I was diagnosed with diabetes last year, but the dr gave me no label type 1 or type 2 (at the time of the diagnosis my values were nearly 600). They put me on metformin only, not insulin. Later they found that GAD was positive and c-peptide not sure, looks low but I don't know the reference value. When my meals are really low carb my values are okay, if I do not eat low carb my values rise immediately (280 - 300). Does this mean that the metformin does not work for me or that I am terribly insulin-resistant?
My GP will not put me on insulin because A1c is too low for insulin. When this will be higher, they will put me on a daily dosis of glargine.
The endo called me type unknown and sent me back to the GP. GP won't put me on insulin because A1c was below 7 % (6.9 % last time). Fasting BG most of the times too high. Will ask (beg) again to send me back to the hospital. Thanks for your answer JohnG.
If you are not getting the response you want, you need to find another doctor. Your numbers are still really high, so regardless of whether you're T1 or T2, your current mode of treatment is not working. The A1C is just one number and should be looked at in conjunction with your blood glucose logs.
Often in the beginning type "unknown" is appropriate until more tests and a bit more history is written. Make another appointment with the Endo or with another Endo. In the meantime, keep your written daily records of time of day, exact food eaten with estimated carb grams, and blood sugars before and 2 hrs after eating. Start each page with the date and your fasting blood sugar. A page a day, with times of each test. Sometimes test 1 hour after eating, too.
Do a couple weeks of low carb, then a week of eating items that spike: fruit, granola/cereal, starches. Take it to the Endo; if the endo has too little time for that appointment, ask for an appointment with his/her CDE.
"A1c too low" is not a reason for denying insulin. You seem borderline, but state you've heard your pancreatic beta cells can be given a vacationwise happy breather by taking insulin. Saving what you've got is a worthy ambition.
If all this gets you nowhere, go to another Endo or a University diabetes center. One of the ways I find Endos is by going to a hospital diabetes teaching center and asking the nurses who they'd go to. And since they won't give me only one, I say, "ok, you give me one, and you give me the 2nd one." And I go on like a zombie, saying I'll never tell....
A GP may or may not go for detailed advanced work with diabetes as he takes his required hours of continued education. Sometimes he doesn't have enough diabetes patients to have more curiosity. And regulation cannot stipulate so many hours in this aspect of diabetes and so many hours in that aspect to the degree that is needed in diabetes.
Just because you've been "sent back" does not mean you have to do it.
Hi Smile: The fact that you are GAD positive means that you have Type 1 diabetes, by definition. I would strongly disagree with your doctor that an A1c of 6.9 is too low for insulin: most of us with Type 1 aim for an A1c lower than that. I would suggest seeing an endocrinologist--I agree with JohnG, a GP really is not qualified to handle someone with new-onset Type 1 diabetes. And of course the only line of treatment for Type 1 diabetes is exogenous insulin. Finally, I wrote my top ten tips for the newly diagnosed which I hope you will find useful. Best of luck, I encourage you to be your own best advocate.
