1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

I was Type 1 all along

Discussion in 'Diabetes Discussions' started by Lord Midas, Aug 22, 2017.

Tags:
  1. Lord Midas

    Lord Midas Type 1 · Well-Known Member

    Messages:
    148
    Likes Received:
    162
    Trophy Points:
    83
    Good find.
    It's a massive article, but did you know that this is apparently a new test for patients, as it's now cheaper to run. It was started for diagnoses about 5 years ago, I was told.

    Before that it was created for and solely used by homicide forensics. They did the c-pep test to determine if someone had be been murdered by insulin overdose
     
    • Useful Useful x 1
  2. James1968

    James1968 Type 2 · Well-Known Member

    Messages:
    441
    Likes Received:
    781
    Trophy Points:
    113
    Thanks
     
    • Like Like x 1
  3. Pearl1957

    Pearl1957 Type 2 · Newbie

    Messages:
    1
    Likes Received:
    0
    Trophy Points:
    21
    I have just had a blood test as my endocrinologist suspects I have LADA and
    not T2 which I was diagnosed with 3 years ago.
    My BGs are largely uncontrollable even after starting on Lantus 5 weeks ago. We shall see but it makes sense,
     
    • Hug Hug x 1
  4. tim2000s

    tim2000s Type 1 · Expert
    Retired Moderator

    Messages:
    8,914
    Likes Received:
    11,783
    Trophy Points:
    198
    I wrote this about 18months ago. http://www.diabettech.com/diabetes/...t-more-prevalent-form-of-autoimmune-diabetes/

    Late onset is misdiagnosed all the time, when it really shouldn't be, and suggests that adult onset T1 is more prevalent than juvenile onset. There's a link to a 2005 paper talking about it in there.
     
    • Winner Winner x 1
  5. Deleted Account

    Deleted Account · Guest

    Wow, just reading your article.
    If
    • 10% of Type 2 diagnoses over the age of 35 are really LADA
    • 25% of Type 2 diagnoses under the age of 35 are really LADA
    And
    • approximately 90% of people with diabetes are type 2
    • approximately 10% of people with diabetes are type 1
    • there are other types of diabetes available (which means my maths does not add up!)
    Does that mean, the number of people with LADA/type 1 who are misdiagnosed with type 2 (10% of 90% is 9%), is about the same as the number of people correctly diagnosed with type 1? Or potentially more as the diagnoses are in adults?
     
    • Like Like x 1
    #45 Deleted Account, Aug 23, 2017 at 3:11 PM
    Last edited by a moderator: Aug 23, 2017
  6. tim2000s

    tim2000s Type 1 · Expert
    Retired Moderator

    Messages:
    8,914
    Likes Received:
    11,783
    Trophy Points:
    198
    Potentially more, exactly.
     
    • Like Like x 1
  7. CherryAA

    CherryAA Type 2 · Well-Known Member

    Messages:
    2,170
    Likes Received:
    2,042
    Trophy Points:
    178
    This is exactly why I hypothesise that if you do not find a significant decrease in blood sugar on adopting LCHF then you may well not be T2. there are far too many instances of doctors taking a lazy way out.

    My own - very expensive doctor, simply made the assumption- as it happens it was a correct assumption but if it had been the wrong one, I would have done the LCHF thing and been told that its a stupid diet by my doctor. I doubt very much he would have re-explored the diagnosis which he made only from looking at my weight.
     
    • Agree Agree x 1
  8. ickihun

    ickihun Type 2 · Master

    Messages:
    13,447
    Likes Received:
    18,378
    Trophy Points:
    298
    I'm sure I was told on here somewhere that c-peptide test does include injected insulin. Just homemade insulin measured?
     
  9. ringi

    ringi Type 2 · Well-Known Member

    Messages:
    3,366
    Likes Received:
    1,218
    Trophy Points:
    158
    Unless someone has been Type2 for a very long time had have killed all their beta cells.

    But remember there is nothing that stops someone being Type1 and Type2 ..... (just very uncommon).
     
  10. ringi

    ringi Type 2 · Well-Known Member

    Messages:
    3,366
    Likes Received:
    1,218
    Trophy Points:
    158
    I expect that the c-peptide test will not always tell between a slow onset of Type1 and Type2 until Type1 has developed to the stage that BG can not be controled using "Type2 methods". One problem is that so many people tell their GPS they are not having suger etc, when they are drinking lot so fizzy drinks etc, therefore the GPs often don't believe poeple who say they are low carb etc.
     
  11. Daibell

    Daibell LADA · Master

    Messages:
    11,846
    Likes Received:
    7,141
    Trophy Points:
    298
    Yes, you can do the test in the presence of injected insulin so I've read.
     
    • Like Like x 1
  12. Daibell

    Daibell LADA · Master

    Messages:
    11,846
    Likes Received:
    7,141
    Trophy Points:
    298
    It should detect T1 rather than T2. A T1 will be producing lower than normal insulin hence showing a low c-peptide. During the honeymoon period, of course, there may still be some insulin so the test could be inconclusive at that time. A true T2 will normally have a high c-peptide as the body will be producing more than enough insulin to try to overcome insulin resistance. I agree the c-peptide may not be conclusive until all the tablets are failing to work together with a low-carb diet.
     
