need help

[mrvirus]

Hi all;
I need help,i ve lots of questions to be answered although i always search information about diabete.I hope u can help me.
All say that there is two types of diabete,type1 and type2.The questions i ve starts from the begining,
Its said that if its type 1,
1)c-peptite level is high,
2)diabetes geared suddenly,
3)most of the diabetes have anticor existance in blood
4)no insulin in blood
5)persons having this type are generally not fat

I ve had it for 6 months.First my glukoz was 360(before eating) and because of my age(im 24),its said that its type 1 and insulins needed but then its said that i was type 2.Now im using oral antidiabetes when i dont inject insulin and it works most of time.
Its geared suddenly,i can say that in a 4-5 days.I had loss in weight,1-1,5 kg everyday during 6 days.During loss in my weight i had a terrible shaking and pain in my calfs.I drank a lot and went to wc continually.I had anorexia for a year before these signs.

But the question raises here,these are my blood test results;

test name result unit Referance
c-peptide 4,95 ng/mL 0,0098-4,380
insulin 3,73 uIU/mL 2,6-24,9

Peptide-c result is higher than the referance and insulin is lower level of the referance


I can give you more information about me and my test results if u ve questions to help me.
Am i type 1 or type 2?

 

[DiabeticGeek]

Am i type 1 or type 2?

First of all, you really should talk to your doctor about this. There are a lot of knowledgeable and experienced people on here, but they are no substitute for a doctor and can't diagnose you at a distance. If your doctor isn't helpful, then ask to be referred to a specialist.

That said, I will do my best :wink:

Its said that if its type 1,
1)c-peptite level is high,

Not true, in T1 C-Peptide levels will be low or zero. C-Peptide is a substance that is a part of the insulin producing process, so high levels indicate that you are still producing insulin. T1 diabetics produce little or no insulin of their own.

2)diabetes geared suddenly,

It can be very sudden, but it varies a lot between individuals.

3)most of the diabetes have anticor existance in blood

I don't understand what you mean by this I am afraid.

4)no insulin in blood

True. Well, nearly true. Type 1 diabetes is the result of a failure of the body in producing insulin, so T1 diabetics have very low levels of insulin (unless, obviously, it has been injected). That said, many T1s still produce some insulin - they just don't produce enough.

5)persons having this type are generally not fat

Not necessarily. Obesity is well known to make you far more likely to develop Type-2 diabetes, although thin people can also get it. Traditionally it isn't considered to be so important with T1, although there is some research that suggests that it is a factor. However, one of the symptoms of diabetes (both T1 and T2) is a weight loss that can be dramatic - especially with T1. Therefore by the time it is diagnosed, many people can not be described as "fat" even if they once were.

c-peptide 4,95 ng/mL 0,0098-4,380
insulin 3,73 uIU/mL 2,6-24,9

Well, this looks like Type 2 to me. The C-Peptide is very high, and that is common in Type 2 (because insulin isn't working very effectively, the body needs to produce more of it). The insulin levels are in the normal range. Presumably this was a fasting test - which explains why it is quite low. However DON'T TAKE MY WORD FOR IT - talk to your doctor. Not only am I not a medic, I don't have all of the information that he or she has.

Lastly, if you are on tablets rather than insulin, that means your doctor is already treating you as a T2. T1 diabetics always need insulin - usually as soon as possible. T2 is often treatable either by diet and exercise alone or by tablets. Sometimes T2 diabetics need insulin, but not usually until other options have been tried first. The drugs commonly used to treat T2 won't help T1 much, and so are not usually used.

Its geared suddenly,i can say that in a 4-5 days.I had loss in weight,1-1,5 kg everyday during 6 days.During loss in my weight i had a terrible shaking and pain in my calfs.I drank a lot and went to wc continually.

Go back to your doctor as soon as possible. It sounds as if the diabetes is out of control - and in all probability your medication will need changing. Are you self-monitoring? If you aren't, then I strongly suggest that you get a glucose meter and learn how to use it - that will help you to work out what is going on.

