Am I pre-diabetic or Type II?

Type 2
1

Hello all!

I am very confused because I developed gestational diabetes last year and my baby is almost 4 months old and my blood glucose is l between 96-115 (using my glucometer). Last month I went to get checked and my dr. sent me for an A1c and it came back 6.0. He said that I am Type II and to follow the diet I did when I was pregnant and to exercise at least 45 minutes every day. I am doing that, but I have been researching about diabetes and I found out on some websites that I classify as pre-diabetic, not as Type II yet. However, other websites mention that there is no such thing as pre-diabetes or borderline diabetes. I won't see my dr. until April, but he was very convinced that I have Type II. My question is, why are so many people being told that they are pre-diabetics if there is no such thing as pre-diabetes? If pre-diabetes does exist, then I guess I wouldn't be Type II quite yet, since my fasting readings are 96-115 and two hours after meals between 119-130 (whatching my carbs). I am very confused about my condition. Of course, no matter what I have, I will continue to take care of myself like a Type II because I am so scared of the complications. I just turned 32 and I have never been overweight, I am rather slim and no history of diabetes of any type in my family.

2

Hello! You may want to get tested for diabetes. The full blood panel. GAD 65 and all. You are your only voice when it comes to your health. If you don’t agree with your doctors decision then keep bugging him until he does a fulll lab work up. I was diagnosed with Type 1.5/LADA when I was 24. I wasn’t overweight at all and no family history of diabetes. Keep voicing you concern and if your doc doesn’t help maybe another doc will.

3

Yes numbers from 96 to 115 are in the pre-diabetic range. I’m prediabetic, too and my fasting is usually about 110 and since i’m severely limiting my carbs my 2hr post meal is usually less than 140. But if I eat a bowl of cereal it goes upwards of 180, so I avoid cereal as I can’t just eat one small serving lol

You don’t have to have a family member with diabetes. It can just appear in your genes for no apparent reason. Doctors typically call pre-diabetes either that or “insulin resistant” which my doctor called it for me. But it’s really the same thing, just a different name.

4

To be honest, I don’t believe there is such a thing as pre-diabetes. “Pre-Diabetes” is merely a very early stage of the disease at which you still have pretty good control, and more beta cells remaining than the rest of us. Like Diabetic_Iz_Me also said… it’s it’s important to get tested. Gestational Diabetes can lead to both Type 1 and Type 2… And if you are in any way slender, you are probably MORE likely to be Type 1… (though you could still be a Type 2. It’s not out of the question.)

5

I’m not quite sure what I believe about there not being pre-diabetes. But I do know that some people can reverse diabetes by losing weight. I would love to be one of those people that can do that but since I’m finding it impossible to lose weight. I have even gained weight on a very low carb diet so I have no idea what I’m doing wrong but its pizzing me off. But yea anwyay, pre-diabetes or not its an early form of the disease.

6

Nobody can REVERSE diabetes, sorry. Losing weight can help your diabetes to be in control, but once you have it, you have it.

7

I meant to say Pre-diabetes, not diabetes.

8

IMO pre diabetes is a bunch of crap. Either you have D or you do not have D. You can’t reverse it, but you can control it with weight loss, diet, and exercise.

9

You could have the begining of type 1.

10

I don’t know a single “pre-diabetic” that was able to “reverse” the disease by losing weight. You still have to live the life of a diabetic, measuring, exercising, etc… so that you can extend the life of your beta cells to the maximum until you finally get officially diagnosed… Tight control can help you avoid complications, reverse some complications, and have the blood sugars of a non-diabetic… but all this does not equate to reversing the diabetes itself, or curing it. I am not quite sure just how quite low carb you are going, and there are groups in our community that can help give you pointers there, etc… Have you ever been tested for other things, like Hypothyroidism, and Polycystic Ovarian Syndrome? Untreated, these things make you gain weight, and make losing weight very, very difficult…

11

Your doctor is incorrect; many pcps don’t know much about diabetes. An A1C from 5.7 to 6.4 is considered pre-diabetes and diabetes is 6.5 and over.

