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Type 1 or type 2

B

Bedforme

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6
A few months ago I had sudden onset of type 2. I became unwell on a weds. Bloods taken on the Friday told that eve that I had type 2, ended up in A & E on sat morning in border line DKA sliding scale over night, then started on insultin and told I was type 1. Now because I didn't have a virus I've been told I'm type 2, but still on insulin. Tablets have not done any thing for my BGLs . My nurse told me that I have missed any symptoms. But I do find this hard to believe. I didn't lose weight till I was il on the weds. I've not had any infections for a few years. I only stared to drunk a lot on the wed. And that's when my eye sight went wrong as well. The only health problem I have is that I am over weight. I don't drink or smoke, and there is no family history. I've just become very confused, and wonder if any one has been through the same thing?
 
jack412 said:
first thing I would do is work on the weight by reducing carbs which will reduce insulin and you wouldn't be the first T2 to come off insulin

http://www.dietdoctor.com/lchf it’s a long page and a video
http://lowcarbdiets.about.com/od/lowcarbliving/a/Food-Cravings.htm because carbs don’t give up easy
testing
http://www.phlaunt.com/diabetes/14045524.php
food count
http://www.myfitnesspal.com/
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Thank you. I've lost nearly 2 stone which has made no difference. I was just over 15 stone now just over 13. I know I've got a long way to go before I'm normal, but would have hoped that 2 stone should have made a difference. I am carb counting, but can't seem to find what a normal carb in take should be. I have done the Akins diet before but it is a very unhealthy did to follow.
 
Bedforme said:
Thank you. I've lost nearly 2 stone which has made no difference. I was just over 15 stone now just over 13. I know I've got a long way to go before I'm normal, but would have hoped that 2 stone should have made a difference. I am carb counting, but can't seem to find what a normal carb in take should be. I have done the Akins diet before but it is a very unhealthy did to follow.
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I think the LCHF is healthy from what I have read. it's hard on atkins because he is very low carb and it gets to the point of cutting out normal veg and nuts
100-150g is what I would consider max, but healthy plate would have you at 200+g

are you also on metformin?
 
jack412 said:
I think the LCHF is healthy from what I have read. it's hard on atkins because he is very low carb and it gets to the point of cutting out normal veg and nuts
100-150g is what I would consider max, but healthy plate would have you at 200+g

are you also on metformin?
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Well done with your weight. I'm on metformin 2000. As far as I'm aware my cholesterol is with in norm, as I've not been started on any stains. I've tried some of the gliptins with no effect, I've also been on gliclazide with no effect. Both medication BMs ended over 20 with breakfast of banana and low fat yogurt. I'm on novorapid (1 unit per 10g carbs) when eating, and 7 units levermer am, 10 units pm. BMs are still verable, between 4-17 mmols. I've been told about A1c but do not know my level. Thank you for talking to me :)
 
for help with BG and insulin, you would be better posting on T1 for some basal bolus help
http://www.diabetes.co.uk/forum/category/type-1-diabetes.19/
have you got some work books?

There is an online course for background and an idea to it. Free to register
http://www.bdec-e-learning.com/

This set of workbooks are worth reading and practising working examples only of carbs and doses
Don't change dose without nurse approval

Workbook 1http://www.diabetesinscotland.org.uk/Publications/9225 Carbohydrate Counting.pdf
insulin carb ratio and correction doses
Workbook 2http://www.diabetesinscotland.org.uk/Publications/9226 Carbohydrate Counting the Next Steps.pdf

Carb listhttp://www.diabetesinscotland.org.uk/Publications/9227 Carbohydrate Tables A6.pdf

Diaryhttp://www.diabetesinscotland.org.uk/Publications/9228 Free Diary Portrait A4.pdf

Basal testing
http://www.diabetes-support.org.uk/info/?page_id=120

Sick day ruleshttp://www.diabetes-healthnet.ac.uk...flet_-_Sick_Day_Rules_for_Type_1_-_Nov_13.pdf
Sick day rules flowcharthttp://www.leicestershirediabetes.org.uk/uploads//documents/Type1 Sick_day_rules_InsulinV3.pdf


A workbook with USA numbers and math rules, but it has a good trouble shoot at the endhttp://www.bd.com/us/diabetes/download/insulin_adjustment_workbook_complete.pdf
 
