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How do doctors differentiate between types.

Squire Fulwood said:
Most Type 1's are children who suffer from an autoimmune disease and lose all function of the pancreas. An adult suddenly getting type 1 would presumably go straight to hospital on a stretcher.

Type 2's are invariably adults with progressive failing of the pancreas. I suppose if you are walking about and arguing with your doctor then you are probably a Type 2.
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Sorry can't agree with you there many many T1's are diagnosed in adulthood My son was 45 when he was told he was T1 his symptoms were almost constant drinking extreme tiredness numbness in his feet...this was nerve damage that had already started... and he had lost an awful lot of weight in a very short time and he was not at all overweight to start with. Doctor diagnosed T1 straight away and no he did not go to hospital on a stretcher he went there straight away from the surgery but did not have to stay in it was for more tests and to show him how to measure his BS levels and learn how to inject himself and what his insulin regime would be from then on
 
Becki84 said:
Interesting comments. I wonder whether a more standardised protocol will ever come into place. I was told in a&e that I had a borderline case, yet neither a c-peptide or GAD antibody test was performed. I had been feeling unwell for 3 years previously, but my GP was reluctant to investigate as he said I was just stressed. I have also been told by a DN that GAD is not particularly conclusive as a number of non-diabetic people also test positive.... Oh what a minefield!! Hurry up with a **** cure already!!


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I wonder what classification I will eventually end up in. I was first diagnosed as being diabetic in June of last year, having had two thirds of my pancreas removed in 1991! The type of diabetes I have has not been discussed as yet and am currently managing on dietary intervention alone. The only comment made to date has been that it was bound to happen sooner or later. I have yet to complete all the standardised tests for diabetic complications. The only symptom I had at presentation was clinically significant weight loss, and I was not overweight to begin with! I wonder what box, if any, I shall eventually fit into.
 
Spiker said "badly". I say they do it by assumptions. i. e. Child, so probably T1, although children can and do get T2. If it's an adult, they assume T2 although the oldest new T1 I read of was 92. In other words, they don't try to find out. If they put someone onto insulin immediately, they may never find out. If Oral T2 treatment doesn't work, they may decide it's T1 after all. In my experience, they treat, sometimes not very well and don't bother what they are treating.
Hana
Ps it's all a bit like "sore throat?" must be a virus!
 
What is scary is that the poor level of Diabetes GP training continues. When my db GP said to me you're not T1 therefore you are a T2 she had apparently only just come off the Warwick diabetes training course. I told her my nephew was diagnosed as a LADA at age 22 she said that's unusual. She's actually a very good GP but they have to rely on good training and it isn't up to it.
 
GAD injections at diagnosis?
http://www.helmholtz-muenchen.de/en/hdc/service/news/news/article/23720/index.html
As I read it, and I might be reading it wrongly. People who had the biggest reactions to the injection had the least insulin (as shown by c peptide) and were likely to need insulin after a shorter time than those who had a smaller reaction These people had actually already been diagnosed with LADA .(presumably by GAD antibody tests)
 
@phoenix that's how I read it too. So we have two independent things that can be tested for: C-Peptide to test insulin production level, and GAD to test severity or progression of autoimmune response.

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Simple: Unless you present with DKA or are a child, you get diagnosed with T2. When T2 meds still don't work after a year or two, they consider T1/T1.5. The increasing prevalence of obese T2 children may force them to make changes however.
 
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