12

To AquariusNL-
I am not going to weigh in on the pre-diabetes debate, because the medical community at large seems to be in debate over whether fasting blood sugars in the 100-126 range is pre-diabetic or early stage Type 2, so who am I to tell you what to call it.
Regardless of what you call it, your blood sugar is messed up and that totally sucks. The one piece of advice I have for you is to find out if your diabetes is pre-diabetes/ early Type 2 or LADA (a form of Type 1 diabetes). The main difference between Type 2 and LADA is that LADA is an autoimmune disease in which your body is destroying your pancreas’ ability to make insulin. If you have no history of obesity, you could be at an early stage of LADA. (I am LADA/ Type1 and was misdiagnosed with Type 2, and it was ridiculous and I had crazy complications from some of the drugs they gave me due to misdiagnoses.) Trust me, you want the information- they are two totally different diseases from what I can tell, that give the same result of high blood sugars. (Although I don’t know much about Type 2, I think it is mainly caused by insulin resistance, not auto-immunity).

I copied the following from Wikipedia. They are the tests you can ask your doctor to give you to see if you have LADA:

Diagnosing latent autoimmune diabetes

It is estimated that 20% of persons diagnosed as having non-obesity-related type 2 diabetes may actually have LADA. Islet cell, insulin, and GAD antibodies testing should be performed on all adults who are not obese that appear to present with type 2 diabetes.[2] Not all people having LADA are thin or skinny, however—there are plus-sized individuals carrying LADA but not getting accurately diagnosed because of their weight. These individuals are more often denied insulin by their health care physicians, considering people who were diagnosed with or have type 2 diabetes are given those treatments by diabetes specialists or their physicians extremely often.[3] Moreover, it is now becoming evident that autoimmune diabetes may be highly underdiagnosed in many individuals who have diabetes, and that the body mass index levels may have rather limited use in connections with latent autoimmune diabetes.[4] Also, many physicians or diabetes specialists don’t recognize LADA or probably don’t know the condition actually exists, and so LADA is misdiagnosed as or mistaken for Type 2 diabetes highly often.

Diagnostic tests include:
[edit] C-peptide (also known as insulin C-peptide, connecting peptide)

This test measures residual beta cell function by determining the level of insulin secretion (C-peptide). Persons with LADA typically have low, although sometimes moderate, levels of C-peptide as the disease progresses. Patients with insulin resistance or type 2 diabetes are more likely to, but will not always, have high levels of C-peptide due to an over production of insulin.[5][6]

[edit] Diabetes mellitus autoantibody panel

Glutamic acid decarboxylase (GAD) autoantibodies, radioimmunoassay (RIA) and insulin antibodies, radioimmunoassay, RIA.

Glutamic acid decarboxylase antibodies are commonly found in diabetes mellitus type 1.

[edit] Islet Cell Antibodies (ICA) tests

Islet Cell IgG Cytoplasmic Autoantibodies, IFA; Islet Cell Complement Fixing Autoantibodies, Indirect Fluorescent Antibody (IFA); Islet Cell Autoantibodies Evaluation; Islet Cell Complement Fixing Autoantibodies - Aids in a differential diagnosis between LADA and type 2 diabetes. Persons with LADA often test positive for ICA, whereas type 2 diabetics only seldom do.[5][7]
[edit] Glutamic Acid Decarboxylase (GAD) Antibodies tests

Microplate ELISA: Anti-GAD, Anti-IA2, Anti-GAD/IA2 Pool - In addition to being useful in making an early diagnosis for type 1 diabetes mellitus, GAD antibodies tests are used for differential diagnosis between LADA and type 2 diabetes[5][8][9] and may also be used for differential diagnosis of gestational diabetes, risk prediction in immediate family members for type 1, as well as a tool to monitor prognosis of the clinical progression of type 1 diabetes.
[edit] Insulin Antibodies (IAA)tests

RIA: Anti-GAD, Anti-IA2, Anti-Insulin; Insulin Antibodies - These tests are also used in early diagnosis for type 1 diabetes mellitus, and for differential diagnosis between LADA and type 2 diabetes, as well as for differential diagnosis of gestational diabetes, risk prediction in immediate family members for type 1, and to monitor prognosis of the clinical progression of type 1 diabetes. Persons with LADA may test positive for insulin antibodies; persons with type 2, however, rarely do.[5][7]

Other characteristics of LADA that may aid in differential diagnosis include:[10]

  • Onset usually at 25 years of age or older

  • Initially mimics non-obese type 2 diabetes (patients are usually thin or of normal weight, although some may be overweight to minimally obese)[3][11]

