What Type am I? Please help!!

Hello AnitaM,

You clearly accept that you're diabetic. So if I were you, I really wouldn't worry too much about attaching a 'type' name to yourself.

My goodness, you should take a look at the agitation some of the users of this website display over the issue of diabetic type! - such as who's better off, or worse off.

I've taken insulin for 30 years, and my condition is exceptionally well controlled. (Indeed I'm sure I'm healthier now than I might have been if I'd never contracted diabetes at all; I certainly eat much better now than I would have done otherwise.)

But that control is mostly a function of my own thinking about the condition I'm in. Almost entirely, it's definitely NOT a function of any expert advice I've received. (Somewhere on this website, I refer to some expert advice I received 30 years ago regarding the cutting of visually read blood-sugar testing strips; and that's one of the few exceptions.)

Please don't take this too seriously, it's intended to be tongue in cheek: you could start a revolution in thinking about diabetes. (God knows, that's needed.) You could call yourself 'type 3'!

I am not a medical expert. (I don't really know what 'type 1.5' is, or is supposed to be; but I'm going to look at that section of this website just as soon as I've posted this message.) However I certainly have expertise with regard to the control of my own diabetic condition. And I believe I have far better insight into what is appropriate to the control of my condition than any medical expert I've come up against, or read about.

Evidently, then, I don't have too much confidence in the orthodox method of diabetic control. Irrespective of type, the orthodox method appears to be that you should try eat as though you weren't really diabetic at all; and the medications are set accordingly, and thereafter adjusted - seemingly ceaselessly.

My inexpert advice to you would be that, if you think you can manage it, seek to take insulin. But whatever you do, don't think you can eat like you weren't really diabetic at all. (Short of a genuine cure, as opposed to the genuinely effective cure - at least in potential - of insulin and/or tablets, that will never be possible.)

Fix your insulin first, and then eat accordingly - rather than fixing your eating habits first, and then fixing your insulin according to that.

Since you're diabetic, I believe you should aim to firmly ensure that others in your familial and social environment (who may eat with you) make adjustments TO YOU, as far as is reasonably possible, rather than the other way round.

I believe I can well appreciate the quandary you must have felt. I seem to see this so often.

As for the insulins, there are so many different types. (Or at least, there are so many different insulin names.) And I only know about the ones I take. But I have ensured - contrary to expert advice - that my insulin regimen is such that the insulins' effect is exhausted by the time I go to bed. So I always know that I can go to sleep safely.

In my opinion, the failure to ensure that diabetics can sleep safely is one of the major failings of the orthodox method of management. (Mercifully, I'm not one of those who tend to doze off during the day; that's a difficulty I wouldn't know how to advise on.)

Elsewhere on this website, I have recently written about the food/blood-sugar regimen I follow. If you do a search for the terms 'rye bread' and 'Betachek Visual', you'll find the relevant postings I've made. (I've been tending to feel that I've been wasting my time; but I enjoyed doing it anyway.) The more relevant postings are probably mostly the longer ones.

I'm sure you'll soon get a handle on your condition that's better than those who advise you.

The responses you report are clearly unhelpful. As for the first one, a hypo may wake you the first time; but I wouldn't count on it. As for the second, it's better to wake with high blood-sugar than not to wake at all.

I would urge that you to get your insulin regimen changed tomorrow, if possible. (If I were you, I would insist on it.) But I am not a medical expert, so I can't advise you on that.

However, it's easy to check on the piece of paper inside the pack that the insulin comes in: this will tell you the length of time that the insulin takes effect. It's effect will always describe a form of bell-curve. I ensure that the effects of the two fast-acting insulins I take, Actrapic and Novorapid, run out together - at around midnight. So I can go to bed safely at 11.00pm; because so long as I haven't eaten anything that's slowly-digested earlier in the evening, then I know that my blood-sugar will fall by a further 2mmol/l. And if my blood-sugar is, say, 4mmol/l at 11.00pm, then I know that half a slice of the co-op's wholemeal bread (with some Marmite or other yeast extract) will cover that.

I remember all too well the fear that you feel. You certainly are not worrying too much about that.

But equally, you don't need to worry at all about waking tomorrow with high blood-sugar. That still happens in my case, occasionally.

I hope you'll find that reassuring.

I've done some more reading, and I don't believe I should withdraw anything I wrote.

