diabetes type 1 or 2

[ecneps48]

hello I have been diabetic for about 20 years I started of with tablets and I am now on Insulin my question is how do I know if I am NOW type 1 or 2
I need Insulin to bring my blood sugars down withot Insulin I cannot bring my blood sugars down does this mean I am now a type 2 diabetic

 

[Rokaab]

Just because you need insulin does not mean you are Type 1; Type 1 and Type 2 are actually two completely separate conditions that can lead to the same treatment.
I.e. Type2 does not turn into Type1, it cant, you will now just be a Type2 using insulin

 

[NicoleC1971]

Hello and welcome! If your blood sugars were controlled by tablets and you are now on insulin after 20 years this means that you are type 2.
Type 1s don't make their own insulin so get treated with this straight away whereas you may still be making quite a lot of insulin or have impaired production plus lots of insulin resistance that stops this insulin from delivering energy to your cells.
Whilst some type 1s get misdiagnosed as type 2 early on they will quickly fail to improve on tablets which is not the case with you.
Might be worth checking out the success stories here where many type 2s have reversed their diabetes so that they need less insulin and less medications just by changing their diet. There is hope if you don't want to inject!

 

[EllieM]

Type 1 and Type 2 are two completely separate conditions that can lead to the same treatment.

True, with two small provisos.
Some T1s (particularly the LADA ones) do get an initial T2 misdiagnosis which only gets changed to a T1 one after their insulin production starts to fail and T1 tests are performed. (A lot of doctors just assume people over 30 are T2 until proved otherwise).

Logically (though I don' t recall any forumites posting that this has happened to them) there is nothing to stop a T2 developing an autoimmune disorder that attacks and destroys their insulin producing cells. At that point they would become T1, albeit an insulin resistant one.

 

[JoKalsbeek]

hello I have been diabetic for about 20 years I started of with tablets and I am now on Insulin my question is how do I know if I am NOW type 1 or 2
I need Insulin to bring my blood sugars down withot Insulin I cannot bring my blood sugars down does this mean I am now a type 2 diabetic

Type 1 is an autoimmune condition where you end up with little to no insulin production, so one would require injections from the get-go, pretty much. (Honeymoon periods, and slow onset type ones being the exception, but eventually insulin shots are the way to go.). Type 2 is a matter of overproducing insulin and thus becoming insensitive to it, and unable to use the stuff properly. After 20 years, two things may have happened: your pancreas has become exhausted and doesn't produce insulin as it once did, if at all, and thus causing a drop and the need for extra insulin. Or, over time you've become so insulin resistant you need the extra stuff.

That would make the next question, which has happened to you? You might want to get a Homa-R test done, see whether you still make insulin and if so, how much. Because if you're still making it yourself, cutting carbs may still be a way back to not needing additional insulin, should you want to get off it again.

Good luck!
Jo

 

[Daibell]

True, with two small provisos.
Some T1s (particularly the LADA ones) do get an initial T2 misdiagnosis which only gets changed to a T1 one after their insulin production starts to fail and T1 tests are performed. (A lot of doctors just assume people over 30 are T2 until proved otherwise).

Logically (though I don' t recall any forumites posting that this has happened to them) there is nothing to stop a T2 developing an autoimmune disorder that attacks and destroys their insulin producing cells. At that point they would become T1, albeit an insulin resistant one.

Well, I'm one of those except I have yet to be formally diagnosed a LADA although my insulin production is low. Yes, my GP just assumed I was T2 at Age 60 despite all the LADA symptoms. I would say that anyone who is labelled T2 but is slim and/or has lost weight recently should be suspicious they may be T1/LADA and get the tests done. They should be even more suspicious if the set of tablets stop working. I was on 320mg (full dose) of Gliclazide with no effect so it's one good measure of dead beta cells. I would ask the OP what is your BMI as this will be one guide to whether you have insulin resistance (T2) or lack of insulin (T1)

 

[Fenn]

Well, I'm one of those except I have yet to be formally diagnosed a LADA although my insulin production is low. Yes, my GP just assumed I was T2 at Age 60 despite all the LADA symptoms. I would say that anyone who is labelled T2 but is slim and/or has lost weight recently should be suspicious they may be T1/LADA and get the tests done. They should be even more suspicious if the set of tablets stop working. I was on 320mg (full dose) of Gliclazide with no effect so it's one good measure of dead beta cells. I would ask the OP what is your BMI as this will be one guide to whether you have insulin resistance (T2) or lack of insulin (T1)

So you can't be type one and overweight?

 

[Antje77]

So you can't be type one and overweight?

Yes you can. Being overweight doesn't in any way protect you from developing T1.

It's just statistically chances are greater of an overweight diabetic adult having T2.

I strongly believe overweight T1's are even more often misdiagnosed than thinner ones. My DN at my GP's office didn't understand why I suspected I wasn't T2 (40 years old, BMI of around 34), but being a very nice person she still agreed to give me a referral to an endo for more tests.

 

[jonathan183]

I think antibodies testing would establish whether your diabetes currently has an autoimmune component. C-peptide test would establish how much insulin your body is producing. Knowing the two could help determine what options are available and help you establish the most appropriate approach with your medical team.