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New Type 1.5

Galaxy

Newbie
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2
Morning all, new type 1.5 checking in.

I was diagnosed 4 months ago when my GP randomly decided to do a fasting test whilst doing my yearly thyroid check. First result was 7.2 and the second 7.3. My HbA1c was 7. As I have other autoimmune disease I asked for a referral to a consultant.

To cut a long story short, my GAD test came back as high and so I am now type 1. The consultant is currently treating me with Gliclazide. My bg's are all over the place, ranging from 4.2 to 22.7 but seem to hover between 9 and 13 mostly. This is low carbing. If I eat carbs then they are usually in the high teens or twenties.

The registrar I saw at my first appointment said she was sure I would be type 1 and said insulin therapy was the best way forward. The consultant overruled this and wanted to wait until the blood tests were back. However, now that they are back he wants me to stay on the Gliclazide?

Judging by the way I feel now {rough} I don't think I have had diabetes for long but I think it is worsening rapidly. The registrar and the DSN agree. I don't know whether to push for insulin therapy or not. I have been running high bg's for 4 months now and despite medication have poor control. I understand that it is early days and that I am honeymooning, I'm just not sure what to do. the consultant wants to carry on with the Gliclazide until I get control or reach the maximum dose whichever comes first.

I would be very grateful for other type 1.5 experiences particularly with oral therapy vs insulin therapy
 
Would it be possible to go and see the DSN at the hospital? The medication you are on now helps the pancreas to squese out more insulin. However this will not be affective for you long term once your honeymoon period is over.
 
Hi. I'm a bit surprised you weren't put onto insulin but perhaps the consultant is being kind and delaying the extra hassle of insulin until really needed (some consultants would disagree). Sitagliptin is another option of an adder to Gliclazide as it extends the length of time the pancreas produces insulin after a meal and reduces spikes. It helps me a bit even though I'm on Gliclazide as well. Push for insulin if your Hba1c stays above 7.5'ish or your meter readings are regularly near or into the teens. Download the current Jun 2012 NICE guidelines from the NHS Diabetes website for their recommendations.
 
Galaxy said:
Morning all, new type 1.5 checking in.

I was diagnosed 4 months ago when my GP randomly decided to do a fasting test whilst doing my yearly thyroid check. First result was 7.2 and the second 7.3. My HbA1c was 7. As I have other autoimmune disease I asked for a referral to a consultant.


Hi Galaxy ... Have you been diagnosed as a Type 1.5 or a Type 2? You also say you have other immune disease and have been referred to a consultant. What kind of Consultant? Do you see an Immunologist for your autoimmune disease and an Endocrinologist for the diabetes? If so, do they consult each other about your treatment? I hear there are new treatments for diabetes based on the immunological aspect of it but I'm not sure at what stage they're at with prescribing them. So I'm wondering if you've heard of them? I suspect I'm LADA but at the moment I'm diagnosed as T2 so I'm doing some research into it as I don't really know much about it yet. Best wishes. :)
 
If you are running that high, you must be feeling pretty rubbish. My sympathies.
If you're getting those bg results on low carb, your current medication is just not working. I'd say it's much better to be on insulin and feel well than avoid insulin and feel ill.
For context - I'm a T1 but I suspect if they'd known about 1.5 when I was diagnosed, I'd have been 1.5 - my symptoms and progression of the disease didn't fit a traditional T1 profile. With hindsight I am incredibly glad they put me straight on insulin and didn't mess about with oral therapy. Sounds like you have a sensible DSN, get him/her on one side and ask for help. Don't let anyone put you off or tell you to come back in a fortnight or anything - you need them to help to make you well NOW.
 
Thanks for all your replies.

I will talk to my DSN. I'm lucky in that she is fantastic and I have no reason not to talk to her and trust her advice. I have read the NICE guidelines and will bring this up when I speak to her, thanks Daibell!

Snodger, I do indeed feel pretty rubbish. The rollercoaster or high and low bg levels are taking their toll mentally and physically. I just want to feel ok and get to the stage where I can incorporate this disease into my life rather than it taking over my life!

Thanks again

Galaxy
 
Agree with the others that insulin is preferable to high glucose readings.
Like Snogder, I'm classified as T1 and went onto insulin at official diagnosis but I' was aware of my diabetes for 3 years before this. LADA is T1 just a bit slower in onset.
There isn't any consesus as to the best way to treat people with LADA. The Cochrane organisation looked the evidence available in 2011 and found that the research that was there was very variable in quality and how they define LADA.

In summary, this review demonstrates that insulin treatment may be preferable compared to sulphonylurea treatment but there is little evidence regarding other forms of treatment. Future studies are needed, should have a clear definition of LADA, investigate patient-important outcomes and use a common method of measuring stimulated C-peptide (a marker of natural insulin production reflecting improved beta-cell function of the pancreas
http://onlinelibrary.wiley.com/doi/10.1 ... 5E2.d03t03


Grace:
I hear there are new treatments for diabetes based on the immunological aspect of it but I'm not sure at what stage they're at with prescribing them. So I'm wondering if you've heard of them?

Unfortunately research into treatments that may stop the progression of the autoimmune attack are still in the research stages.
Diapep277 is the most well known of these drugs. It is in stage 3 clinical trials and according to their website they are still recruiting subjects but they don't have a trial centre in the UK
http://www.andromedabio.com/clinical_trials.php
Blog with more details about diapep
http://asweetlife.org/feature/diapep277 ... -diabetes/
 
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