  13. ickihun

    ickihun Type 2 · Master

    Messages:
    13,447
    Likes Received:
    18,378
    Trophy Points:
    298
    Very interesting.
    I think I need to ask outright if I am an exhausted type2 or a long onset type1 with additional severe insulin resistance.
    Mind u. I think I must be type2 as IR been present since teenage yrs. If I had off and on type1 would that still cause IR?
    Maybe when honeymooning I was kicking out high levels of circulating insulin then none, off and on?
    Irratic longterm honeymooning?
    What is anyone's period of the longest honeymooning, I wonder? Decades, surely not?
    I know I felt good on insulin in pregnancy, twice. Always felt ill after births and no injected insulin. Severe weight gain AFTER births.
    I must plug nurse on wednesday or consultant if nurse relucant to commit to my diabetic status.
    They may be afraid to commit since op coming up and I have history of panic attacks.
    I must get mine re-confirmed after this thread!

    Im only querying as I had symptoms at 6yr old and diet was a good one with normal fresh fruit/veg, meats, fish and cooked fresh daily as father was on very very good wage. I've always loved cycling, swimming and walking. Me and my bike were joined at the hip.
     
  14. CherryAA

    CherryAA Type 2 · Well-Known Member

    Messages:
    2,170
    Likes Received:
    2,042
    Trophy Points:
    178

    I agree entirely that if you are T2 and no longer have functional beta cells, then the treatment required will be insulin. I also agree that there are many unfortunate people with complex medical problems that require and deserve proper medical attention.

    My point is rather that absent any medical tests IF you do find that LCHF will bring down your blood sugars which you can test in a week, then it is quite likely that that may of itself be sufficient treatment if enough weight is lost as a result.

    The study I have participated in showed that LCHF does work to bring down sugars and reduce any need for medication amongst the majority of T2 diabetics in the study . 27 of 29 people found that a diet of 20% protein, 20% carbs and 60% fats brought blood sugar under control and reduced medication whilst almost eliminating insulin usage even in diabetics up to 30 years diagnosed. - One participant had been diabetic for 30 years, much of it on insulin and on LCHF for 6 years. Of the two outliers, one has already been re-diagnosed as T1 as a result of the info provided by the trial and the second is under investigation at present.

    Interestingly ALL participants in the study had lost weight- the mean weight was 21 kg and as such easily meets the same criteria as the Newcastle Diet.

    Other studies have shown that the improvement in Hba1C is closely correlated to reduction in weight in a linear fashion between weight at diagnosis and ideal weight. The fatter you are the more weight you need to lose to bring the visceral fat down.

    In just the same way the Newcastle Diet is being said to " reverse diabetes" - a significant proportion of the LCHF sample no longer had ANY clinical markers for diabetes including fasting insulin. It is not known if in fact those people " could eat" carbs again as a sample- because they are comfortable with their diet as it stands - which is not true of ND because ND is necessarily a short term solution not a long term life change.

    I know for me personally carbs do not have the same adverse effect on me now than they did one year ago. I don't particularly want to add them back to my diet other than in small quantities because I don't particularly miss them.

    It is likely that most T2 are diagnosed before they actually get to the point of having lost all beta function simply because the symptoms are usually too serious long before that point for most people.

    Overall therefore it is highly likely that IF LCHF does not bring down blood sugars and show immediate measurable improvements within say 30 days THEN further medical investigation is required.

    What should not be accepted is a simple statement from the doctor for ANYBODY which states -" you have T2 diabetes, take this medication , with or without insulin and pop along to see the diabetes nurse. "

    EITHER LCHF ( or drastic rapid weight loss via significant calorie deficit such as the Newcastle Diet if that 's the preferred option ) and no medications is a solution of itself -

    OR you need proper medical assistance to determine the clinical state of the relevant organs.

    In my opinion no-one should take drugs before they have tried LCHF or ND absent the proper medical investigations especially when the drugs themselves have so many side effects for so many people.

    I also think its a pity that LCHF ever got to be called LCHF - in reality it is quite simply a REAL FOOD diet where you are getting rid of the biggest starches such as potatoes, pasta and rice just like your grandma would have done.

    The component one really needs to address is not to eat too much protein - 1g per kg of ideal body weight is far less than most people eat.

    If you stick to the protein limit in total but eat nothing that requires a label and instead replace the food with real proteins - of whatever type - from a wide variety of proteins from nuts and seeds dairy , eggs through to fish and meats including the fatty varieties, couple that with substantial real vegetables - ( probably of pretty much - whatever type according to taste but recognising that the less starchy the better ) accompany those with substantial good quality oily dressings such as avocado oil or olive oil plus a wide variety of vinegars , treat fruit as sweets instead of staple foods and used stable oils - butter, lard, coconut oil goose fat according to taste to cook with -- Then the chances are that your foods will turn out to be around 60% fats on a much smaller quantity of food than one has been used to eating and you will still not be hungry.

