No known reason why but I am not a "TYPE" anything any more.

[PeteN11]

Last year I posted this thread.....

Wow! My pancreas is producing Insulin Again!

I was diagnosed T1 just over 3 years ago. Usual symptoms and BS of 38. A week in intensive care with insulin being pumped in 3 ways including via my neck.:eek: On recovery I was on 40 Units of Lantus and 30+ Units of Nova Rapid with each meal. My NHS trust team trumpets the need for 225g of...

www.diabetes.co.uk

Only got to see the consultant again last week and the latest c-peptide test came in at 2.8. hba1c is 50. He confirmed that on diagnosis 4 years ago whilst in hospital with a DKA the test came back as negative.

I haven't used insulin for quite a while and my BG has been steady between 4 & 8.

I continue on a low carb diet and get Ketone readings between 0 and 1.4 and have lost over 3 Stone (20kg). I have carb tested when the craving gets bad and even with a bag of Fish & Chips (It was heaven) my BG is normal four or so hours later.

So I have been discharged from the clinic being told to forget about insulin, no need for any tablets, only test if I feel I should and he will write to my GP to do another blood test next year. He will also provide any evidence needed to get my full Driving Licence reinstated.



The consultant could give no explanation to why this has happened but I firmly believe that the change coincided with going low carb and yes I realise that others doing the same have had no such luck.

So thanks for all of you that gave me advice and support over the past few years and the best of luck with your own troubles.

 

[Ronancastled]

Read up on various forms of Type 3c, surprised your Endo didn't pursue it further.

 

[Oldvatr]

An HbA1c of 50 indicates that you may still be diabetic, but not needing insulin may indicate Type 2. If you keep up the low carb then you may find your levels drop below 48 but you need to keep an eye on things since they could go up again. The Consultant will discharge you from his clinic since he only deals with insulin dependant patients. Your GP should pick up as a T2D, since your HbA1c is above 48 and technically in the diabetic range.

 

[HSSS]

He confirmed that on diagnosis 4 years ago whilst in hospital with a DKA the test came back as negative.

on what basis did they say type 1 back then? Dka alone? Antibodies? Insuli/cpeptide?

i think your post is saying the consultant this week admitted they got it wrong back then And have been type 2 all along

 

[Oldvatr]

This may be an explanation

Hyperosmolar Hyperglycaemic State (HHS)

Hyperosmolar Hyperglycaemic State (HHS) occurs in people with type 2 diabetes who experience very high blood glucose levels (often over 40mmol/l). It can develop over a course of weeks through a combination of illness (e.g.infection) and dehydration. Some people who don’t realise they have type...

www.diabetes.org.uk

 

[PeteN11]

Read up on various forms of Type 3c, surprised your Endo didn't pursue it further.

I have read up on that and did not suffer from any of the symptoms.

 

[PeteN11]

This may be an explanation

Hyperosmolar Hyperglycaemic State (HHS)

Hyperosmolar Hyperglycaemic State (HHS) occurs in people with type 2 diabetes who experience very high blood glucose levels (often over 40mmol/l). It can develop over a course of weeks through a combination of illness (e.g.infection) and dehydration. Some people who don’t realise they have type...

www.diabetes.org.uk

I had high ketones levels so this does not apply.

 

[PeteN11]

An HbA1c of 50 indicates that you may still be diabetic, but not needing insulin may indicate Type 2. If you keep up the low carb then you may find your levels drop below 48 but you need to keep an eye on things since they could go up again. The Consultant will discharge you from his clinic since he only deals with insulin dependant patients. Your GP should pick up as a T2D, since your HbA1c is above 48 and technically in the diabetic range.

The consultant deals with all types of diabetic patients not only those that are insulin dependant. As I said I will monitor my BS over time especially if I feel any difference.

 

[PeteN11]

on what basis did they say type 1 back then? Dka alone? Antibodies? Insuli/cpeptide?

i think your post is saying the consultant this week admitted they got it wrong back then And have been type 2 all along

Maybe I didn't make it clear in the OP but the consultant said the c-peptide test on admission to hospital for DKA was "negative" meaning it was zero.

