Can you change from Type 2 to Type 1?

So, if a person is Type 2, then you can assume that you are insulin resistant??

If you are still producing some insulin as you mentioned from your C-peptide test I would call you a Type 1.5 diabetic working towards a type 1. At some point you will not produce any insulin. If your endo checked and you have antibodies present it is only a matter of time before you are completely insulin dependent. This is what happened to me!!

I’m currently still producing a little insulin as well. How long was the decline to depency. Just curious because my doc keeps upping the insulin almost everytime I go back, and I wondered if that was normal.

yes because each time you go in you are most likely producing less insulin on your own.

Dr. Bernstein maintains that if you keep your BG normal, (and he means between 80 and 100 almost all the time) you will protect your beta cells and maintain some insulin production. I am actually seeing better fasting numbers now that I am using insulin and staying in control- my last A1C was 5.6. I will keep you all posted on whether I can keep making insulin indefinitely. I am guessing it also depends on whether the autoimmune attacks continue. I have a low level of antibodies just to my islet cells. The other 3 antibodies were negative.

Maybe for a short period but in the end our Beta cells are waving us goodbye!

This is a blurb from Joslin Diabetes Center if you want the rest of the report here is the link:

BOSTON — June 12, 2006 — Scientists at Joslin Diabetes Center have discovered that a surprisingly high percentage of people with type 1 diabetes (insulin-dependent) who have had the disease for 50 years or longer (the Joslin Medalists) may still have residual functioning, insulin-producing islet cells and/or islet cell antibodies. The findings were presented June 12 at the American Diabetes Association (ADA) 66th Annual Scientific Sessions in Washington, D.C.

And since I’ve lived with D almost 50 years I think it applies also to me.

I have read that a handful of T2s also had the antibodies - and I was under the impression that meant they were misdiagnosed LADA T1s… so not T2s with antibodies at all.

This is quite posiible and ultimately all patients of T2D become T1D when most beta cells die and they become Insulin dependant. This is natural history of Diabetes and this process has generated “Accelerator Hypothesis,” according to which both Types of Diabetes evolve as a common process. When process is rapid outcome is Type 1 Diabetes and when the same process is slow otcome is T2D.

Dr. L.K. Shankhdhar (Diabetologist), Membership No: 1003

But just because they become insulin dependent doesn’t make them a type 1, does it? It makes them insulin dependent type 2s who’ve lost their own insulin production.

I thought the days were gone where Type1s were insulin users and T2s were non-insulin dependents… It seems more accurate to me to describe the types by their causes, not their treatments.

Perhaps labels are just unfair all around! Maybe we just all just call ourselves pancreatically challenged, and leave it at that!

I like that pancreatically challenged.

Sounds good to me M.

T2 patients have 2 phases in their life-initially they are Insulin requiring since Oral drugs have failed still they are not T1 since some Insulin secretion is there and they do not harbour a tendancy to lapse into Diabetic ketoacidosis but later in their life they become utmost Insulin deficient and need Insulin for survival and become Insulin depedant just like any T1 Diabetic.

No. In T2 diabetes some times Insulin resisitance become too much and oral drugs fail and they need Insulin but they are not Type 1

Dr. Shankhdhar

Type 1 Diabetes is of two types-Autoimune and Idiopathic. 90% T1 patients belong to Autoimmune type, also called subtype A. Most of these pts are antibodies positive. Subtype 2 or Idiopathic variety included rest.

Crux of T1 Diabetes is absolute defiency of Insulin which makes them Ketosis prone.

Dr. Shankhdhar

Thank you for clarifying this point Dr Shankhdhar…that is what I always understood to be the case.

Let’s answer this question while putting the issue to rest: first, what “type” of diabetes a person has nothing to do with what they use to treat their disease, that determination is due to the etiology or “cause” of diabetes. The official word on that subject is determined by an international Expert Committee, working under the sponsorship of the American Diabetes Association, who last updated the classification in 2003. Specifically, if you want to know the details, see the Report of the Expert Committee on the Diagnosis and Classification … . Put another way, its almost impossible to have type 1 and not know it. The same cannot be said about type 2, or even what is popularly called “type 1.5” even while that officially does not exist. There are very clear distinctions among patients who use insulin in terms of how insulin impacts them, the impact of hypoglycemia, impact on total daily dosages and even the effect of insulin has on food. Generally, people with type 1 (and type 1.5) almost always have a much larger risk of hypoglycemia and have a much higher sensitivity to insulin than do people with type 2.

Hope this information is helpful to everyone.

I stated in my profile, "I had a bile duct obstruction due to the many stones in my gallbladder. I had to have an ERCP, which gave me pancreatitis. I had my gallbladder removed on October 13, 2006. My diabetes has been caused by the destruction of my beta islet cells due to the pancreatitis. i have a bit of insulin dependency (cause I cannot make enough) and some insulin resistance (I carry extra weight around your midsection). Soon I will no longer be a Type 2, and will be a Type 1. Time will tell how soon that is. "

Soon, I won’t have any beta islet cells, my pancreas will stop creating insulin altogether. AT THAT POINT, i will be a Type 1.

YES, you can go from being a Type 2 to a Type 1!


The problem is that the terms Type 1 and Type 2, though each has a dominant form, cover about 35 different kinds of diabetes all different.

Most of the “Type 1s” here have autoimmune diabetes, which is what destroyed their pancreas. You don’t have that.

Most of the "Type 2s: have a diabetes characterized by extreme insulin resistance–they can use 10 times as much insulin as an insulin sensitive person. You probably don’t have that.

You have surgically induced diabetes. Some people have drug induced diabetes. I have a genetic form of insulin-sensitive diabetes.

Bottom line “Diabetes” is really a sympton, high blood sugar. Type 2 means in practice only “with significant insulin resistance” though my doctor continues to code my insurance forms “type 2” though I have no insulin resistance because I can survive without insulin shots.

It’s as if “Cough” were a disease with Type 1 cough requiring antibiotics and Type 2 cough not. DUMB.

thank you jenny! you put this in the best possible way. I’m currently being treated in a Type 1 fashion. it is hard as i don’t fit anywhere, and yet i feel very alone.