though, literally falling asleep here there and everywhere lol

Insulin works… it is just early yet you’ll need to work with your care team on dose adjustment.. basically if your too high.. you’ve not had enough insulin somewhere

Your care team may have just put you on a starter dose.. expect you to make records then communicate with them and they will suggest dose changes… that’s certainly what happened for me

 

[BethJo]

With gad antibodies, weight loss, low insulin what else does she want for goodness sake? A second opinion could be in order here to get the official diagnosis to open up the full range of management options (pumps/cgm etc)

The only thing for type 2 would be your dad and that is nowhere near as strong as the rest of it.

Honestly, I have no idea ‍ to me it’s blatantly obvious and clearly it is to others too but she’s basing it purely on the T2 in my family. My dad was diagnosed at around age 50 and she said “most of the time the diagnosis gets younger through generations” ermmm since when lol

I agree a second opinion might be a good idea, I’ll speak to my GP and see if I can be changed clinics as he’s set on it being T1. He even said he doesn’t understand what the consultant is confused about lol

 

[busygardener]

Hi there. Just read your posts and it sounds just like me. I was diagnosed 14 years ago as T1 because my diabetes came on so quickly - within a few months. I'd had years of serious stress and that's what brought it on. I was put onto insulin straight away but it became increasingly difficult to keep my levels under control. For a couple of years or so I was on and off insulin. Eventually my consultant decided it was not T1 at all but T2. Since then no insulin, just medication - initially gliclazide and metformin but now just metformin. Things often take time to sort out so it's probably early to worry too much yet.

 

[Antje77]

Unfortunately it seems the insulin isn’t helping much, I reached a highest level of 22.6 yesterday evening. I feel the effects of it all though, literally falling asleep here there and everywhere lol

Finding the right dose can only be done by trial and error, so they start you out on a low dose and titrate up depending on your blood glucose.
Some people need less than 10 units a day, others a couple of 100. So in the early days it's completely normal to see high levels still when on insulin!
The falling asleep is likely caused by high BG's, not by insulin.

 

[Rokaab]

Also to add to what @Antje77 said even after you been at it a long time, some days it will just all go pear shaped and just not behave for no apparent reason

 

[Daibell]

My dad T1 for many year was recently put on metformin and it massively improved his control.. and in the time he has been on it his hba1c has dropped significantly

so while it may have little effect for some/most there are some that it helps greatly... its important to remember everyone is different so what 1 person experiences may be completely different to the next.. personally i had major issues with metformin and they could pay me enough to take it again...

OK, I accept we are all different. I've been taking Metformin for 20 years now and insulin for 8 years. When I stopped Metformin for a while it made a change of about 1 mmol in my BS so very little for me. My BMI is 22 and low body fat so it may be that it helps more with others.

 

[BethJo]

Here’s a funny one for you guys if anyone sees this. So if you look through my thread you’ll see all the details relating to my questions. Since starting metformin 4 days ago and only taking long lasting insulin once in those 4 days because I’ve felt like ****, my glucose levels have actually stayed at a steady level around 10. I’m shocked to say the least and I’m now questioning whether I actually have type 2 diabetes. The positive GAD test is strange though as surely I wouldn’t have that at all with T2 ‍ very confusing times!

 

[EllieM]

Here’s a funny one for you guys if anyone sees this. So if you look through my thread you’ll see all the details relating to my questions. Since starting metformin 4 days ago and only taking long lasting insulin once in those 4 days because I’ve felt like ****, my glucose levels have actually stayed at a steady level around 10. I’m shocked to say the least and I’m now questioning whether I actually have type 2 diabetes. The positive GAD test is strange though as surely I wouldn’t have that at all with T2 ‍ very confusing times!

I'd be really careful about skipping insulin because you feel bad. Have you talked to your team about this? Metformin can help some T1s a lot, so it might well reduce your levels, but 10 is still above normal levels for non diabetics. Remember that if your insulin production goes down to zero (which will happen eventually if you are T1) then you'll die quite quickly without it. And it's common for some new T1s to have a honeymoon period, where they produce more insulin for a while.

If you're getting gastro issues because of the metformin, try asking for the slow release version.

Good luck, and I'm glad your levels have come down.

 

[BethJo]

I'd be really careful about skipping insulin because you feel bad. Have you talked to your team about this? Metformin can help some T1s a lot, so it might well reduce your levels, but 10 is still above normal levels for non diabetics. Remember that if your insulin production goes down to zero (which will happen eventually if you are T1) then you'll die quite quickly without it. And it's common for some new T1s to have a honeymoon period, where they produce more insulin for a while.

If you're getting gastro issues because of the metformin, try asking for the slow release version.

Good luck, and I'm glad your levels have come down.

I’ve not spoke to them about it no, the consultant said to stay on it but the insulin seems to keep my levels really high even on the metformin. I’ll carry on taking the insulin with the metformin from now on even if it causes high levels as I know it’s dangerous in T1 not to have the insulin. I woke up today with a level of 8.2 but that’s a 15 hour fasted reading so the metformin is definitely doing it’s job. I’ll speak to the team at my next appt next week yea I’m definitely struggling with the side effects of the metformin, I can barely eat.

I’ve read about this honeymoon phase as well which makes sense as I was diagnosed in May and have likely developed diabetes somewhere after Christmas going on the timeline of results etc

Thank you, fingers crossed they stay low lol x x