So that means i must be type 2! And I should be able to improve management with significant weight loss and further increase in activity to counteract what must be inherent insulin resistance.
Knowing this is type 2 makes me feel like this is my own fault to have this. After all, I must have been doing stuff significantly wrong to get Type 2 at 38!
My endo will surely have no reason to manage me on insulin if he knows this… unless I get pregnant again.
Wait a gosh darn minute. Don’t you for a minute think that you went and got diabetes through your own fault. This is just a piece of information putting together the puzzle of who you are and what kind of diabetes you have. And believe me, everyone has their own individual D. I struggled to get the GAD65 test for two years because I do not respond to T2 medications over the long-term. Mine came out negative as well. But that is just wrong to have that used to deny you proper health care.
You need to realize, GAD65 does not “prove” LADA or T1 and it doesn’t disprove LADA or T1. It is highly correlated, but so is needing insulin and being female. You may well not be T1 and you may well not be T2. Only time and a better understanding will tell. But I believe you have a “right” to normal blood sugars. I am sorry that you recent loss, I know that must have been heartbreaking. Of course you can try again and I think you have every reason to beleive and demand that you need normal blood sugars to enable you to get pregnant again and have a healthy child. If that involves insulin, that is fine, but you may also find that some medications help.
So take this news as a plus. You have some hope that T2 medications may help and if not, you can always fall back on insulin.
I agree that although it is important to know what type you really are, it is also important to get the best treatment possible regardless of what type you are. You are the one that will suffer because of lack of good treatment, not the idiot doctor. I hope that you get things straightened out.
Did you get a c-peptide test to know how much insulin your body is producing?
This may be a good thing to ask for in the future.I think that most people with autoimmune diabetes test positive for GAD, but not all.
The c-peptide is useful information regardless of whether you are type 1, type 2, LADA, or other. If you have low insulin production (regardless of type), then it makes sense to inject insulin. If you are normal, usually you don’t need to inject insulin (though some still do in an attempt to preserve their insulin production. If you are high, then injecting insulin won’t lower your blood sugar and you would need to address the insulin resistance.
I think that living with diabetes, it is best to treat these tests as useful information in getting the right treatment and knowing the right actions to take. Avoid guilt! Guilt doesn’t lower your blood sugar and that is the goal
According to my endo, a low-normal c-peptide with a fasting blood sugar in “normal” range (under 200 mg/dl?) doesn’t tell you anything. Mine was low-normal with a fasting of 135 mg/dl. Perhaps others have better info.
I agree with the advice that’s already been given. This is absolutely not your fault regardless of what type of D you have.
There is no definitive test for T1 vs T2. GAD, IA2 and insulin autoantibodies are “highly suggestive” and clinically useful but not definitive. Some people will test + in the absence of autoimmunity and some people with T1 will test -. As long as your doctor appreciates the complexity of the disease, that no no two patients are the same – let alone two types, then you’ll be in good shape.
Here are my thoughts on type 2 and factors that trigger type 2. I came to accept also that my lifestyle did play a role on my triggering diabetes and that I could control some of the factors that are causing me trouble. I think I fall into the neo philosophy from the matrix. I just happen to catch the matrix this weekend and I thought about an intersting part about the movie. Morpheus asked Neo if he believed in destiny and Neo said no because that would mean there is no free will, he believed that he could control his outcome of his life. So my thought on controlling the outcome of type 2 and reducing factors is that I believe that I can reverse some of the damage that was done and gain better control of my bgs through excercise, reducing stress, and adjusting diet. I have done it this past 8 years.
I believe this because of my son. Because if I can teach him to control his environmental factors such as diet and excercise and stress levels maybe he wont trigger type 2. So in order for me to believe that I can help him I have to accept that I may have triggered my type 2 and I am 100% fine with that. I have no reservations accepting that I had a little bit on triggering. I accept it as a challenge and not as a downfall because I like to be in control.
I have evidence on my side that once I reduced stress, dropped weight, and excercised on a regular basis I went from using insulin to no insulin and now on a lower dose of metformin.
So hopefully your message here is one of hope that tells yourself that you can manage things that can impact you positively and help you go towards better control because if we can manage the risk factors then positive things will happen for you.
Although you might think that the body works by releasing insulin and glucagon in response to blood sugar levels, it is much more complicated. The body releases insulin in response to “eating” and this “incretin” pathway is how Byetta, Victoza and Januvia help diabetics. Another pathway is the signaling to the liver which releases glucose, drugs like metformin affect that pathway. Another pathway is apparently through signalling from the hypothalmus which provides regulatory functions for glucose control, and that is how fasting levels are maintained. You can get “insulin resistance” in that pathway resulting in constantly elevated fasting and that is perhaps one of my “issues.” If my body thinks the proper “setpoint” is 135 mg/dl, then it won’t release more insulin to lower the glucose level.
I think that a better test is just like you describe a “stimulated” c-peptide, eat some carbs and see if it generates an insulin response. If you eat a bunch of carbs, blow a 200 mg/dl on the glucose test and have a low c-peptide, then you pretty much confirm insulin deficiency. Unfortunately, doctors don’t seem to order this test, I don’t know why.
No, no, no. You didn’t do anything wrong, or neglect to do something right. There are no answers (yet) why some people are T2 or T1. We all want the answer, but blaming ourselves is not the correct one. Tu members taking on self-blame will bopped over the head with a glucose meter:)
I ditto what everyone else has said, Sally. They are finding that Type 2 diabetes is a lot more complex than thought and that perhaps people gain weight due to insulin resistance long before diabetes is diagnosed rather than the reverse. Whatever the science, self-blame and guilt is never useful and always hurtful. It’s bad enough to have a problem such as diabetes without adding to it guilt for getting the problem to begin with! You are going through a rough time now with your loss and struggling to figure out this diabetes thing with little outside help. Be kind to yourself. Do something frivolous, whether buying a new blouse, going to a hot spring or whatever simple pleasure will soothe and relax you.
I was just reading some old e-mail correspondance I had when I was struggling with my own diagnosis. I was so stressed, and I was retired and living in beautiful Guatemala! It’s hard work, but your treatment will get stable in time and life will settle down. Honest!
I am the LAST person in the world you would except to have diabetes too. Type2 and thin and 40 years old at dx. I have been vegetarian/vegan for 20 years and ate very healthy, was very active most of the time and I still got it. Believe me, I look back and I keep trying to think what I did wrong (I was sedentary around my dx - did that cause it? I gain a few pounds around my middle but I only weight 130 at dx - did that do it?).
Well, I found out about the genetics of it and my family history (which I didn’t know about before because my mom didn’t tell me because she figured since I was a veg I wouldn’t get any diseases HA!) that my grandmother, aunt and some cousins all had/have diabetes and they found out around age 40 like me. Even my cousin when she found out I had it said “How can you have diabetes? Your a vegetarian.” (well, my cousin is a bit “slow” so I ignore that - I am sure she hasn’t researched her diabetes and figures it was because she was overweight)
In fact, I posted an recent article on here. It is really illuminating and might help you not feel so much like it your fault. It focuses on a bunch of different possible causes - stuff that is out of our control! (ie NOT OUR FAULT). It might help you feel a bit better:
I feel the same way. I got the crap gene in the family. I honeslty can see a pattern in me and other people in family who have it. We are the only “short” women in the family. My mom is 5’9" and the rest of the females in my my family (my moms side) are taller. My grandmother, aunt and my other cousin that have it, we are the few shorter females in the family. So, I often wonder if I have similar genetic code as my shorter female relatives and it happens to include diabetes. (not saying short means diabetes but in my family it might) Plenty of super fatties in my family with no diabetes - my dad has a big belly - no diabetes. No I do not take the fat thing very seriously anymore.
Actualy 38 is not early for diabetes. Lot of Type 2 adult diagnosis happen around mid age (40). I was dx at 40 and my cousin at 38 or 39.
I think it is HOW your body stores the fat that makes the difference. I have almost no fat on me but the fat I do have is around my middle. It is new theory that how a persons body stores fat (actually more precisely WHERE it stores it) can be a factor - a body that stores fat closer to the organ and not the skin seems to be a new factor they are looking into (which would explain thin type 2s)
(Oh, I am sorry for the lose of your baby too. There will other chances. I am sure your body is going haywire right now so take that into account with your numbers too. Our female hormones can sure mess up our BG numbers. It might be better to analyze your numbers more when you are completley healed - you will get a better picture than of how your treatment is working for me.)
Sally, just because you do not have the antibodies that indicate you have either type 1 or LADA does NOT mean you caused your diabetes. IN NO WAY, SHAPE OR FORM DID YOU CAUSE YOURSELF TO HAVE DIABETES. The genetics behind type 2 are extraordinarily complicated, and just because your current relatives do not have diabetes does not mean it was not present in your family in the past. You just had the unfortunate luck of getting the right combination of genes and environment to cause you to develop diabetes, regardless of type.
At least rapid weight loss (if that is really what would happen), unprecedented in my 8 years with this Dr., would probably make him sit up and take notice.
Sally, I hope it does. It didn’t when I was diagnosed. I’d been overweight for most of my life when I was diagnosed, and at that time, they put me on a 1500 calorie/day diet. That was 500 calories/day more than the lowest calorie diet my family doctor had put me on 9 years earlier, so I had no reason to expect it would work. Instead, my weight dropped like a rock, and I mean DROPPED. Within a week, I went from a size 14 jeans to a size 10. Then, in less than a week, I was down to a size 6. I had to hold my jeans up when I went to Mass! I talked to my doctor about how quickly I was losing weight, and he was not concerned at all. He thought it was just fine that between my dx date (3/22) and the last day of classes (around the 1st of May), I had lost around 40 lbs – with no signs of stopping. It wasn’t until I dropped down to 88 lbs that I finally got a doctor to notice the weight loss was going too far and that it wasn’t resolving itself on its own. Shame none of the doctors I saw at that time bothered to ask the question why I was losing weight so quickly than ever before. Would have saved me a lot of grief.
