Back in the Type 2 Camp

For the past couple of weeks I've been reevaluating my diabetes status. ...

When I was first diagnosed 5 years ago I was a non-obese with sudden onset and classic symptoms of type 1, including ketoacidosis. After having some antibody tests done and seeing an endo, the initial conclusion was that while I had no indication in the anti-body tests that I was a type 1 (or 1.5 if you prefer), I was probably in a honey moon phase and that, eventually I would show my "true colors". Incidentally, I had completely forgotten this part of the diagnosis until some events (described next) made me look at the original diagnosis from the endo.

About 6 weeks ago I was pretty interested in my fasting insulin levels. I am (now) a runner, and I've read that fasting insulin will be lower in athletes. When I got the results back I was indeed at the low end of the scale: 3 (average normal range 3 -19). So I began some more intense meal time testing, particularly post-prandial, including 1 hr post meal (typically I only did it two hours PP). When I first did it I got a huge 1hr pp spike -- to 210 -- which is really unheard of for me. So, since it was time for my semi-annual check-up, I ordered a slew of blood tests, including anti-islet and c peptide.

Well they came back with me still firmly in the type 2 camp. And why did I have a couple of strange pp glucose spikes? Sweet potatoes. I've traditionally eaten sweet potatoes as an alternative to white potatoes because of higher fiber content and lower GI index rating, but I've found out that for my body, they actually give me a higer spike than regular potatoes, including fries. I tested this fairly rigoursly, over a couple of weeks, including the same amounts of exercise, carb/fat/protein ratios, meds, etc. and consistently the one factor was sweet potatoes. In fact, in attempt to really blow things up, I went out to a traditional wisconsin friday night fish fry, had 4 peices of deep fried cod, clam chowder, coleslaw, french fries, a roll, and ice cream --- a meal tipping over 1000 calories, over 100 grams of carbs---, and my 1 hr pp bg was 165 with a 1000 grams of metformin (on a day with no exercise).

So on another day I tried a relatively low carb dinner (30 grams of carbs, about 400 calories), on a day I ran, added a sweet potato, and again a 1 hr pp of 203. And I never get anywhere near that with much higher carb or calorie meals (although I don't usually have those.

Lesson: diabetes is an idiopathic disease. While there are some broad generalizations, it pays to know what inputs (food, stress, etc.) and outputs (exercise) do for you blood glucose levels.

Your post is somewhat similar to mine that I just posted on my blog. I am a Type 2 and having problems now with meal time spikes that I didn’t have before. I am on low carb but have noticed a difference in the last few weeks.

I at DX was overweight; but came in with Type 1 DX symptoms at extremely high levels and extreme onset, all within about 2 months. I would have shortly been in DKA .

Watching closely my diet, exercise and BG now. Hope to get more tests done too. I am getting similar spikes now to yours however I am even more low carb than your test meals. Your right though it is a idiopathic disease and it reacts different in all of us.

Interesting information about the sweet potatoes. They always work so much better for me than regular potatoes. Of course, I am a Type one, so have no automatic insulin response at all.

I had a thought about your comparison meals … how did the fat content compare? You did not indicate how much fat was in the smaller meal, but the fat level in the large meal was really high. The high fat content could have delayed the “spike” in that meal, which looks like a good way for you to avoid the spike altogether (looks like your body is able to compensate for the spike later, but not right away.) If the fat content in the small meal was significantly less (proportionally), that could explain the 1 hr spike.

Its certainly possible those high levels of fat in that meal had something to do with a lower spike (but you are right, they continued to fall after 1 hr, not rise any further, so it wasn’t really a delay). In the kind of “crazy” meal, the fat levels were certainly higher, but so were the carb levels, proportionately. In the two meals where I had sweet potatoes, were talking about 30 or so grams of carbs, and fat and protein grams in the mid 20s.

Mostly my blog was just an attempt to comment on the nature of individual factors, and their variable impact on people with diabetes. It was also tied into the commentary that I was reevaluting my diabetes at that point because of previous indications that I might be a 1.5. So low insulin levels for me and high spikes with certain meals, were not an indication that I had 1.5, but that being an athlete (low fasting insulin) and eating sweet potatoes (glucose spike) were what led me to those glucose readings.

Like with a lot of things, but especially with diabetes, it seems like the more you learn, the less you know!

So true – its different for us all with this crazy disease. So cool that you are figuring out what works for you and what doesn’t.

welcome back to T2 I guess.

yeah it always a fun experiment to see what is going to cause a spike and what isn’t. Big D loves to keep us guessing.

You are a Ketosis Prone Type 2 diabetic and you hit it on the head when you said, “idiopathic”, which is what the ADA calls it. This is actually a fairly common syndrome but most docs don’t know about it. I’m working at putting out a blog on this, check it out and leave a comment.



Thanks for your comments. I posted a reply on your blogspot bog. Repeated here for anyone who’s interested:


Thanks for your comment on my blog at tudiabetes (type2runner). I’ve never heard of KPD so thank you for bringing it to my attention. Its in my folder of “stuff to research more”.

It certainly sounds like what happened to me, though key markers don’t match-up. For instance it seems like you had active symptoms for a long time, in the time periods you were not active. This wasn’t the case for me: my periods of activity came and went but I never had any symptoms until a month before diagnosis. I also have no immediate family members with the disease. An uncle developed it in his 60s and a great-grandmother had it, but otherwise, no one i know of. Also, though I know this isn’t a key indicator: I’m non-hispanic white. Seems like most of the info I’m seeing out there is about people of african and mexican descent. I wasn’t obese either. And my insulin resistance is minimal: though this could certainly because of the high level of exercise I engage in…



The blog uses a lot of minority health info. This is because the syndrome has been explored most extensively in African Americans but it cuts across all ethnic lines and weight classes. I think I have to make it a clearer about what makes a KPD T2.

Actually, you’re pretty typical of a Ketosis Prone T2.


Thanks again. We all have our own areas of interest and I think that naturally shows itself in the areas we research. What this points to is how varied the disease is, there is a whole continuum, not just two, (or 3 or 4) types. As you know, its difficult enough communicating information about just two types, and getting people to act on that information. I will be researching this more myself in the next couple of weeks and will communicate with you on that.

I tried my email but it said “no reply for TuDiabetes” So here it is.

> The absence of autoimmune markers and the presence of measurable insulin secretion have
> proven useful in predicting near-normoglycemic remission and long-term insulin dependence in adult patients with a history of diabetic ketoacidosis.
That is poorly worded. It is now well-documented that KPD’s can and do stay in remission. As to your excercise, If you read my blog then you know I use to cover 4000 to 5000 miles of cycling for better than 20 years. How can I still be diabetic. I’ve got a theory that may interest you. I ate heavy carbs during that period because I was taught to carb load. Now that I test my blood, I know that I have a severe reaction to carbs. This means my body was constantly having to pour insulin into my system to keep up with it. I now believe that I essentially shut down my pancreas by eating those high carbs. I bring this up because the few KPD’s I’ve talked to all seem to spike pretty easily with carbs. It is also known that KPD’s have problems with glucose toxicity. Hyperglycemia shuts down the ability of pancreas to secrete. This is why you went DKA even though you obviously have the ability to secrete insulin.

My point with all this is that you should think about going to a higher fat, protein diet. This keeps your body burning fat as your main fuel. You then take enough carbs to refuel your glycogen stores and you’re good. Yes, excercise is good but being a KPD means you have to aware of how you do it.

Nope, I’m not aware of DESA. I doubt, however, if they’ve ever heard of KPD T2 either.


Oh, forgot to tell you, I’ve started a group for KPD’s. I would love to have your input.