How do they know which type you are?

As the title states. When diagnosed with diabetes, how do the hospital determine which type of diabetes you have? Is there a possibility that they can assume wrong or is it strictly based on lab tests?

When I was Diagnosed with Diabetes, the DR put me on pills first and that didn’t work… So They put me on Insulin shots… I really can’t remember to much on what happen… it was 15 yrs ago… You see, I had Gestational Diabetes with my 2nd child… The DR said I wouldn’t get Diabetes until I was 40… but it will be Type 2… So that why they put me on pills first… (22 yrs old at the time)

One way they can tell is by giving you a C-peptide test which measures the amount of insulin your body produces. If it is low then most likely you will be a full type 1 even if you still produce some insulin. Another way they can tell is when I was first diagnosed they put me on Metformin and it did nothing. the reason I was type 1 and insulin resistance was not the issue like it was in type 2. It actually can be difficult to pin down the type in the beginning. After they start treating you is when it becomes more apparent.

Another way to tell is if you have antibodies to insulin or your islet cells, then you have Type 1, which is an autoimmune disease. The most common is GAD but there are 3 more I think. I have one of the less common. I still have C-Peptide and low fasting BG so the antibody test was the only way to confirm a diagnosis for me.

I forgot the antibody test, good call.

For adults who eventually are diagnosed w/ Type 1, they almost always assume that it is incorrectly Type 2. Simply because of the age. I fought for the antibody tests to prove I was not Type 2. Once those came back, I was off the Type2 drugs on on insulin full time.

So true, they said I was type 2 in the beginning and I am not. PCP doctors know very little about diabetes IMO. Now I have a GREAT endo. No more guess work!

yeah same here I was diagnosed type 2 at the start. After more blood work two days later they said no way you’re type 1 time for insulin. lmao

A low C-Peptide is indicative of type 1, but is not a definitive test. They also need to do blood tests for Islet-cell and anti-insulin autoantibodies. The reason is because some patients with type 2 also have low endogenous insulin production remaining, and may therefore have low C-Peptide, but the etiology of their disease is due to insulin resistance, not autoimmunity as type 1 is. For that reason, you must have all of those tests to determine if you are type 1, although usually if you are not overweight and relatively young, you are more likely to have type 1.

Ya thats how they basically diagnosed my type one, they saw I had BG of 27mmol/L and said in order for it to be that high I’m probably type 1 as type 2 the BG generally creeps up gradually.

This is what bugs me. My blood sugar was 41 at diagnosis and i was in DKA, yet my endo thinks I am a T2. And the meds have been working like a dream for the past four months! i am going to persuade her (somehow) into getting me an antibody test and a c-peptide retest/

Some Type 2’s get hit with a very rapid onset of the symptoms. I thinkthe expanation I was given was that the pancreas keeps increasing insulin production to keep up with insulin resistance, but eventually it gives up and you crash. Sky high blood sugars, rapid weight loss due to metabolism of muscles, insatiable thirst… all the classic symptoms.

My endo told me that i experienced something called “stress hyperglycemia”, meaning the unbearable physical and mental stress I’d faced (infection + finals week) had my pancreas doing what you just described. My rationale for wanting an antibody test done is to rule out LADA, because if I have LADA, an insulin regime would be a better treatment plan than meds.

They guess based on a bunch of factors, such as age, antibody levels, medical history (if you’re on or have been exposed to something that causes type 2), weight, c-peptide, ketosis, and insulin sensitivity.
I was 17 at diagnosis and the doctor first guessed type two. After the bloodwork came back saying that I was in DKA, a lot more tests were run. With DKA, a negative cpeptide, a BMI of 18, very high antibody levels, on no medications, and normal insulin sensitivity, the diagnosis was decided as type 1. I prefer to call it autoimmune diabetes.

