Sara,
To clarify for you I was diagnosed as pre-diabetic by an ob-gyn in 2005 aic7.0% and had gestational diabetes with 2 out of 3 pregnancies. Nothing else was ever said about diabetes, nor were any tests run. Then in 2008 I was typed 2. Then on Friday I tested positive for gad-65 and low-normal cpeptide. Hope that clears you up. Secondly I had readings in the 420’s and then fasting was 250 and up after meals was 350 or worse, and I took my oral meds as prescribed. To insinuate that my type 2 was uncontrolled is a strong assumption on your part. I was in control as far as I know,since I was not on any medication until 2008 and that is when things went wild and also when my thyroid was diagnosed. So to put this in perspective you might as well say that for the past 3 years the oral meds did nothing. Here to current day and hmm let’s see I would say things are amidst, not to mention type1 runs on both sides of my family as well as autoimmune. oh yes and let’s not forget that cholesterol and triglycerides and LDL and HDL is all normal…not typical of a type 2. I will also have you know that since I was put on insulin my A1C went down form 12.6 to 9.0% which is pretty darn good in my book in the course of 2 months so let’s be real here. Victim card, really? Nope not playing that card I just want the right diagnosis, oh and Sara I asked for the other test and she said it is not nessesary…so Thanks for your comment though. Each person has their opinion.
I fail to see how an A1c of 9% puts her at risk if she goes on to a pump, particullarly since her c-peptide shows she is still making insulin. If she checks her blood sugar regularly and followed the proper protocols if something happened to go amiss, the risk is minimal.
Thank you Mossdog. I keep a log book of everything I eat, the carbs, my BG starting, and my BG ending, as well as how many units were used and any correction units used. I then total each day up for total carbs and total insulin units used. I then take that data and using an app graph those results. I think Sarah just felt like I was being fake and had no control, but one should never judge anybody period. We are not here for that but to support one another no matter what type. I thought I could come on here and vent…but I guess not? J/k I know I can because everyone has been fantastic in helping me and supporting me. Thanks to all who have enveloped me with your support. You all have helped me accept this and motivated me to keep going. Oh and thanks for those who made me realize that the fact that I am on proper care is more important than anything. Without all of you I never would have insisted on insulin or even been aware of LADA, but it is good to know that I am 1.5 I know that and that really is all that matters. Type matters with my insurance, but for now I will play the waiting game, and if need be take the appropriate action as such.
Tom I totally agree! I wish me many more years of c-peptide as well =) I think she figures that since I am on insulin it’s working, but more importantly I think she is stuck on how a LADA presents, my thing is everyone with this disease from what I can tell, progresses at very different times. You are right that LADA does progress much slower. I am waiting 6 months and then we will see. I am also going to take BSC’s advice and keep doing MDI and finish tweaking. Right now my carb ratio is 1:8 and lantus is 26 and that works, although doc suggested I should up my ratio for dinner to 1:6 which is working. I think I got high at dinner because the lantus was wearing off. SO I am on 42-46 units total a day. I am accepting this more and more. I’m just happy that all of you have been so great!
Sarah: Stardust was diagnosed with diabetes (FBG > 125 mg/dl) and she is GAD antibody positive, so yes according to the WHO and Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, she has Type 1 autoimmune diabetes. By definition, antibodies are not present in Type 2. Stardust does great charting and is working really hard to get the correct treatment for herself and improve her situation. The problem is not with her (or with any other person who has Type 1 but was misdiagnosed as having Type 2), the problem is with a medical system that refuses to correctly diagnose a person and pretends all adults (esp those who are “overweight”) have Type 2 diabetes. And an insulin pump most certainly is not dangerous for a person who charts carefully, does a lot of testing, and is quite capable.
Hi Stardust: Yes, you can come here to vent, that is what we are here for. Sarah just doesn’t know the particulars of your situation, and it is so easy to blame a person rather than a whole medical system that needs a radical overhaul when it comes to its approach to adult-onset Type 1 diabetes. The actual fact is that the majority of new-onset Type 1 diabetes in adults is misdiagnosed as Type 2 diabetes, a different disease, and that is the real problem and the real tragedy. You are doing so great, really being your own best advocate (which is what we all need to do to get really good care), and you are getting the correct treatment (exogenous insulin). Now it is just a matter of tweaking your regimen.
You took what I said and summed it much better than I did originally! Thanks Melitta. I think I goofed on my carb ratio today. I did my normal 1:8 with breakfast but then did 90min of zumba…bs ended in the 49 oops. I have not played with insulin and exercise before now. I figured since it was 1hr after breakfast that the carbs from breakfast would hold. Maybe I should do a 1:10 ratio and see how that does.
Hi Stardust: My lowest blood sugars have always been associated with exercise. Since I wear an insulin pump, I turn my pump WAY down 1.5 hours before exercise. If it will be really vigorous exercise, I turn it down by 90% using a temp basal. At lunchtime, when I often go for a 3 mile walk, I’ll eat lunch but really lower my bolus. Exercise burns a lot of blood sugar! Sadly, it takes a lot of trial and error to learn what works for you.