  • Oftentimes, but not always, a lack of family history for T2DM (family history for type 2 diabetes is sometimes involved regarding a latent autoimmune diabetic adult)[12][13][14][15][16]

  • Persons with LADA are insulin resistant like, but at prevalence levels less than, Type 2[17][18]

  • Human leukocyte antigen (HLA) genes associated with type 1 diabetes are seen in LADA but not in type 2 diabetes[7]

  • Although some people having type 2 diabetes may inject insulin, this only rarely happens; in contrast, people with LADA require insulin injections around three to 12 years after so called type 2 diabetes diagnoses[19]

13

Your story and numbers are pretty identical to mine… except I was never told to check my BG after giving birth which was a mistake so they only caught my diabetes 4 years later. I was diagnosed with type 2 diabetes at the age of 23 and I am thin my A1C at diagnosis was 6.1 and now my past two were 6.0. My fasting BG is 95-115 and my after meal numbers are 80-140 but I am STILL a type 2 diabetic I personally do not believe in “pre-diabetes” it’s kinda like pregnancy you can’t be a little bit pregnant you either are or you aren’t. Good luck and keep us updated, way to stay on top of things.

14

“Of course, no matter what I have, I will continue to take care of myself like a Type II because I am so scared of the complications. I just turned 32 and I have never been overweight, I am rather slim and no history of diabetes of any type in my family.”

This is the bottom line and is a great attitude. It might be why your doctor is calling you diabetic because he wants you to take it seriously and make changes. However, that is giving him the benefit of the doubt, and he is still diagnosing you incorrectly. I also agree with others who wonder if you are in fact developing Type 1 or LADA which is a slow onset type 1 that occurs in adults. If so, unfortunately, diet and exercise will only help for so long before your numbers begin to rise dramatically. People might state “there is no such thing as pre-diabetes” as they see it as just an earlier point on the continuum. To me this is largely semantics and pre-diabetes is a diagnosis that is well defined by the numbers. The only problem with it, as others have said is that people confuse “control” with “reversal”. Many people diagnosed pre-diabetic are able to prevent progression of their condition to full blown diabetes by using weight loss, exercise and diet. But if they stop these things their blood sugar will rise. Remission is a closer term than cure.

I could think of situations regarding say insurance coverage, where you might not want the diagnosis of diabetes if you were pre-diabetic. They also used to use fasting blood sugars for diagnosis and 100-125 is pre-diabetes while diabetes is 126 and over, but A1C is considered the standard for diagnosis now.

15

I do have hypothyroidism which is treated and I probably do have polycycstic ovarian syndrome and am seeing my gyno next month to talk about it with her. I haven’t been to her in almost 5 years (or any other gyno for that matter) so it’s time I see her. And in the past 5 years I’ve gained tons of weight (like 100 pounds or more), moreso in the past 3 years though. I think I’ve finally leveled out.

My low carb diet plan is less than 30g per meal. I usually eat about half that per meal.

16

If you have gained a lot of weight, your thyroid medication may not be enough anymore… They may need to up that, too. Yeah, PCOS will make you gain mad weight, just like that.

It’s because your body is making excess insulin, and making you gain weight AND making you insulin resistant. You won’t be able to control it well without medications. I take birth control pills for that, but there’s also Clomid, and Metmorfin, as alternatives. Your doctor will know more, when they see you.

17

That’s a good point, DWQ. When I was diagnosed with diabetes, I had been on thyroid replacement meds for years and all of a sudden the dose was off. I now get my thyroid levels checked regularly but they seem to have stablized. It was odd when I got diabetes all my other medications and conditions changed - some for the better, I no longer have high blood pressure.

18

I read everywhere that 6.5 is the diagnosis for A1c for diabetes. Is that what you know to be true? My a1c is 6.2.

19

I think when a person is pre-diabetic, the more ideal tool for diagnosis is not an A1C, but a glucose tolerance test. The A1C can present quite a few flaws at diagnosing Diabetes in persons who are not already exploding with high blood sugar. Jenny Ruhl, a well respected member of our community, writes about this A1C fail in a recent blog post: http://diabetesupdate.blogspot.com/2010/10/massive-a1c-fail-it-does….

20

That makes sense because I could have lows and highs and they balance each other out. I have been testing a lot this past month and have not seen very many numbers in the 80’s or 90’s. I’ll ask my doctor to do a glucose tolerance test. I’d like to see how that affects me.