I hope that this helps,

Tim.

 

[timo2]

Welcome to the forum mrvirus,

I assume from your spelling that you are turkish? (antikor=antibody, glukoz=glucose)

3)most of the diabetes have anticor existance in blood

It's possible for both type 1 and type 2 diabetics to have insulin antibodies present in
their blood, sometimes at quite high levels.
Autoimmune type 1s will have evidence in their blood of an immune system attack
on their own pancreatic beta cells. (the presence of beta-cell-specific autoreactive T-cells)

All the best,
timo.

 

[mrvirus]

Thanxz for your explanations and help.
First of all i want to say that my first doctor to whom i was diagnosed told me that its type 1 and the second one told its t2.To the last one its neither t1 nor t2,namely between them.He talked about type 1,5 which takes the feature of the two types.After diagnosing he told me to use insulin at the same time with oral anti-diabetes.I rejected using it.I was suggested to use oral medicine for a time to test whether it would work or not.Now its controled and glucose was under 125 regularly with a diet based on 7 times a day.
After having signs of it,I have 19 kg loss in my weight and its now 73.It looks as if its stoped now.To the doctor it can continue untill i m taken to my ideal kg.
I looked for informations about the test results and what they are for.In an artical i read that Peptide-c is a kind of inslin which is called proinsulin.Before the process,its excreted with insulin and then they are seperated as insulin and peptide-c.
As u said ,DiabeticGeek,i was told that beta cells dont work effectively and there can be lots of reasons for it,ex:being fat,irregular alimentary,stress etc...Sugar in blood cannot be transfered to muscles and im told that body uses the areas full of oil stocks(I cant find the right word to use).
I dont know wheter it would be appropraite to write the names of the medicines i use here,if u give information about it,im going to write them for your views.

Now i decide to visit a hospital having an endocrinology service.Ive understood that The internal medicine service isnt enough for this kind of illness.
Thanks again.

 

[mrvirus]

yes timo u re right i ve some spelling problems.
by using anticor existance in blood i mean immune system .
thanks for your explanations.

 

[DiabeticGeek]

He talked about type 1,5 which takes the feature of the two types.

Welcome to the confusing world of diabetes. :shock:

I am afraid that it's not really a single disease. The original "diabetes", which has been known for quite literally thousands of years, is what is now called Type-1. Type-2 was discovered much more recently, and there are now known to be various other types as well. There is MODY (Mature Onset Diabetes of the Young) and LADA (Latent Autoimmune Diabetes in Adults) as well as Gestational Diabetes (a temporary condition that occurs in pregnant women) and various much rarer and weirder conditions. The phrase "Type 1.5" is usually used to refer to LADA, although occasionally MODY is also called type 1.5.

LADA is usually diagnosed by antibodies in the blood which attack the beta cells of the pancreas. As such it is an autoimmune disease (rather like arthritis), where the body's protective immune system goes awry and starts attacking itself. In most respects it is quite similar to T1, but the onset is very much slower. It is easy to mistake for T2 - because, among other reasons, it often responds to the drugs that are used to treat T2. LADA usually needs insulin therapy at some point, but not always immediately. Sometimes it can be controlled with drugs for some time, and sometimes a combination of insulin and drugs are appropriate.

From your symptoms, it sounds like the drugs alone are no longer cutting it. You either need different drugs or, if it is indeed LADA, you might well need insulin. Like I said before, go back to your doctor and talk about this. Ask him or her whether you have indeed been diagnosed with LADA - at least then you will know what information to look for!

