I don't know which I am!

[JPW1]

Hi
I was diagnosed as Type 2 in 2012 at 42 years old, despite being on the skinny side of skinny! It's now almost 8 years later and I've just started insulin as my glicazide etc. just wasn't doing anything anymore. The last two weeks have been "interesting"! My HbiAC have been creeping up for the last year but I think my marathon running and training were keeping things in bay for a couple of years. Anyway - I'm on Tresiba 10 units, and Fiasp 2 units with lunch and dinner, Tresiba is working well but I expect I need a bit more to get things looking right (waking around 7.9 though I had a 5.3 on Sunday), bedtimes around 9 at best. Spiking with every meal, so I probably need a good few units more of Fiasp, perhaps just need to get into carb counting.

As my title says I don't really know what I am - GAD was negative, but I'm told it can be - guess I'm just glad I'm getting the treatment I need now.

 

[bulkbiker]

Anyone ever suggested testing your endogenous insulin production via a c-peptide test?

Hi and welcome by the way.

 

[JPW1]

Anyone ever suggested testing your endogenous insulin production via a c-peptide test?

I don't think that has been done, but when I stopped my Glicazide it made no difference whatsoever, which I think suggests that the beta cells aren't doing much.

 

[Lamont D]

Go back to your GP and ask what your GP is thinking what is happening to you!
Then if your GP is not sure, guessing, following guidelines, ask for a referral to a specialist endocrinologist.
Clearly something is going on through your changes in medication, it would have been nice or even courteous for him to explain!

It's your health, you need the right answer, you have a right!

 

[JPW1]

To be fair GP referred me to Diabetic Specialist and I'm being well cared for by Diabetic Specialist Nurse - just now sure whether I'm "still" type 2 or now type 1 or LADA...not really sure I'm that worried as I am sure the insulin programme is what I need, and is beginning to work....just had an 8.3 before evening meal - last week it was 18!

 

[Lamont D]

A dsn in my experience is a trained nurse for those who do know the reason why they are diabetic, also to do six monthly, yearly tests, hba1c, take bloods etc.
They are not diagnosticians. Did your dsn recommend the change in meds?
But, I would still ask what is happening.

 

[JPW1]

They are not diagnosticians. Did your dsn recommend the change in meds?

Nope, diabetic specialist dr. suggested insulin therapy, on suspicion of T1, and DSN and I are now working towards dosage from my BG readings.

 

[bulkbiker]

To be fair GP referred me to Diabetic Specialist and I'm being well cared for by Diabetic Specialist Nurse - just now sure whether I'm "still" type 2 or now type 1 or LADA...not really sure I'm that worried as I am sure the insulin programme is what I need, and is beginning to work....just had an 8.3 before evening meal - last week it was 18!

If you are T2 and overproducing your own then the last thing you need is more. However if T1 or a variant then yes you will need it. That's why testing is important.

 

[Lamont D]

That's fine then.

I was in same degree of not understanding what was going on and my surgery including a specialist diabetic doctor and dsn, still had no idea what was happening to me. It wasn't until I had a referral, did a true diagnosis of not being diabetic and quite a number of tests to prove it!

Always remember, that other than hba1c tests, a surgery has little scope for tests, even diabetic tests such as c-peptide, GAD, and glucose tolerance tests have to be done in hospital. And even the basic insulin tests are only done very rarely!

Hope you get sorted.

Best wishes

 

[AloeSvea]

If a Diabetes Specialist is saying "suspicion of type 1" and is treating you with insulin, then that sounds like a type 1 diagnosis to me, albeit is a puzzlingly ambivalent one! Yes - do get the Diabetes Specialist to be clear with you, and discuss the insulin-production tests you have had, (I have to believe they have tested this... I mean...) and, what the results are.

It is in fact very important that they and you know which disease it is, as one is an autoimmune disease, and the other is metabolic, and the treatments, and management plans are lifelong, and different. This is your well-being and your life at stake here. It really is important that you have the right diagnosis.

 

[satindoll]

@JPW1 .
Hi you are not alone in your oddity, its quite possible you are like me a "Non-producer" especially as you are a skinny skinny as I am, my specialist admitted he'd no idea as to why I'd become a non-producer so he did every test he could think of but they posed more questions than they answered, but unlike you I was put on insulin immediately as oral meds were out of the question and things have been a lot more settled..
You will be fine once you've worked out your ratio's and got to grips with carb counting, its a bit daunting at first but once it clicks you'll be up and running again.

 

[Daibell]

Hi. Same story as me i.e. always slim and full dose Gliclazide finally did nothing. Get a C-peptide test done if you can, I had mine done privately. From what you say you are almost certainly LADA but I can only guess. You will need to start counting the carbs shortly and adjusting the Fiasp dose to suit at mealtimes; ask the DN for guidance. Be aware that Fiasp is one of Novo's newer insulins and very fast acting; more so than the NovoRapid that many of us use. There are pros and cons between these two but be aware that you need to eat fairly soon after injecting to avoid hypo risk

 

[JPW1]

Thanks @Daibell, yes I've studied a lot over the last couple of weeks - ready to go carb counting as soon as I'm allowed! Fasting and bedtimes are coming into line....post meal spike still big, but I guess a few more unites of Fiasp will sort that out.