It is because Type 1 and Type 2 have different causes and even though on the surface treatment might be similar for some, really the ultimate cures for the diseases might need to be quite different (even if both ended up using islet transplants for a cure, for example, Type 1 would need to address the autoimmune issue and Type 2 might need to address a host of “separate” but related metabolic issues). Also, in terms of stopping or preventing Type 1 and Type 2 from progressing at an early stage, very different treatments would be needed.
It would be like calling food poisoning and the “stomach flu” (I forget the actual name of it) the same name because on the surface they have similar symptoms. Well, in reality there are very different things going on in the body to create those symptoms, as the causes are different, so they are called different names.
Hmm… wish we could find out whether they are related or not. I do know that I have a thin T2 friend (skinny actually) who spent many years on oral meds with no success. Two months on insulin and he’s doing fine! Weight loss and execise works for some and not for others. It’s progressive for some and not for others. It’s so confusing!
See, I love this line of thinking. We get caught up in “what type am I?” etc, In the end, what matters is how we take care of ourselves. I left HOW I got diabetes back with my diagnosis. It doesn’t help me now. Focusing on NOW, and what I need to do is what helps.
Keep my numbers consistent, exercise, and above all else, BREATHE.
Unfortunately it does matter what type you are. It matters in the treatment that you receive and to the insurance companies. One member was worried that she was turning 65 soon and wouldn’t pass a C-peptide test so that the new insurance would cover her pump. If there are so many different reasons why one has high sugar, I wish that doctors (endos in particular) would find out the reason and treat accordingly. Presumably genetics would be helpful but…
The labels are only important in as far as getting the right treatment. The worst case scenario of getting the wrong label stuck on you, is if you were insulin deficient but called a Type 2 and being given a cocktail of pills, none of which are going to work if you are insulin deficient. Which would lead to the patient walking around with deathly high blood sugars, and at the same time, being blamed for being non-compliant. So if wrong label leads to wrong treatment, that’s bad! Wrong label+right treatment is irritating but not ultimately life-threatening.
Then there are LADA’s like me for whom the oral meds do work for awhile, but current wisdom states that it is not a good treatment for Type 1’s because it hastens beta cell destruction.
My doctor told me recently that more and more the medical profession is leaning towards starting type 2’s on insulin sooner rather than later. If this becomes routine it will eliminate the worst of the results of misdiagnosis, but there are also some insurance issues that would be impacted with the wrong diagnosis, such as the number of test strips you are prescribed and being approved for a pump or CGM. I still want to know my Type if for nothing else that I read about it and learn as much as I can, and much of the information from the opposite type would not be particularly helpful.
I hope my story, which is dated 1983 , will help .
It was sooo much easier , when I was diagnosed ( really ??) …almost 29 years ago as an over age 40 person : I was diagnosed with diabetes ,put on medication , visited the lab weekly , numbers stayed high . Asked the Doc to put me on insulin ; he listened and within 2 months " was trained to administer insulin " by being in hospital for 5 days ;even got the privilege to leave the hospital for my daily walks, as long I was there to report to the lab at 4 pm .When did the title type 1 come in for me ?..I can’t recall .I don’t think that the word " non compliant " was ever used by my GP in 1983 . My thinking is simple : as long as the treatment works , it works .If it does not, than proceed to the next step .
The reason that it is so critical for someone with Type 1 diabetes to get a correct diagnosis is that the consequences are so dire and can happen so swiftly. If a person with T1 is misdiagnosed as Type 2 and not given exogenous insulin immediately, the resulting high blood sugars can cause rapid onset of complications and even death due to DKA. So it truly does matter to get a correct diagnosis. I was only misdiagnosed for one week–I know people who were misdiagnosed at about the same time as me who didn’t get proper diagnosis/treatment for some time–they now have complications. It is tragic.
That’s what I am saying too Melitta …quote" if it does not work , then proceed with the next step " …and some maybe waiting a long time ! I did not… and here to tell my story .
Melitta, you made me laugh …another thing I do , besides telling .
Being pro-active helps .It works every time , when I wear my Team D singlet …people ASK
I think the challenge is that if you actually appear in the ER in DKA, you have a good chance of getting a diagnosis of Type 1. If you show up Type 1 at a routine physical and you display poor blood sugar signs, your doctor will routinely commit what is called a Type II error (click the link and think about why this is funny). Yes, things can go south quickly, but it is also harmful when someone suffers for years with ineffective treatment and elevated blood sugars. It is interesting, if you ask doctors about their error rates, they have an alarming misconception about these things. Instead, you will find that most doctors make a diagnostic decision (like you must be Type 2) and will stick to that decision despite overwhelming evidence that they are wrong. I call this cognitive dissonance.
Hahaha! Well you can show up in the ER with DKA + almost zero C-peptide + off the scale for antibodies and STILL be released from hospital with a T2 label. In my case, non-fatal misdiagnosis since in addition to the wrong T2 label, I also got Novorapid (what we call Novolog), Lantus and a place in carb-counting class.
I agree that cognitive dissonance is rife in the diabetes world. Although I am not sure telling someone with 400+ Gad that they tested negative for antibodies is cognitive dissonance. I think that’s a plain and simple lie!
Hmm. And let’s not get into the cognitive dissonance about carbs…
I agree with you in the Medical context. The thing is, the OP was upset because a nurse called her a T1. Even from an Endo’s point of view, the title doesn’t matter, the treatment is what is important. If you are a T2 who is insulin dependent, that is what you are. You need the insulin to live, and diet and exercise will only take you so far.
It doesn’t matter at that point whether you are a T1, T2, etc.
For insurance purposes… that’s a WHOLE nother boat.