With people who are older or younger, they often don’t bother to confirm- people under 10 are often just assumed to be type 1, and people over fifty assumed to be type 2.

as soon as i told them my brother was type 1 they just knew that was it. I think they only tested my blood glucose level. It was 25.3mmol or 509mg/dl. And the fact that i was 21 and not overweight. I still don’t think i’ve had a c-peptide test or an antibody test.

I was diagnosed as LADA, Latent Autoimmune Diabetes in Adults after the bith of my 3rd child in 2006. I was diagnosed with gestational diabetes during that pregnancy and my symptons didn’t just disapppear as I was told I could expect.

I lost weight with diet and exercise after her bith, but kept getting lows and knew my body just didn’t feel right. I was never hospitalized or anything, but after I went to a general physican who was clueless to help me and said, yeah, you do have diabetes, I can put you on a pill or you can see an endocrinologist, I thought- “No way!” I can’t leave my hands in this guys care. I finally got into the endo and a dietician who immediatly said "you look like LADA. She tested my fasting BG and gave me the 75 mg glucose and my sugar spiked to over 325. She ran the right tests- which is most important- SHE KNEW WHAT SHE WAS LOOKING FOR- beta cell production and levels of GAD-25. I do not have any other typical type 2 symptoms and I still produce some insulin on my own. That was almost 1 1/2 years ago.

I now am on 2 types of insulin pens and I also take Januvia twice a day. I exercise 4-5 days a week and I control my diet and count carbs. Here’s what I know: I have to be responsible to myself. No one will take care of me, but ME! I decide what food and medicine goes into my body. I can determine alot of my future health complications. I can’t control everything, but I sure can educate myself and put that education to good use on a dialy- and hourly basis.

It’s a relief to hear that others have also been misdiagnosed. I have been going on the T2 assumption for about a year and a half with my PCP, but when I finally went to an endocrinologist he said no way and rediagnosed as LADA. My insulin production is still very reasonable, which is good. I try not to worry about what will come next, but I’ll admit it is hard not to.

I too was misdiagnosed with type2 and put on metformin for 2 years with some response, but not enough. My PCP just kept increasing the dose and I was being treated as if the lack of control was my fault. About Nov of 2007 my BG went out of control and my A1C hit 14! I have no family history of diabetes, however, I did have GD with both of my pregnancies but that was controlled easily with diet. Jan of 2008 I suddenly dropped 10 more lbs. in one week from 108 to 98lbs and could not seem to quench my thirst. I called my PCP to give me a referral to see an endo who diagnosed me with type1. I have been on insulin now for 3 months and go for an A1C test next week. I’m still trying to get the insulin-carbs under control. I was started on 1unit/15grams by my PCP and after seeing the endo and a CDE was put on 1unit/10grams then after a recheck was told to increase 1u/8g. I seem to either get too much and get hypo; in fear of going too low at the next meal or while at work I don’t seem to take enough and have a high BG reading. I have good days and bad but my BG is much better than the 350-550+ readings I was getting.
My endo has suggested a pump but at this point I’m just not ready.

Gosh Kristy, We have soooo much in common. I am also being pushed towards the pump. I am biting the proverbial bullett and am talking a one-on-one pump class next week tio see how the thing works and if it will work for me. I use pens now and Januvia. Although my A1c was down to 5.9 (yeah!) my C-Peptide production is down to .3. I’m almost ka-put on the Insulin production.

Anyway, It will be interesting the path we choose. It’s so much to think about and so much to calculate. It’s especially with little ones under foot.

Good luck, Rebecca

Initially they treated me w/ insulin and w/ pills. After 3 months, they tested my blood for antibodies (against pancreas cells, I think). Since they found antibodies they said keep the insulin and stop taking the meds, for they won’t do any good. Turns out my bod is really really responsive to insulin, so little changes make a big difference. That’s type I. My pancreas had a honeymoon for about a year…that 10% islet function worked again, and I tapered down the insulin. I’m tapering up again, so that 10% must be about gone.