 

[mrvirus]

DiabeticGeek you re right,the last doctor told me what u re talking about right now,i mean,LADA,but he didnt use the term LADA,but simply told me that my immune body system attacks to beta cells and kills them as if they re viruses.He told me thats why my peptide-c is high although insulin level is at the bottom of refences.He added that insulin and peptide c are excreted euqally by pancreas and over peptide c is to be emptied by urine.
I use metformin(1000mg) two times a day after im full,and in the mornings before breakfast,a 4 mg medicine is taken.In additional to them,at the last visit to my doctor he wanted to see a test result which is called GLUKOHEMOGLOBIN(Hb1C) and it was %11,33 and the referance was 4,8-6.
I ve no idea what it is,i forgot the explanation of the doctor,couse there is many tests i had.
If u have an idea about what they re,i hope u can also help me,at the same time im going to search them on the net.They are;
Hemogram,Sedimenrasyon(sedimentation),Ure(Bun),kreatinin(creatinine),sgpt,sgot,cholesterol and trigriserid(i know 2 of them),c-peptide-insulin,glukohemoglobin,urine volume for 24 hours,microalbumin in urine,post parandial blood glucose,these are some of them.

Thanks for your helps,im going to search LADA term to get more information about it untill i find time to visit endocrinology service.


Im filled with admiration for your knowledge.
P.S:I sometimes have difficulties with finding the right words to express myself as i havent taken English for specific purposes (ESP).

 

[DiabeticGeek]

at the last visit to my doctor he wanted to see a test result which is called GLUKOHEMOGLOBIN(Hb1C) and it was %11,33 and the referance was 4,8-6.
I ve no idea what it is,i forgot the explanation of the doctor,couse there is many tests i had.

What you are talking about is the HbA1c (glycosylated haemaglobin - sometimes also called glucohaemaglobin). This is one of the best ways of monitoring diabetes - it gives you very good picture of how good your control is, and people with a low HbA1c are far less likely to develop complications. If you are interested I posted a description of what HbA1c is on another thread. In brief, however, it gives you an indication of what your average blood glucose (BG) has been over the last three months. A value of 11.33% is very high - I am afraid it means that the diabetes is out of control (it suggests that your average BG has been somewhere in the 16-18mmol/l range). Doctors generally consider an HbA1c of over 7% to be a problem that needs correcting quickly, and you should really aim to have an HbA1c in the 5-6% range (people with very well controlled diabetes sometimes manage to keep it under 5%).

You do need to get this sorted out as soon as possible - before it does you any long term damage. Go back to your doctor and discuss it with him - especially since you are still thirsty (that is a common sign of very high blood glucose). LADA is often treatable with drugs, but if they aren't working then you might well need insulin (most LADA patients need insulin sooner or later). It would also be a good idea to change your diet substantially. You can fine tune it later, but for the time being give up sugar and obviously sweet things completely, and substantially cut back on carbohydrates (bread, potatoes, pasta, rice, fruit juice etc.). Try to live as far as possible on meat, fish, eggs, cheese, vegetables and lots of green salads. This may be dull, but you can experiment to make it more interesting once you get the diabetes under control. HOWEVER (and this is important) don't follow a very low carb diet if you are put on insulin - then you will need a somewhat higher carbohydrate intake (hopefully you will get advice from your doctor and/or dietician). It is also important to exercise - you should aim to do at least 45 minutes of moderately strenuous exercise per day.

It is quite possible that your BG is already on the way down (don't forget HbA1C represents the average over the previous three months). Therefore, it would probably be a good idea to invest in a home blood glucose monitor. If you are lucky your GP might give you one and prescribe the consumables (although many are reluctant to do so if you aren't on insulin). I then suggest that you measure your BG every morning before eating - then you can tell if the overall trend is downwards. If it isn't, then you need to do something about it.

As for interpreting the results of a full blood screen, that is quite complicated - you would probably need an endocrinology text book to do it justice :wink:. I wouldn't bother - the most important figures right now are fasting (preprandial) blood glucose and glucohaemaglobin (HbA1c). You may want to consider other figures like cholesterol and triglycerides later on, but at the moment your main concern needs to be getting your BG under control.