 

[Oldvatr]

your cpep result at 2.8 is outside the normal level, and indicates you are overproducing insulin. This is indicative of a T2D with severe insulin resistance. If the IR you had was the adipose IR in the liver and pancreas due to ectopic fat, then that may stop insulin secretion. As Taylor has shown.major weight loss can remove that fat, and the pancreas output can increase. The high value of your latest cpep may be showing that you still have residual IR in the muscle tissue and mitochondria / cells that is why your HbA1c is high (its higher than mine) It is also possibly why they were so forceful on your original admission with the insulin infusion via the neck. They had to really get it into you to overcome the IR in a hurry to quell the DKA. They mainlined you, and it worked. Type 1's do not normally suffer severe IR as a byproduct.

 

[TipeWun]

Genuine question as I am new to this forum - are the people replying with long medical explanations actual medical professionals or is this knowledge gained from years of treatment for diabetes? I see people in many threads implying that doctors’ advice is wrong and they don’t know what they’re doing and just wondered why that is

 

[Oldvatr]

I am not a medical professional, but I have been researching my condition for over 30 years. I base my research mainly on scientific study reports from recognised archives where I can and usually provide a link to one or more papers if I can. My commentary on these papers is tempered with a working knowledge of simple mathematics, biology, chemistry and physics. and ultimately on my own personal experience.

 

[PeteN11]

your cpep result at 2.8 is outside the normal level

Only by 0.1 and the blood sample was not taken during fasting as it should be.

your HbA1c is high (its higher than mine)

Your hba1c figure is absolutely pointless to use in any kind of a comparison with mine.

 

[HSSS]

Maybe I didn't make it clear in the OP but the consultant said the c-peptide test on admission to hospital for DKA was "negative" meaning it was zero.

C peptide is a numerical result usually rather than a negative/positive.
So the c peptide on initial admission was zero? in which case you’ve gone from no insulin production to slightly over normal? or are you mixing it up with Gad or antibody tests? Even those whilst conclusive if positive are inconclusive when negative despite not all medics explaining this

So the high insulin production now and the lack,of use of insulin means type 1 is and was highly unlikely and type 1 doesn’t just go away (without transplants). Low carb does not “cure” type 1 or else loads would be able to reproduce your situation. There are type 1 that low carb or even keto without “cure”.

Which means whatever caused your DKA was something else. Type 2 (rare but it happens), type 3 due to some medication or illness maybe? A rarer type of diabetes maybe? Or some other condition that caused a temporary problem with insulin (assuming it was in fact zero). Somewhat of a mystery I suspect at this point in time 4 yrs you may never know, presuming it doesn’t rear its head again.

As your hba1c is still above the diagnostic threshold (regardless of type) and in case whatever odd event caused problems before comes back I’d keep up with regular checks and the low carb and try and reduce it back towards normal.

 

[Oldvatr]

Only by 0.1 and the blood sample was not taken during fasting as it should be.


Your hba1c figure is absolutely pointless to use in any kind of a comparison with mine.

I am a T2D diabetic in control, you are claiming to be non diabetic and no type at all. My HbA1c is below the diabetes thresho;ld, yours is above. Thats the difference.

 

[PeteN11]

C peptide is a numerical result usually rather than a negative/positive.
So the c peptide on initial admission was zero? in which case you’ve gone from no insulin production to slightly over normal? or are you mixing it up with Gad or antibody tests? Even those whilst conclusive if positive are inconclusive when negative despite not all medics explaining this

So the high insulin production now and the lack,of use of insulin means type 1 is and was highly unlikely and type 1 doesn’t just go away (without transplants). Low carb does not “cure” type 1 or else loads would be able to reproduce your situation. There are type 1 that low carb or even keto without “cure”.

Which means whatever caused your DKA was something else. Type 2 (rare but it happens), type 3 due to some medication or illness maybe? A rarer type of diabetes maybe? Or some other condition that caused a temporary problem with insulin (assuming it was in fact zero). Somewhat of a mystery I suspect at this point in time 4 yrs you may never know, presuming it doesn’t rear its head again.

As your hba1c is still above the diagnostic threshold (regardless of type) and in case whatever odd event caused problems before comes back I’d keep up with regular checks and the low carb and try and reduce it back towards normal.

