Type I "Progresses"?

I read in another forum from a nurse saying that Type I and Type II can progress. I say, NO Type I doesn’t progress because we don’t have any more insulin producing cells. The diabetes won’t progress but, maybe the complications will. What do you say???

Of course it progresses. 30 years ago I was on two shots a day of R+N and no home bg testing, just urine testing. Now I take 5 shots a day (MDI) and extensive home bg testing.

Keep in mind, for 99% of the world, the severity of our disease is the number of shots or fingerpricks we do a day.

(Also why multiple companies have wasted trillions of dollars trying to bring inhaled insulin to the market.)

I think you can most noticeably see the progression in LADAs because it comes on so much slower and … progressively their symptoms get worse and their ability to care for themselves using low-carb and no insulin wanes until they do need insulin. Their beta cells progressively are destroyed.

When a person is initially diagnosed with Type 1 diabetes, not all of the beta cells have been destroyed by the autoimmune process (often you’ll see it stated that about 80% of the beta cells have been destroyed). Following diagnosis, the remnant beta cell mass is completely destroyed quite quickly in some (especially babies) but quite slowly in others (especially adults who maintain tight control), by the immune-mediated process. So yes, Type 1 diabetes “progresses.”

Kari is right about LADA. But even in sudden onset Type 1’s there is progression, if you think about the honeymoon period, during which their pancreases produce a little to almost normal amounts of insulin, and then they gradually descend into total failure of the beta cells. Of course that progression occurs over a pretty short time span, but technically the nurse is correct. But I don’t know if she actually knows enough about what she’s talking about to know about honeymoon periods and LADA!

Do you know what “sustained” C-peptide levels means? I read the article, and that’s indeed the word they used, but they didn’t explain it.

According to the study abstract:

"Random serum C-peptide levels showed that more than 67.4% of the participants had levels in the minimal (0.03–0.2 nmol/l) or sustained range (≥0.2 nmol/l). Parameters associated with higher random C-peptide were lower hemoglobin A1C, older age of onset, higher frequency of HLA DR3 genotype, and responsiveness to a mixed-meal tolerance test (MMTT). Over half of the Medalists with fasting C-peptide >0.17 nmol/l responded in MMTT by a twofold or greater rise over the course of the test compared to fasting."

So it sounds like “sustained” is still fairly minimal.

That’s very interesting info! Thanks!

Sportster, I agree with you.
What does progress mean? Progress in what? A (nurse’s) statement like that only reveals what he/she doesn’t know - or it’s a generalization that has no basis. Some nursing programs have little more than a 2 hours lecture on diabetes nursing, and perhaps that is based on an hour of physiology. And some have had little contact with people with diabetes. If there are 4 questions on the licensing exam relating to diabetes mellitus, that would be a lot.

I tend to go with you on that one. I maybe wrong or I maybe right but either way that’s the way I feel.

One of the big differences between Type 1 and most other autoimmune diseases is that it isn’t diagnosed until almost all the damage has already been done.

It would be like if MS was only diagnosed when someone woke up one day and couldn’t walk. Usually it’s diagnosed much sooner because there are symptoms.

By the time Type 1s get symptoms, over 90% of the beta cells have been destroyed.

I would say LADA is a bit different because its honeymoon can go on for a few years. So it’s diagnosed a bit earlier in the grand scheme of things.