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Oh the types they are a changing

Fenn

Well-Known Member
Messages
1,405
Type of diabetes
Type 1.5
Treatment type
Insulin
Well I’m sure this is boring as I’ve talked about it before, but I over the years have referred back to posts to see what I’ve forgotten, adding several years to diagnosis for example,

Had my appointment with diabetes consultant today and he has changed my 2013 T2 diagnosis to a T1 diagnosis, mainly due to a c-peptide result of 0.05 and the fact my insulin doses are low, I think suggesting I’m not very insulin resistant? But I never questioned that part so it’s a guess what he meant.

Sounds silly but I’m not totally convinced of T1 because I carry some belly fat, I have just been reading dcuk definition of LADA and there is a line about it’s possible to be overweight so I am really not sure what to think now.

https://www.diabetes.co.uk/diabetes_lada.html

So what am I? I’m sure I’ve read a hundred times that LADA is for thin people, I’ve never been that, I was born big, even as a skinny kid I was the width of a shed and taller than everyone else, does this once again come down to everyone is different and I could in fact be something in the middle?

I am having great success with my insulin since switching to levermir so I’m totally not stressing about any of this, the new diagnosis makes very little difference to my life and treatment, although doc said he was applying for me to get libre on prescription, not sure what’ll happen there, I am happy to pay for them as I think they are so life changing, they are worth the money.

Weird times.

Thanks for reading.
 
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Fenn said:
mainly due to a c-peptide result of 0.05
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Still no units hey? but as I seem to recall saying is it's that low then you have stopped producing much of your own insulin so need exogenous... hence one of the T1 varieties.

Glad you finally got the correct diagnosis though.
 
bulkbiker said:
Still no units hey? but as I seem to recall saying is it's that low then you have stopped producing much of your own insulin so need exogenous... hence one of the T1 varieties.

Glad you finally got the correct diagnosis though.
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Thankyou Sir

I was sat there thinking about you and actually asked for the units and still didn’t get an answer! I’m actually thinking nooooo bulkbiker will be cross with me lol

Thankyou bruv
 
Hi Sound

Hi Sounds like you have had a rough year, TIA collapsed lung, heart bypass… My goodness, this all takes it’s toll. You could have been type 2 back in 2003 but perhaps all the trauma recently has impacted your pancreas hence the c peptide test and new diagnosis. Glad you are already on insulin and in control.
 
Fenn said:
I’m sure I’ve read a hundred times that LADA is for thin people
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Being fat or overweight in no way protects you from developing T1.
I strongly suspect overweight T1's and LADA's are misdiagnosed much more often than thin ones, because HCP's have even less reason to suspect something else than T2 might be going on.

I was diagnosed with LADA at 41 years old (T2 diagnosis at 39) with a BMI of around 35, so classic T2 representation.

edit: And a Dylan reference is always welcome in my world!
 
no idea if it's the right symbol, but just wanted to say love the thread title
 

If you're not making much of your own insulin and you're only injecting low doses then T1 (T1.5/LADA) makes perfect sense to me. Typical insulin resistant T2s with exhausted pancreases are often on literally 100s of units of insulin a day (They make extra strong U300 and U500 insulins for the insulin resistant.)

As for T1s/LADAs being thin, it doesn't have to follow. With a T1 mum the T1 diagnosis aged 8 was very fast, but as an older adult I see some stomach fat and insulin resistance that I firmly blame on my T2 dad..... (My poor children are genetically doomed as 3 of their 4 grandparents were/are T2 and 1 was T1.)

I believe @searley has a similar timescale of T2 followed by T1 to you....
 
The cut-off for type 1 is 5 years after diagnosis. Type 2's also lose their beta cells if they run their blood sugars continuously over a long period of time, which is your situation. You will need insulin to replace your worn out beta cells as they aren't producing insulin anymore.

The five year cut off is given here:
https://www.exeterlaboratory.com/test/c-peptide-plasma/
 
ert said:
The cut-off for type 1 is 5 years after diagnosis.
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What do you mean by cut-off?
I was only rediagnosed because I asked for a referral. If I hadn't, I would still be listed as T2. My treatment hasn't changed by the changed diagnosis, like Fenn, I was already on insulin when I got my T1 label.
 
Antje77 said:
What do you mean by cut-off?
I was only rediagnosed because I asked for a referral. If I hadn't, I would still be listed as T2. My treatment hasn't changed by the changed diagnosis, like Fenn, I was already on insulin when I got my T1 label.
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The specialists classify the need for insulin in the first 5 years because of beta-cell failure due to autoimmune or viruses as type 1. If you have diabetes for 10 to 20 years and wear out your beta cells that is not type 1 - it's type 2.
 
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ert said:
The specialists classify the need for insulin in the first 5 years because of beta-cell failure due to autoimmune or viruses as type 1. If you have diabetes for 10 to 20 years and wear out your beta cells that is not type 1 - it's type 2.
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You might have missed the fact thet Fenn has been on insulin for years.
 
Antje77 said:
You might have missed the fact thet Fenn has been on insulin for years.
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The post-state when he started insulin, so I just listed the general cut offs.
 
This is why I find myself in a confused state, I think I was started on insulin six years after diagnosis (will look back)

the problem with a “cut off”
5 years -1 day type 1,
5 years +1 day type 2
 
It’s very interesting going back 3 years, doing math, I believe I was five and a half years post diagnosis when I started Insulin.

Interestingly, @EllieM said three years ago…

Are you absolutely sure that you're insulin resistant rather than just having some sort of delayed onset T1? (ie LADA)
If you've got LADA then you absolutely need insulin and it will help you enormously....

Took the doctors three years longer than you Ellie
 
Fenn said:
Took the doctors three years longer than you Ellie
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Wow, that is some detective work!
Though to be fair before I became a moderator I did tend to rather jump to LADA conclusions when anyone posted with rising bgs and/or a need for insulin. I try to do it less now....
 
I probably missed it somewhere but are there not antibody tests that can confirm or disconfirm true autoimmune type 1? There are other reasons for a pancreas to pack up? Not that it matters much I suppose if you’re underproducing. I maintain that diabetes is a spectrum of both production and resistance. Always remember that T1 and T2 are not mutually exclusive. You can be T1 and develop T2 through excess insulin dosing over a period of decades. You can be T2 and wreck your pancreas but not be T1. You can be T2 and later develop autoimmune T1 (less likely).
 
Some viral infections attack the pancreas I believe leading to type 1? It has me side eyeing reported onset after COVID but I’m not sure if would be a direct attack or trigger of an autoimmune response?
 
So no
Dandelade said:
Some viral infections attack the pancreas I believe leading to type 1? It has me side eyeing reported onset after COVID but I’m not sure if would be a direct attack or trigger of an autoimmune response?
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I think it possibly would be. As viral infections go Covid is one of the worst. It affected every part of my body, so why wouldn't it affect the pancreas? I know my BGs as a T2 are now harder to control post Covid.
 
Jim Lahey said:
I probably missed it somewhere but are there not antibody tests that can confirm or disconfirm true autoimmune type 1?
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There are, but not all T1s have them. Also, I'm not sure whether they persist several years after diagnosis and insulin death? Antibodies imply T1 or LADA, but lack of antibodies doesn't prove lack of T1/LADA....
 
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