Bedforme said:
Well done with your weight. I'm on metformin 2000. As far as I'm aware my cholesterol is with in norm, as I've not been started on any stains. I've tried some of the gliptins with no effect, I've also been on gliclazide with no effect. Both medication BMs ended over 20 with breakfast of banana and low fat yogurt. I'm on novorapid (1 unit per 10g carbs) when eating, and 7 units levermer am, 10 units pm. BMs are still verable, between 4-17 mmols. I've been told about A1c but do not know my level. Thank you for talking to me :)
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the metformin should help the insulin work better and help with the weight too
as you know it's hard work dropping the Kg's, the trick I found is to find what carb level you run best at
http://lowcarbdiets.about.com/od/lowcarb101/a/carblevel.htm

there are some clever guys here who can help you with working out what to tell your nurse about changing your dosages
they normally suggest starting with overnight and 'miss a meal basal checks
 
Hi. It can be difficult diagnosing T1 from T2 if you are overweight. You are more likely to be T2 due to insulin resistance. The best way forward is to ensure you are low-carbing and adjust the insulin as the weight goes down; do test as often as needed to avoid hypos. As and when your weight is in the 'normal' range it becomes easier to determine what meds to continue with. It may be you can do without the insulin? If insulin is still required then it may be you are actually a T1 but the treatment going forward will still be insulin. BTW, the thing you were told about viruses isn't really valid. Most Late onset T1s are due to pancreatic anti-bodies which are not known to be virus related. Your pancreas can be damaged by viruses, anti-bodies and pancreatitis etc
 
Thank you. The virus situation was because my consultant implied that was why I was type 2. At the moment my weight loss has not changed my BMs. I know I still have a long way to go. The only thing that I would have thought, that if I'm still producing some insulin, the gliclazide and gliptins would have had some effect on my BMs which they didn't. I'm not really that worried which type I am, it's just more interesting how the diagnosis is made with only one blood test. And that my history isn't norm. I've no family history, don't drink or smoke. It was sudden on set. The only factors are that I'm over 40, short and fat :). I am being good with my diet, my dietitian said I was being too strict. Work outs are a little harder, as l work 12 hour shifts have four children. I do walk the dog every day. Yes I know I need to do more.
 
Type one is an autoimmune condition ie the 'body' attacks it's own beta cells and kills them. This happens when it mistakenly sees the beta cells as an invader. It produces antibodies to get rid of it, just as it would produce antibodies to a viral infection.
That's where he's coming from with the virus suggestion. Something has to trigger the antibodies and trigger the autoimmune reaction , one persistent theory with many papers written about it is that one of a group of viruses does this.. It's far from proven but I notice that there have been a lot of papers about it in the last couple of years such as this one reported here http://www.sciencedaily.com/releases/2013/10/131022091721.htm

Whatever the trigger the normal tests are not for viruses but for antibodies and the most frequent antibody is for anti GAD which is a blood test most often given to distinguish between T1 and T2 (there are other antibodies but this is by far the most common in adult onset T1)


Whatever the type, since you are on insulin then you do need to learn to use it. I'm not sure how long you have been using insulin but for obvious reasons they do tend to start with conservative doses and if necessary work upwards.
What is helpful is to really keep very careful records of what you eat with the carb count,(and weigh, don't guess) how much insulin you take ,the levels before and 2 hours after eating and the levels at bedtime and first thing in the morning. (Oh and any exercise you do)

Putting it simply (probably too simply)if your glucose has risen outside your target at the two hour postprandial reading then it maybe that the amount of insulin you take for each 10g of carb is too low.
If on the other hand, you find that the levels are rising overnight or in the period before the next meal , then your basal may need adjusting.
At the moment though, it's recording and hopefully being in contact with a diabetes specialist nurse who can advise on adjusting doses/ratios
 
Thank you very much. Makes it a bit clearer. I've only had this for 4 months. But for the first two months my nurse was trying her hardest to get me on tablets. It wasn't till I saw my consultant that he said to stop all tablets, apart from metformin, so I can try to get a normal life. I'm slowly working out what I can and cannot eat and the insulin I need for different foods. I've been keeping good records on foods insulin and activity. But when u think you've cracked it, the BMs play up. I am getting more good levels of BM than at the begining of all this. :)
 
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