I’m sorry that I’ve cross-posted this under Type 2 and Type 1.5 as there isn’t a general forum for all types. I am in the process of trying to learn if I am Type 2 or 1.5. Everything is pointing to 1.5. I had my first endo appointment today and she didn’t trust the lab that did my c-peptide (.38) so is having me re-test. Antibody tests are not available here in Guatemala. But my question right now is because I am wondering if this endo knows what she is talking about. She said something that totally contradicts what I thought I understood. So I need to decide if I can trust her. Here is my question:
Isn’t it true that Type 2’s need generally to take higher doses of insulin than type 1’s or 1.5’s due to the fact of insulin resistance? (She said the opposite).
Yes, generally T2’s need more insulin because of insulin resitance, but not always… especially if the insulin is only supplemental to other drugs, or if they just don’t need much to get their numbers in line, however some type 1’s have a fair amount of insulin resistance as well… sometimes that can be caused by the body’s immune reaction to the injected insulin itself.
It’s hard to tell for sure about your c-peptide level without knowing your lab’s normal range, but it pretty much shows you’re not making much insulin on your own. If you are newly diagnosed it would point towards type 1… if you’ve been diabetic for a while, it’s harder to tell. Negative antibody testing doesn’t necessarily rule out T1 either… though it certainly can confirm it easily.
I don’t really have a current regimen! At least not one that has worked for me, which is what set me to investigating if I am in fact Type 1.5. I started on insulin in February this year. I was dx as Type II and stable on oral meds for just about a year when my numbers started climbing. Since I got put on insulin I have been all over the place, some very high numbers and some dangerously low. My dose has been changed several times. I’ve been tried on a couple different oral meds/doses to go with the insulin. I still need to work on my diet which is healthy but too much carbs. But even when I eat the same thing I can see wildly varying numbers.I am currently taking Lantus at night. The endo reduced it yesterday from 15 to 10. I take Glucobay 50mg before meals but am considering reducing it due to side effects.
It would appear that you are not making enough insulin if your C-peptide are so low. Most Doctors diagnose type 1 if you are over 5 years of age or have any tummy grease which most of us do. Then all oral drugs with the exception of possibly metformin are not useful and will only make your control a nightmare.
You need a slow acting insulin like lantus and a fast acting insulin before meals. This way you will find a dosage and regime and diet that works for you. Buy a book called “using using” or Thinking like a pancreas and figure out waht dosage you need yourself this is something the doctor cannot do.
Metformin if your body can stand it can be added to insulin to give a bit better control but cannot substitute for insulin.
I don’t understand your endo cutting the insulin.
Using insulin does not give you the license to eat anything because if you do you will gain weight like crazy if you are insulin resistant a bit. You want to minimize the amount you use. Low carb diet and a lot of exercise to combat resistant are a must for survival.
You have probably been misdiagnosed in the bigginig and your pancreas is dieing which is very unfortunate. Getting on a proper insulin regime may still save some of your own insulin production which makes the disease manageable. Once your pancreas dies and heaven forbide you develop insulin resistance the disease will be your worst nightmare. .
Thanks all. I appreciate the input. Unfortunately I don’t have too much choice in endos because I live in Guatemala and must have one fluent in English or I’ll really go crazy! I am going to look into those two books.
The endo lowered the insulin dose because I was waking up in the 50s every morning. This morning I had to fast and go and find the lab in an unknown area, then find somewhere to eat breakfast so I was very grateful to be 89 instead with the lower dose.
I like your 1-6, Dave and will use that as a guideline. #1 is kicking my butt but I have to be patient on that one; the others I have more control over.
I wouldn’t worry about your new endo doing a retest. It is my experience that every doctor will want to repeat tests with their own lab that they are familiar with.
I do appreciate your taking time to respond in such length. However, for you to state unequivocably “You are an insulin dependent type 2”, something that multiple doctors have not been able to determine is just not helpful. I am fully aware that the need for injected insulin doesn’t change type 2’s into type 1’s. However, if you had done anywhere near the amount of research I and others on this board have done you would be aware that 15% of people who are diagnosed Type 2 have been found to be incorrectly diagnosed and they are in fact Type 1.5 or LADA which is Latent Autoimmune Diabetes in Adults. It is an entirely different type of diabetes. These terms are beginning to be recognized by the medical community, though they are not yet officially sanctioned diagnosis. That has a lot more to do with insurance payments than medical knowledge.
If you don’t know about something, you probably shouldn’t comment.
We are all diabetics and it is not helpful to start a war. It will be funny if we find that the causes of both types of diabetes are somewhat similar. Typing diabetics is not a great idea in my mind since it allows the doctors to call you a type 2 automatically if you are older than 5 years old and not to put you on insulin when you need it. Better would be a 2 dimensional classification of how insulin resistant you are from none to a hell of a lot and how much insulin your pancreas produces from 0 to 300%.
Anthony , I need to remind you about my story , back in 1983 …I was over 42 years when diagnosed …" mis" diagnosed as type 2 …the meds and exercise did not lower my glucose levels . I , thank my lucky stars, realized , that I needed insulin and mentioned this to Doc and was hospitalized well within 2 months of original diagnoses and put on insulin . No doubt in anyone’s mind then , that I could manage my diabetes with pills and exercise .I was( am ) not insulin resistant .There are basic differences in the " types " of diabetes.
Lets help the Medical Community rename : to avoid confusion .
Nope. I have no desire to start wars. Oddly enough the post by Emmy that I was responding to seems to have been removed, which makes my response not seem to make much sense. I agree that we all have diabetes and I have learned nothing if not that diabetes is endlessly variable. Anthony’s suggestion of re-phrasing categories based on resistance and insulin production makes a lot of sense to me. I personally don’t like the term Type 1.5 and prefer LADA. But I absolutely agree that a correct diagnosis is a critically important starting point to correct management of our diabetes. After that the individual variations come in and all the excellent self-management skills and information shared on boards like this.
Thanks, Jenny. When the endo said that I couldn’t be a “type 1” because then I would need much more insulin I was like…WHAT??? I think I need to see if I can find another endo.
Your Endo is quoting an average this again may not be so if as a type 1 your pancreas is still somewhat working and you have very little insulin resistance you can do on very low dosages as Jenny mentioned. a more typical type 1 dosage is 0.5 unit per kg of body weight per day. This is why typing is so bad it does not encourage the Doctors to do their job but to label you.