    For many people if they stick to the protein limit say 50- 80 g per day depending on natural body size and try to keep actual carbs to under 30g per day, they will find that they naturally do not add enough fats to get to the 60% part and as a result the diet will almost naturally become close to a ND restricted calorie one- where it becomes necessary to actually consciously add in enough fats to keep weight stable once the initial weight loss phase is over.


    Difference between ND and LCHF

    From cron-0-meter - for me ( 1.67 height female) it is clear that it is possible to achieve 99% of all daily requirements of minerals , vitamins and proteins from 30g of carbs and 60 g of protein. I try to stick to 100g combined maximum in a day.

    If that is applied to the ND 800 calorie limit - the I would end up with a diet which was 15% carbs, 30% protein and 55% fats. -- this is exactly happens to me on my " good days" when I found I did not need extra fatty snacks.

    If those very same carb and protein restrictions are applied to a 1200 calorie LCHF diet the you end up with 10% carbs 20% proteins and 70% fats - that is exactly my average proportions in this clinical trial - which will include some " good days" and some " bad days" .
    sorry if this went off the point a bit -!
     
    #54 CherryAA, Aug 24, 2017 at 8:34 AM
    Last edited: Aug 24, 2017
  15. ringi

    ringi Type 2 · Well-Known Member

    Messages:
    3,366
    Likes Received:
    1,218
    Trophy Points:
    158
    I improved my BG and Hba1C very quickly on LCHF but did not lose much weight, my weight was not recorded on the GPs computer when the Hba1C was done. However I am now losing weight so my next Hba1C will look like the improvement correlates with the weight lose as the Hba1C will be at the time of my review when my weight is recorded.

    I expect that on both VLC and LCHF, BG improves very quickly but weight lose takes longer, the only real way to track improvement in the underlining diabetes is to do standardised glucose tolerant tests. As otherwise better BG results can "just" be because someone is controlling their diabetes better.

    What I love about LCHF is that it is a easy control method, that often results in much better than just control……
     
    • Agree Agree x 1
  16. ringi

    ringi Type 2 · Well-Known Member

    Messages:
    3,366
    Likes Received:
    1,218
    Trophy Points:
    158
    If only doctors could believe what people told them about their diates.....

    I think Metformin and SGLT2 inhibitors can be a very good short term option combined with LCHF, as they result in weight being lost quickly and BG comming under control quicker. I do not intent to stop taking Metformin until by BG has been well within normal values for a long time.

    We need to move away from the "drug for life" mindset, and start giving people hope that simple changes to their lifes con defeat Type2 - this does not stop drugs being used short term.
     
    #56 ringi, Aug 24, 2017 at 11:43 AM
    Last edited: Aug 24, 2017
  17. CherryAA

    CherryAA Type 2 · Well-Known Member

    Messages:
    2,170
    Likes Received:
    2,042
    Trophy Points:
    178

    Here is the research which links Hba1C and weight loss covering 17,204 adults - this is general data and does not record the extent to which the weight itself was lost as a result of a low carb diet ( which statistically it well may have been given the relative success rates of such diets compared to a standard one.)

    "At group level, weight loss in obese and overweight patients with T2D was consistently accompanied by HbA1c reduction in a dose-dependent manner. The model developed in the present study estimates that for each kg of mean weight loss, there is a mean HbA1c reduction of 0.1 percentage points. HbA1c-lowering is greater in populations with poor glycaemic control than in well controlled populations with the same degree of weight loss."

    ie - if you already controlled your blood sugar via carb restriction or diet before weight loss , then the improvement in hab1C coming from weight loss itself will be smaller than when you start off with very high blood sugars.

    I agree with you entirely that the easiest way to go about achieving blood glucose control is via LCHF , and I also agree that a measure of control looks to be possible without weight loss as long as the carbs are drastically reduced.

    My point really is that a properly constructed LCHF diet can also be a "Newcastle Diet " of real foods designed to provide the appropriate nutrients in terms of the relevant nutrient percentages - thus the best of both worlds in terms of sustainability and results and as such appropriate for those who need to lose anything form a small amount to a very big amount of weight in order to achieve improved health.
     
  18. ickihun

    ickihun Type 2 · Master

    Messages:
    13,447
    Likes Received:
    18,378
    Trophy Points:
    298
    Everytime I stop metformin I add 2stones immediately then more as time progresses with no appetite suppressant.
    Im on metformin for life unless there's a cure. Permanent cure not a remission.
     
  19. prancer53

    prancer53 Type 1 · Well-Known Member

    Messages:
    213
    Likes Received:
    212
    Trophy Points:
    83
    Indeed...I have had diabetes for 56 years and am now finding that I have 1 sided conversations with gps which relate to type 2 diabetes. They obviously think I am mistaken when I say I was diagnosed as type 1 in 1961...........!!!!!
     
    • Like Like x 2
  20. prancer53

    prancer53 Type 1 · Well-Known Member

    Messages:
    213
    Likes Received:
    212
    Trophy Points:
    83
    Yes I am always treated as a type 2 now in spite of having had type 1 for 56 years as stated in my medical records. Medics give me very inappropriate diabetes advice (relating to type 2) and the more I insist I am type 1 the more they just smile & carry on talking........
     
    • Hug Hug x 1
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook