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New diagnosis, uncertain if it is Type 1 or Type 2

C

CraigDT

Well-Known Member
Messages
56
Type of diabetes
Other
Treatment type
Insulin
Hi,

I was diagnosed about a month ago. I had the classic symptoms, really thirsty, drinking loads of sugary drinks, etc. I even had some blurred vision which was a bit scary at the time. The thirst came on over a couple of weeks and I went to the doctor and had fasting BG of 20 and loads of Ketones. I was sent to hospital to make sure I wasnt about to go into DKA and got put on a drip to rehydrate me.

Now I am out and have been put on a Basal-Bolus regime, checking my blood sugar and injecting myself 4 times a day.

When I was first diagnosed the doctors weren't sure what type of diabetes I had. I am 36 and overweight, my dad had age related type 2 which might suggest type 2. I turned up with Ketones and had lost a stone and a half in weight which might suggest type 1. To try and sort it out they did an antibody test which came back negative. The doctor said that they are still unsure what type I have.

I realise that my initial treatment is likely to be similar whatever I have but I am finding it frustrating not having a diagnosis. The doctor basically said they would wait and see what happened with my blood sugar and that might give them a clue.

I am 6'5", so for my size I think I am on pretty low doses of insulin. I take 12 units of slow acting and on average 1/3/5 units with breakfast/lunch/dinner. I seem to have really low insulin requirements in the morning, a massive bowl of cereal only requires 1 unit and my blood sugar still drops a bit.

Has anyone seen or experienced any different techniques to differentiate between type 1 and type 2?

Has anyone else experienced this sort of pattern when they were first diagnosed?

Any perspective from people who have gone through would be greatly appreciated!

Cheers,
Craig
 
Hi,
I'm sorry that this happened, it's usually a complete shock to most of us. It does seem though that you have doctors who are being proactive which is good. It's also good that you have been put on a basal bolus regime which is much more flexible than some alternative insulin regimes.

There are several different antibodies but tests for all of them are not easily available so you may not have been tested for all of them. Most people though have anti GAD or ICA antibodies.http://labtestsonline.org/understanding/analytes/diabetes-auto/tab/test/
T1 is usually defined as being antibody positive.

So with no detected antibodies it probably is a matter of wait and see , with the doctors using their clinical judgement .
Insulin doses actually vary considerably and may not be that high , especially if you still have some insulin of your own to help.

There are people who are ketosis prone yet are antibody negative so don't have classic autoimmune T1 or LADA which is a slower onset autoimmune diabetes usually starting at an older age. There are shades of grey and not everyone conveniently falls into a box with a label type 1or type 2, I can't find an introductory article . This one may help explain a bit though you can only read the first part of it http://www.uptodate.com/contents/syndromes-of-ketosis-prone-diabetes-mellitus )
 
Oh! I had not heard of Ketosis-prone Diabetes. Thanks for mentioning it.
 
Hi Craig,
It seems that my situation is not entirely disimilar to yours. I am now 54 and have officially been diabetic since 8th Oct' when I was told to report to AMU with BG reading of 31mmol/L and ketones in my urine after significant weight loss (I was slim beforehand). Staff kept asking me if I 'felt' alright and seemed not to believe me when I said 'I feel fine.'
So anyways, the specialist diabetes nurse that came to see me in AMU that afternoon looked me up and down and proclaimed that I am a type 1 and started me injecting insulin twice a day. A couple of weeks later I was asked to vistit the diabetes nurse at my GP's surgery, I walked in, she introduced herself, she looked me up and down and said 'I think you're a type 2."
As an engineer and somebody who's made a life out of testing everything I don't understand how they can make these judgements and start filling people with drugs when they don't know what's actually happening. I started on 6 units of Novomix30 twice a day and this went up to 12 units twice a day over the folowing weeks.
Because I feel light headed most of the time since I started injecting I am now experimenting with 10 units (under my own guidance) and so far it does not seem to be affecting my BG readings. If it stays this way I plan to try 8 units from the coming weekend to see what happens.
So in summary, 5 weeks in, and I have no idea which diagnosis is right. I don't really know if I am a 1 or a 2. I've also beome thirsty and have started weeing frequently again and when I tried to discuss this with the diabetes nurse she could not give an explanation for this.
 
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