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T2 - In which way?

Discussion in 'Ask A Question' started by PickledPepper, Jul 26, 2010.

  1. PickledPepper

    PickledPepper · Well-Known Member

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    Okay, I'm a T2 (no, not a terminator machine sent back to assassinate a future resistance leader silly!). I seem to have controlled it a bit at the moment. I am told this thing doesn't get any better....

    I've figured out the condition involves 1 of 3 possibilities:

    1) The receptors on my muscles, which open them up to receive glucose are bags of sh**e and not doing their bit properly. The old pancreas is working fine in generating insulin. It just isn't working on the receptors like it should be.

    2) The pancreas is a monkey and not doing it's job properly. Receptors related to glucose are fine. Just not enough insulin being pumped into system to enable them fully.

    3) Both of the above.


    Next big question. How do we figure out exactly which of the above is true for us? What tests can be done?

    Sometimes, the GP and Nurse don't seem to have much of a Scooby! (As in Scooby Doo = clue). They have recommended that I follow their course of action (met + simvastatin + them being stingy with test strips) for 3 months before referral to a specialist. I'm not following their plan but am trying a more natural approach for the moment having taken met and sim for month and a half or so and then ceasing due to the levels of dangerous gas met was causing me to pump into an already teetering ecosystem.

    So how do I find out exactly how the condition is effecting me beyond the generalities? What tests must I insist on getting done by the Diabetologist, when I do eventually get to see him in a few months?

    I'm all fired up!
     
  2. zanc

    zanc · Well-Known Member

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    The test you want is, I think, a C-Peptide test. I asked my Nurse/GP if I could get one as I wanted to know what exactly was wrong with me. However, I was told the test was too expensive and no matter what the result was the treatment would be the same.

    I came away very disillusioned and a little angry.
     
  3. PickledPepper

    PickledPepper · Well-Known Member

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    Thanks for that. Will look into it.
     
  4. Lisa65

    Lisa65 · Member

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    I would like to know this too. i've just started metformin, but if that along with carb control and exercise doesn't lower my BG enough and my DN wants to add in other meds, surely it would make sense to know whether the pancreas is still producing a decent amount of insulin or not.

    If the problem is mainly insulin resistance and there is in fact loads of insulin still being produced, there's little or no point in adding a drug like glicazide, is there? Forcing the pancreas to pump out even more insulin constantly when there's already plenty available is just going to wear the beta cells out quicker, surely?

    I don't see my DN again until the end of October, but I'm going to ask her about this C-peptide test, and if I don't get anywhere with her, I'll make an appointment to see the nice GP at the surgery, he is one of the rare breed of GPs who actually listens to what his patients say.

    PP, I have found that fairly drastic carb reduction works well to reduce the gaseous emissions caused by metformin. If I stay pretty well off all carbs, its not too bad. I take the modified release metformin too, which doesn't seem as bad.
     
  5. Patch

    Patch Type 2 · Well-Known Member

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    I've asked about the C-Peptide test. Both the Dr., and later the DN looked at me with a blank stare. Neither of them knew what it was.

    I'd love to know if:

    A) My Pancreas is f****d, and doesn't make insulin, or:
    B) Pancrease is fine, but insulin resistance is up.

    My bet is that the pancrease is fine - I'm overweight, so I'm assuming the insulin is there (they don't call it th efat building hormone for nothing!).

    My care team doesn't seem interested in finding out, though.
     
  6. phoenix

    phoenix Type 1 · Expert

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    C peptide test here
    http://www.labtestsonline.org.uk/understanding/analytes/c_peptide/test.html
    To be honest I haven't heard of people normally having it except when there is a doubt whether the person might have a slow onset form of type 1.(eg: if they don't have the 'normal' type 2 features, and/or oral drugs have only 'worked' for a short time or don't bring levels down... even then many people seem to have to push for the test)

    Insulin resistance usually seems to be assumed if a person has features of the metabolic syndrome
    http://www.labtestsonline.org.uk/understanding/conditions/insulin_resistance.html
    (page 1 describes IR, page 2 the various tests.
     
  7. cugila

    cugila · Master

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    Many people find that the only one who will order such a test is an Endocrinologist. Mine has intimated that will be done as I now seem to be producing much more of my own Insulin at various times of the day. At the moment it's on hold as I'm trying something else for now.

    Most GP's as you found Patch haven't a clue what you are talking about. Was the DN just a Practice Nurse or a proper DSN at a Diabetic Clinic ? I would have thought any DSN would know exactly what it was, part of her training as they are very highly qualified.

    Might be worth asking for a referral to an Endo and try again.

    Ken
     
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