Here it is; I totally love my PCP. I usually see him at the end of the day, because we chat so long medical and non-medical.
Anyway, at yesterday’s appointment (he likes to see me every 3 or 4 months), I asked him what type of diabetes he thought I had (prompted by my reading of medical records when I was in hospital with dengue a few months back). He said definitely type 2.
I asked him why? He said because I developed diabetes too late for it to be type 1.
I replied I wasn’t sure given:-
Not all autoimmune diabetes develops during childhood. There is also adult onset which can be fast or slow.
Hypothyroid since 2000 (antibody negative though, for the antibodies tested), asthma, and allergies (ie. autoimmune), and we have strong family history of autoimmune / allergies.
It developed when I was 38 (in 2008) in my first weeks of pregnancy, and I started insulin a few weeks later. I was not overweight at that time, and actually had just completed iron man (ie. very physically active). I have stayed on insulin because I like the control it gives.
No known family history of diabetes.
I have very normal blood pressure and Cholesterol (though low HDL).
I have only tested anti-GAD and it was negative.
The only oral medication i have tried is metformin and it made no difference to blood sugar levels.
I have always had an excellent Hba1c (in the low 5s), but my insulin requirement has been increasing over time, now coming up to 8 years of using insulin.
My ex-Endo, never gave any diagnosis other than gestational…
He was thoughtful and said he would research…
We both agree that it won’t affect management at this time, but I do want to know… maybe will be important for insurance etc. in the future. He said it would also affect the way I am managed if ever hospitalized (and can’t manage myself). I even have this perception that if I am type 2, then it is my own fault and I should have done more to prevent it (I know this is a fallacy, but it is how I feel)…
Any ideas on a good up-to-date medical reference on this I can throw his way? I do know from Melita’s posts that Type 1 is not necessarily autoimmune.
Of course, Type 1 autoimmune diabetes can be diagnosed at any age, so your doctor saying you developed diabetes “too late” for it to be Type 1 is not rational (but good that he was thoughtful and said he would research). Dr. Anne Peters, editor of The Type 1 Diabetes Sourcebook, says that the oldest person that she has diagnosed with Type 1 was in their 90s. The key thing, of course, is that you are being treated with exogenous insulin and seem to be doing well. IMO, it is important to get correctly diagnosed (and it can certainly help with getting better gear such as a CGM), but the most important thing is to be treated correctly.
He is a GP (and a really good one), so I don’t expect him to be ‘expert’, but then he does have plenty of patients with diabetes, so he should be more knowledgeable. I must educate him.
I was on insulin before I knew him, but I do know that he typically will put patients on insulin if blood sugar is not controlled on 2 oral meds…so earlier than most…
JustLookin, I was 63 when I was diagnosed with Diabetes by my GP. He thought Type 2 because of my age, but put me on insulin very soon since orals did nothing but make me sick. I saw an Endo some years later to get a pump; I distinctly remember her changing the dx to Type 1 and saying that I was “exquisitely sensitive to insulin”. I found TuD about then. Between pump training and TuD, I learned for the first time all about carb-counting, I:C ratios, corrections, etc. Twenty-two years after the initial diagnosis, I’m no longer on a pump, now MDI and being treated by another GP–but all my numbers and the amount of insulin I need have remained the same. In summary, I’ve had Type 1 since the age of sixty-three and my D is stable at the age of 85 years old. (I do have four other autoimmune conditions as well.) Best wishes.
Well done Trudy1 for taking control. My dx was as an adult in first few weeks of first pregnancy aged 25. Taken off insulin after delivery as they didn’t think an adult could be T1. Took until 2013 to get c peptide test and them to accept am a definite T1. On a pump now for 14 months.