In particular, I read Anita's wording that the nurse said she suspects Anita is type 1.5. That's not a diagnosis, it's expressly a suspicion. (There were two other diagnoses preceding: first of type 2, and then of type 1.) And it's not even clear whether it's the doctor's suspicion, or merely the nurse's.

I didn't write anywhere that the type doesn't matter. I think someone else needs to do some reading.

One thing I'm ever more clear about is the haziness of the thinking of medical experts in regard to all forms of diabetes. In particular, the orthodox thinking in regard to diabetic management is appalling.

Two things stand out for me in illustration of what's wrong with orthodox diabetic management. Anita herself expressed an all-too-understandable fear of a night-time hypo. And I believe that shows by far the greatest failing of orthodox thinking in regard to management. Second only to that is the general, shockingly bad HbA1c readings that one sees clear evidence of on this website.

Thanks Brett,

I had just come back downstairs to add that the very fact that someone like Anita should come here to seek advice, when the medical advice she had received was so conflicting, speaks volumes.

Thanks again, and goodnight!

Hi Anita,

I tend to have low blood-sugar readings throughout the day, especially in the morning. (By 'low blood-sugar', I mean anything below 4mmol/l.) But they're generally not a problem. And I certainly do not ordinarily count such readings as being indicative of hypos.

I start eating rye bread as soon as I need to eat in the morning, though I start to eat it slowly. And it has a tremendously moderating effect on my blood-sugar.

I'm certainly not invulnerable to having a genuine hypo, where - wittingly or unwittingly - I begin to lose control. But I would have to be seriously distracted for this to happen.

The idea that any blood-sugar reading below 4mmol/l is indicative of a hypo is plain wrong. (It's correct to say that such a reading is SYMPTOMATIC of a hypo.) And worse still, it's a dogma. I first found this dogma being expressed, directly to me personally, by the professor of diabetes at the diabetes centre I attend. (And it's quite possible that this message will now attract some criticism, which I will welcome!)

I wonder if you've tried eating rye yet? (It's very nice with Biona Pear & Apple Spread, but that's entirely optional.)

But if you do try this, be careful not to eat too much rye later in the day. (I eat by far the most in the morning, and I don't eat any after 4.00 in the afternoon.) Otherwise, your blood-sugar will rise later in the evening.

I certainly wouldn't recommend that you aim to keep your blood-sugar as low as I tend to keep mine, especially if you're living alone. (I'm a carer for my 92-year-old mother; so naturally she can keep an eye on me.) But I hope you will find what I've written something to think about.

There is what I believe to be a highly significant linguistic issue involved.

No blood-sugar reading is ever a hypo: they're not the same thing at all. A hypo is something BEHAVIOURAL.

The fact that, etymologically speaking, 'hypoglycaemia' means 'low blood-sugar' is neither here nor there: there is just (though undoubtedly so) an important ASSOCIATION between low blood-sugar readings and the occurrence of hypos - hence the use of the word 'hypo'.

The important association involves symptomatology. A low blood-sugar reading is merely one symptom of a hypo, which may or may not be occurring.

I may feel a hypo coming on, and quickly drink a large glass of orange juice. Then almost immediately I'll start to feel better. But if I also immediately test my blood-sugar (using a meter) then I may very well get a reading of, say, 2mmol/l. And yet I'm certainly not then having a hypo on account of the large glass of orange juice I just drank!

Eating rye bread throughout the morning seems to keep a certain amount of carbohydrate constantly, slowly, leaching into my blood-stream. And this, I believe, is what prevents my blood-sugar from ever CRASHING.

So I can happily spend the day getting moderately low blood-sugar readings (using the far more economical visually read strips, I hasten to add) without any problem at all.

How healthy this practice may or may not be in the long term is, I understand, a debatable issue. I've heard about, and seen, evidence both ways.

Also, it is often claimed that by constantly having lowish blood-sugar one loses one's warning symptoms of a hypo. Well, with regard to that, I can only speak for myself. When I was first diagnosed with diabetes 30 years ago, and began taking insulin, I certainly had warning symptoms that I never get now: palpitations, sweating, ... etcetera. But I lost those kind of warning symptoms NOT VERY MUCH LESS than 30 years ago!

And I'm still here.

If, instead of the kind of diet I have, you spend your life eating white bread and potatoes (etcetera, etcetera), then I would agree with that professor (though certainly not with his form of expression): any blood-sugar reading below 4mmol/l is EFFECTIVELY indicative of the occurence of a hypo.