Well then back to testing, testing, testing! LOL! So much fun. I will just check tomorrow 30min into my workout to be safe!
When I exercise within 1-2 hours of eating I reduce my bolus significantly, anywhere from 25% to 50%. So instead of my usual 1:10 ratio I will use 1:15 or 1:20 (this varies somewhat depending on the type of exercise, the intensity, and the duration). It sometimes means I start out high and end up in range, but after 20 years I still haven’t refined the art of starting in range and ending in range!
I am on a pump but I do not fiddle with the basal rate there for exercise. I find it too difficult to not end up really high with ketones an hour or two after finishing. I do, however, turn the pump down by about 10-20% for overnight if I exercise in the evening.
I didn’t state an opinion… I stated a fact. A change of 12.6 to 9.0 is significant, however it doesn’t change the fact that both are medically considered uncontrolled. I didn’t say that was your fault, I merely said that should be your FOCUS, because as long as you are being allowed to use insulin, whether you are labeled as a T1 or T2 by the medical community doesn’t matter very much in terms of immediate effects… what matters is that you have available to you the tools you need to control your diabetes - all I am saying is that you’re ahead of the game there, and it seems like you don’t even realize it.
FWIW, I was told that I had to be a T2 when my c-peptide was only 0.7, which was the bottom limit of the lab where it was tested, so it does happen… and the diagnosis was only made based on the fact that I was diagnosed with GD while pregnant (with a random BG over 500 - no joke) and I walked around on the verge of DKA for four months after the birth of my baby while I self-medicated with insulin on my own (with some success, since even at the highest, my a1c only crept up into the upper 7’s, despite regularly having BG spikes into the 400’s) and waited to get in to see a doctor who would entertain the idea that maybe, just maybe I wasn’t a T2… so I get where you are, I do, except that in my case I had to rely on what I could buy OTC (keep in mind at that point I DID NOT have a prescription for insulin), and I actually walked out of more than one doctors appointment crying after being yelled at for self-medicating with insulin - all while I was literally saving my own life, and I knew it, but I was seeing a moron who couldn’t get past her own pre-conceived notions of who could be diagnosed with T1… apparently at only 20 and 120lbs, I still didn’t fit that picture for her. I didn’t even have a prescription for enough test strips to test enough to be safe, I had to buy more myself.
So it could be worse - THAT is all I was saying… at least you have access to insulin at this stage. The details WILL work themselves out, and you’ll probably see later that it isn’t as vital as you feel it is now to get a T1 or LADA diagnosis… because you already have what would be the result of such a diagnosis, which is insulin, which is something that MANY of us have been denied at some stage.
Is your insurance denying you a pump without a very low c peptide?
Without a type 1 yes they are denying me a pump and that is the only reason.
I feel sorry for you, because I know clear-cut Type 2’s who have gotten pumps. Pumps should be available to anyone who is insulin-dependent! Or at least those who have been proven to need MDI – if you’re only taking one shot a day (many Type 2s can get by on just a basal), it’s not so bad, but when it gets to 5 or 8 or 10, it gets bad.
Right now, all I can say is have patience. Your C-peptide will decline, and the doc will have to reclassify you eventually. I hope!
I was misdiagnosed as type 2 because I am overweight as well. I was on oral meds for several years and they didn’t work no matter what I did. Finally I got pissed and went to a new doctor and requested a c-peptide. The first one they did my c-peptide was 1.2. I have since moved and gotten another new endo and my latest c-peptide is .08. Hang in there and if you have to go see a different doctor and get a second opinion.
Thanks. I just didn’t think kaiser would be like this. I hate doing the 5+ shot thing but it is what it is.
When I was first formally diagnosed, I was overweight, but not obese. I was given Glucotrol, a sulfonylurea, which didn’t do a bloody thing. This was before the days of Metformin and the other new drugs that have come out. Which may have been a good thing, because instead of being put on a merry-go-round of medications, I went on insulin within 5 months of my formal diagnosis, and it worked wonders. It took away the constant hunger I was feeling, and I LOST weight instead of gaining as some people do. I am currently ONE pound away from normal BMI (and that one pound is being stubborn, but I’m patient, LOL!!)
It’s been 20 years since diabetes symptoms started showing up, and insulin has been a godsend. I don’t really care how I’m typed, except that I was told in no uncertain terms by the CDE who was involved in my treatment during my coma last September that I need to tell all medical folks that I am Type 1, because that’s the protocol that works. And in the end, that’s what really matters.
The advantage of being diagnosed as type 1 is insurance. If you ahve a formal diagnosis of type 1 you dont’ have to fight near as hard for the latest technology.
Correct. Insurance is a biggie. If my endo said so then kaiser would comply.
I agree with you. If you have the GAD 65 antibodies you are probably LADA and I would definitely diagnose you as such if I were an Endo. Just because you are overweight and not using insulin doesn’t change the fact that you have antibodies. There is a rare form of type 2 only found in South Africa that has antibodies but as far as I know they haven’t seen it in other parts of the world. Still for your Endo to ignore your high GAD 65 antibodies doesn’t make sense. And there are different subforms of LADA and it can take up to 10 years or longer for insulin production to stop. I definitely would consider you to have LADA.