Thin Type 2 or Honeymoon Period Type 1

[ert]

Do all type 2 diabetics have high insulin levels on diagnosis?

My specialist diagnosed me with T1DM as I had extremely low insulin on diagnosis on a c-peptide test. I am GAD and IA2 antibody negative. My specialist suggests that the antibodies only stay around for 6 months and they must have missed them. I've managed to keep my blood sugars in the glucose impaired range for two years through a keto diet, interval running and weights, and fasting. I still wonder if I could be a slim type 2. My BMI was 22 on diagnosis. Slim type 2 diabetics are supposed to have more type 1 like symptoms but T2DM, more importantly, is potentially reversible. Do all type 2 diabetics have high insulin levels on diagnosis? Medical articles I've researched suggest that it takes a type 2 diabetic 20 years to end up with insulin levels as low as mine.

 

[Bluetit1802]

Do all type 2 diabetics have high insulin levels on diagnosis?

My specialist diagnosed me with T1DM as I had extremely low insulin on diagnosis on a c-peptide test. I am GAD and IA2 antibody negative. My specialist suggests that the antibodies only stay around for 6 months and they must have missed them. I've managed to keep my blood sugars in the glucose impaired range for two years through a keto diet, interval running and weights, and fasting. I still wonder if I could be a slim type 2. My BMI was 22 on diagnosis. Slim type 2 diabetics are supposed to have more type 1 like symptoms but T2DM, more importantly, is potentially reversible. Do all type 2 diabetics have high insulin levels on diagnosis? Medical articles I've researched suggest that it takes a type 2 diabetic 20 years to end up with insulin levels as low as mine.

What happens after a meal that is carb laden with no exercise?

 

[ert]

What happens after a meal that is carb laden with no exercise?

My blood sugars go above 20 mmol/L. I have high ketones, so it's something I just plain can't do. I don't have enough baseline insulin to clear more than 12 grams of carbohydrates in a meal.

 

[Bluetit1802]

What happens after a meal that is carb laden with no exercise?

My blood sugars go above 20 mmol/L. I have high ketones, so it's something I just plain can't do. I don't have enough baseline insulin to clear more than 12 grams of carbohydrates in a meal.

I am no expert but that sounds more like T1 on honeymoon to me. Does this bother you? (The thought it may come to an end and you will need to inject?)

 

[ert]

T2DM is potentially reversible. So it bothers me, not to know what type I am. If I had the antibodies, then I would believe myself to be T1. But I don't have them. My working theory. Thin type 2 diabetics have severe blood sugar spikes due to the saturation of fat cells (hidden obese), and the inability to grow more fat cells when their blood sugar spikes. This could cause the islet cells to be destroyed more quickly than with an overweight, insulin resistant T2. If this theory had any basis, a thin T2 person could potentially be diagnosed with low insulin. I'm trying to find medical articles to answer this.

 

[Guzzler]

Slim T2s can be hyperinsulinaemic. Insulin Resistance and Hyperinsulinaemia go hand in hand.
It is my understanding that there are those with age related T2 due to beta cell dysfunction/death but this can only be proved by autopsy as biopsy on the pancreas is impossible in the living.
It is also my understanding (those with LADA and T1 are welcome to correct me, here) that GAD results can be ambiguous, it is not uncommon.

 

[HSSS]

I’m thinking this through logically rather than from any deep knowledge of type 1. I understood if you have lost beta cells then they’re gone. Whether it’s from type 1 or a slim type 2 whose cells were lost due to inability to create more fat storage they’re still gone. I can’t see how you come back from that to produce more insulin. I guess the difference lies in whether you lose more (type 1) and the honeymoon ends at some point or you’ve stopped the loss (type 2) and you stay where you are. Either way it would appear to keep doing what your doing and wait and see what happens to your insulin levels is really the only realistic path. To go back to higher carb eating would probably hasten the end of the honeymoon or possibly set off the destruction of beta cells again at some point.

 

[Kittycat_7_]

Hi,
If you have ketones present sounds more like type one.
Take care

 

[ert]

I'm on a low carbohydrate diet with intermittent fasting, which means my ketones will be higher.

 

[Guzzler]

Hi,
If you have ketones present sounds more like type one.
Take care

A slim T2 in ketosis has ketones present. This also applies to those who are overweight/losing weight.

 

[EllieM]

Hmm, there's always MODY??? Occurs in 1-2% of people initially diagnosed with diabetes. Doesn't always need insulin.....

 

[HSSS]

Ketoacidosis type high or nutritional ketosis type levels?