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So confused now about original diagnosis ?

B

Bubbatara

Member
Messages
16
Type of diabetes
Treatment type
Tablets (oral)
Hi
I was diagnosed in 2008 after having months of admissions to the hospital with no idea what was wrong (they saw inflammation of my liver,gallbladder system but no stones) I was then taken to my gp as my sister is a type 1 - I knew the symptoms. My sugars were 28 and I was sent to the local A&E whom put me on a sliding scale and started me on insulin with dietician input. I lost over 10kg and then constant clinic testing with dietitian control. I then unfortunately had a amputation not long after and was on injections while I was going through this. However my sugars were going low on readings and I was told my settling period found I was producing some insulin and moved to a type 2 regime of metformin and diet.

I'm confused as how could I be a type 1 regime then moved to a type 2 ? Was this due to the weight loss ? As with type 1 you don't produce any insulin at all I was under the impression via seeing my sisters clinic. - since diagnosis I've had a heart attack/kidney died and having removed in the next month or so/ amputation/ sight is going off / psoriasis / stress etc

I'm confused and now changed endocrine clinic as my other hospital was negligent. Could they have got my diagnosis wrong as my diabetes on type 2 regime has been really irratic plus when I'm ill I'm on a sliding scale in hospital. Should I ask for a review of my diagnosis ?
 
Hi. You've had a very complex and sad experience. I can only guess at some of the conclusions. As you were apparently very much overweight at diagnosis it would seem you were probably a T2 with insulin resistance. Hospitals will usually put you onto an insulin regime to rapidly get your blood sugar under control but that doesn't mean you are T1; it's just the best way of getting very high bloods under control. The weight reduction will have helped remove insulin resistance and allow your blood sugar to be more stable. Obviously your other problems may well be associated with your blood sugar control and I can't comment on that. Having the right weight is a big help when trying to control blood sugar, so do try to have a low-carb diet to remain at the right weight and see how you go. Ensure you keep in touch with your diabetes experts.
 
Thank you for your reply and kind answer.
I lost over 10kg, now am at the weight I've been since I was younger (size 10/12) trousers.
My physician at the hospital said I was to "settle into a category" and hence why I was left to see how stable my sugars went. (Is this category system known of) I was on injections.
I think they didn't explain properly when originally diagnosed. I took for T1D, as I was on insulin plus family history. I didn't realise I could be a T2D on insulin injections.

I'm finding my metformin tablet is now not really controlling my diabetes. (Diet is good/monitored, as with my conditions I can't afford to tilt them off kilter.)
I am beginning to have most medications via injection, as they think I can't absorb vitamins and iron.
Could my body be resisting metformin or can medications need topping up ? Could this be a sign that I'm not producing insulin now and I should be more cautious of signs ?
Sorry I know this is advise of medical content, just wondering if anyone experienced needing a T1D regime when they are T2D ?


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Hi. It is always possible that you are a Late onset T1 (LADA or T1.5). Being overweight would give all of the T2 symptoms which the low-carb diet and slimming down will largely 'cure'. If on more than one tablet type and your blood sugar still can't be controlled then LADA becomes a possibility. Normally a LADA will have lost weight prior to diagnosis as the pancreas isn't producing enough insulin to make use of the carbs whereas an insulin resistant T2 thru excess weight will have too much insulin but it can't be used efficiently. These things are complex and you can have both diabetes types at the same time! So, your physician may need to prescribe further tablets such as Gliclazide (diamicron in the USA?) and possibly a gliptin. After this insulin comes back on the horizon. Only time and monitoring will tell where you are in the spectrum.
 
Thank you , I have a family history of type 1 and I have had a heart attack so was told I'm restricted medication wise. I've just seen someone not taking metformin for kidney problems which concerns me as I have severe kidney problems. I have requested a clinical change of hospital as I don't think this current hospital has any idea - my insulin injection regime was working perfect and the tablets just don't seem to make any to little difference. I would prefer the insulin route as then I could protect my future health better. I've taken care of my weight as having health issues, you realise you have to or medication is rendered useless in the long run.

what is LADA sorry and also 1.5 diagnosis ?


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Hi. LADA is Late onset Autoimmune Disease in Adults often called T1.5. It's effectively T1 but can come on at any age and can appear slowly or quickly. The diagnosis is similar to a T1. GAD anti-body and c-peptide insulin level tests can be given to help diagnose T1.5. Often a person loses weight before diagnosis as the body has little insulin to handle the carbs and if it appears fast there can be ketones and urgent attention is needed
 
Oddly as I'm not active I expected to put weight on as previously but I'm loosing or staying still - very odd for me so I'm going to ask my clinic app dr or nurse if I can be checked. I'm Definatly sure I have ketones as I'm peeing and drinking vast quantities like I was at my diagnosis. My home nurse is coming over next week so I may ask her to bring some dipsticks. Just to be on the safe side.

Thank you for all your amazing advice xx


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Bubbatara said:
Should I ask for a review of my diagnosis ?
Click to expand...
Check the blood tests they did at diagnosis to see whether they tested you for glutamic acid decarboxylase 65 (GAD65), Islet cell antibodies (ICA) and c-peptides. These are what they ought to test for to differentiate T1 and LADA from T2. If they didn't test, I'd ask for a test now.

Kate
 
Thank you everyone for your advice - app I was never given the tests to determine which type I was and they think I was just assumed to be type 2. My new clinic thinks I may have been a late onset and are planning all these tests for long term care plans. As I'm due for a operation in April and quite major surgery they have put me back on my insulin regime to help regain control. I have been found this week that the numbness, thirst , toilet trips, bleeding gums etc is my sugars being exceedingly high (17-20) in the morning as I wake up and now we are working to titrate my novamix dose or I may go on the 4 injection regime next week if this doesn't show some lowering of my sugars. Thank you all so much and I was so educated that the nurse agreed something was not adding up and my metformin was not giving me sufficient insulin assistance.

So aiming for the control and health to fully prepare myself. Again many thanks to all.


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