I think most of that coincides with what I said in the OP except I kind of condensed it a tad better. Don't think I ever mentioned the word "Cure".

 

[PeteN11]

I am a T2D diabetic in control, you are claiming to be non diabetic and no type at all. My HbA1c is below the diabetes thresho;ld, yours is above. Thats the difference.

All I am "claiming" is that my consultant cannot attach a label to me any more and has withdrawn all my medication and the need to test (unless I feel the need of course).

One thing I have learnt on this forum is that no 2 people are alike. We all have different BG readings, we all take varying levels of insulin (if any at all) resulting in differing levels of control so having some sort of pi@@ing contest over whose level is better for them than your own is I feel somewhat childish and not all helpful.

 

[HSSS]

I think most of that coincides with what I said in the OP except I kind of condensed it a tad better. Don't think I ever mentioned the word "Cure".

Well to me your op had half said and implied things a few of us have sought to clarify so perhaps it was less clear to people other than you who already knew what you meant.
I’m not saying you used the word cure but by identifying as type 1 and stating your resumption of insulin production/no longer needing to inject insulin ”coincides” you firmly suggest and imply low carb cured type 1 which simply doesn’t happen . We might be individuals but that would make you the first I ever heard of. More likely it wasn’t straight forward type 1 to begin with.

 

[EllieM]

Genuine question as I am new to this forum - are the people replying with long medical explanations actual medical professionals or is this knowledge gained from years of treatment for diabetes? I see people in many threads implying that doctors’ advice is wrong and they don’t know what they’re doing and just wondered why that is

Hi @TipeWun and welcome to the forums. You ask an important question so I'm going to risk taking the thread off topic by answering it here.

Forum rules are in my signature and that of every other moderator (though you may need to "toggle" the signature to see them)

Community Ethos & Forum Rules

Welcome to the Diabetes.co.uk Forum - the world's largest diabetes community. This is a compassionate, inclusive environment and below are the Forum Ethos and Rules. Please take a few minutes to have a read! Forum Mission Statement/Objective The Diabetes Forum helps people improve their...

www.diabetes.co.uk

Possibly the most relevant rules here are these
A11.
Important: Members are generally not Health Care Professionals, and those who are participate on the Forum as Members, not Health Care Professionals. Members are unable to diagnose any condition, or instruct in the alteration of medication, irrespective of personal or professional standing or experience.
B13. Remember: We do not give medical advice. If you give advice then it is through your own experience or a link to a reputable site external to the forum.
and
C12 includes a warning against
Posting medically dangerous information. (eg. Telling users to alter medication dosage, ignore their healthcare professional).

So members post from their own experience, and what they've read in journals and learnt from others who have posted. Having said that, as a long term T1 (52 years) most of my GPs reckon I know more about T1 than they do, and I certainly have a very good grasp of my own particular metabolism.

I have to be careful what I say about T2 (my only personal experience is helping my T2 dad) but a lot of the T2 members here have surprised their medical professionals by using a low carb diet to improve their condition. (I should stress that that is not the only way to treat T2 and you don't have to be a low carber to post here). Traditionally, T2 seems to have been regarded as a progressive illness by the medical profession and the way that some of our members have reduced or even eliminated their medication is new to many doctors.

As for the titles such as "expert" and "well-known" under users' names, I believe that to be purely a function of how many posts you've made (happy to be corrected if the algorithm is more complex) and it certainly doesn't refer to any medical qualifications that members may or may not have.

 

[oldgreymare]

Hi @PeteN11,
Going back to your original post, I recall that on my diagnosis of diabetes (no DKA but HbAC1 of 128 and very strong OGTT result), the endo put me on insulin for a month before ordering c-peptide and GAD Ab tests. He explained that this was because chronic high BGs can result in severe insulin resistance and it may be possible to simply burnout the pancreatic Beta cells and they stop releasing insulin. But that in Type 2 they may also recover insulin production if BGs are brought under control. So possibly why your c-peptide was so low on diagnosis but since has recovered? Congratulations on your progress. As per others' comments, stay vigilant.