what am I?

[qbix]

Hi all,

I was diagnosed with type 1 diabetes back in January 2012 with an hba1c of 91. I was immediately put onto Novo rapid and lantus, taking 8 units of lantus a day and ca 1 unit of Novo rapid per 20 g of carbs.

After diagnosis I completely changed my diet, cutting out all snacks, eating porridge ever day for breakfast, salads for lunch and what ever my wife cooked for me in the evening. I fastidiously carb counted and ate a lower carb lifestyle (typically between about 150 to 200g a day). As a consequence my next hba1c was 40, so naturally I was delighted and let things slip a bit, and as a consequence my last one was 47.

Now I know these numbers are good, so it isn't a moan, but given the amount of insulin I am on (which I know is very little, given I am 6 foot and weigh 13.5 stone) and my apparent ability to keep a good hba1c. Am I really diabetic or just glucose intolerant or none of the above?

My bg is typically between 6-8 first thing and varies depending on what I am doing that day. I have been as low as 2.8 thanks to a miscalculation on my part and as high as 15 after eating something I shouldn't have.

I guess I am doubting the diagnosis as I never had any other tests other than my hba1c and was just put straight onto insulin. I guess they just immediately assumed type 1 as I am not really overweight. The other thing that makes me wonder is that if it is genuinely auto immune like type one is supposed to be shouldn't I be put the honeymoon phase by now given it has been nearly 2 years?

Any opinion would be appreciated. Even if no one replies to this I guess I just needed to share my story so far and have a bit off a brain dump.

 

[pavlosn]

Hi all,

I was diagnosed with type 1 diabetes back in January 2012 with an hba1c of 91. I was immediately put onto Novo rapid and lantus, taking 8 units of lantus a day and ca 1 unit of Novo rapid per 20 g of carbs.

After diagnosis I completely changed my diet, cutting out all snacks, eating porridge ever day for breakfast, salads for lunch and what ever my wife cooked for me in the evening. I fastidiously carb counted and ate a lower carb lifestyle (typically between about 150 to 200g a day). As a consequence my next hba1c was 40, so naturally I was delighted and let things slip a bit, and as a consequence my last one was 47.

Now I know these numbers are good, so it isn't a moan, but given the amount of insulin I am on (which I know is very little, given I am 6 foot and weigh 13.5 stone) and my apparent ability to keep a good hba1c. Am I really diabetic or just glucose intolerant or none of the above?

My bg is typically between 6-8 first thing

Hi

An hba1c of 91 is definitely diabetic as are fasting levels of 8.

Wonder if you are really t1 though. Have you never had a test to confirm this ( some kind of antibody test I believe)?

Pavlos

 

[Squire Fulwood]

Yes, I agree. Non diabetics do not have an hba1c of 91. The fasting levels quoted are probably due to good control using insulin which suggests they would be higher without.

I think you are looking for a technicality to do with auto immune or not auto immune so that you can change your category. For practical purposes I don't think it matters. You obviously are not producing (enough) insulin naturally and you have to inject. I have no idea if changing your category has any legal implications.

The vast majority of T2's can control their diabetes with good diet and some exercise. If you can't do that without insulin then you are not very different from a T1.

 

[graj0]

"How much insulin does my pancreas produce?" is the question to ask your GP. Patients with diabetes may have their C-peptide levels measured as a means of distinguishing type 1 diabetes from type 2 diabetes or Maturity onset diabetes of the young (MODY). Measuring C-peptide can help to determine how much of your own natural insulin you are producing as C-peptide is secreted in equimolar amounts to insulin. C-peptide levels are measured instead of insulin levels because C-peptide can assess your own insulin secretion even if you receive insulin injections, and because the liver metabolizes a large and variable amount of insulin secreted into the portal vein but does not metabolise C-peptide, meaning blood C-peptide may be a better measure of portal insulin secretion than insulin itself. Seems that it is better to measure C-Peptide some time after initial diagnosis, so you fit the bill.
I ended up paying for mine after 17 years of being type II, just because I wanted to know, seems the NHS round my way aren't so keen in "the patient would like to know". Knowing that my pancreas wasn't too bad, insulin secretion was in the normal range, helped persuade me that lowering my carb intake to less than 100gms (RDA is 300 gms) was the way to go. That enabled me to dump Gliclazide, Januvia and Atorvastatin.

 

[noblehead]

''What am I''

I would say your just a well controlled type 1 qbix, don't try and fix what isn't broken.

 

[qbix]

Thanks for the responses guys. Most appreciated. After reading some of the posts on here I feel like a bit of a fraud taking insulin as I see people who have much higher BG and are being refused insulin. @graj0 where did you get your c peptide test done? I have mentioned tests to my gp a couple of times and he has just looked at me blankly as if I were mental or that he had no idea what I was talking about.

 

[DeejayR]

Seems that it is better to measure C-Peptide some time after initial diagnosis, so you fit the bill.
I ended up paying for mine after 17 years of being type II, just because I wanted to know, seems the NHS round my way aren't so keen in "the patient would like to know". Knowing that my pancreas wasn't too bad, insulin secretion was in the normal range, helped persuade me that lowering my carb intake to less than 100gms (RDA is 300 gms) was the way to go. That enabled me to dump Gliclazide, Januvia and Atorvastatin.

Interesting, thanks for that idea. I may follow a similar path before I get on to any medication in the first place.

 

[graj0]

. . . . . . . . where did you get your c peptide test done? I have mentioned tests to my gp a couple of times and he has just looked at me blankly as if I were mental or that he had no idea what I was talking about.

Cyrex Laboratories which seems to be called Regenerus in the UK. Here's their UK address and phone number. Aero 14, Redhill Aerodrome, Kings Mill Lane, Redhill, RH1 5YP Tel. +44 (0)333 9000 979

You might like to Google both names because I couldn't find c-peptide on their UK website. You would of course have to organise for the blood to be taken, I have used two places in London which is a pain, then I found a place only a few miles away from me in Hazlemere, attached to a private GP's surgery. I had wondered if my own DN would have drawn the blood at the surgery, probably for a fee.

 

[LittleGreyCat]

Always worth asking your surgery if they will do a c-peptide test for you as a private patient, or to recommend somewhere local who can.

 

[qbix]

@graj0 and @LittleGreyCat thanks for the info. I will probably look it up. @noblehead thanks. I know what you mean. It will make no difference to my condition whether or not I know what type I am, I guess it is just something that has always been lurking in the back of my mind and feels like it needs an answer