Well, that's a surprise

Turns out the endo says I am a type 1, not type 2 like previously thought. My A1c was 5%, but the endo says it’s just the honeymoon phase. Great.

I’m confused, Chef. At original diagnosis your A1C was 5.0? That is not a diabetes level A1C. Or was this after working on it for awhile? What led to your diagnosis?

What is your treatment plan, now?

Interesting, did you get an antibody test? Were you GAD positive? Kudos to your doctor for being proactive. As a type 1 being diagnosed early, you may have the rare opportunity of extended your honeymoon for possibly a long time. Some type 1s diagnosed as adults (LADAs) have gone more than a decade before needing insulin.

I was diagnosed with an A1C of 17.1%. After 3 months managed to get it to 6.1. My last visit resulted in a 5.0% rating.

She did not order the tests. She just said given my numbers, that is what she thought. She also offered to be my endo, as she believes all type 1 should have one. Otherwise the wait is over 1 year!

She did not order the tests. She just said given my numbers, that is what she thought. She also offered to be my endo, as she believes all type 1 should have one. Otherwise the wait is over 1 year!

She did not order the tests. She just said given my numbers, that is what she thought. She also offered to be my endo, as she believes all type 1 should have one. Otherwise the wait is over 1 year!

I have to admit - I don’t know if we can get some of these tests that Americans talk about. Maybe it’s because of our medical system here - not sure? Glad that she’s taken you on as her endo! I’m now playing the waiting game to find one here in Montreal that a) speaks English; and b) understands pumping. I’m having to look at a large hospital (Royal Victoria) here in Montreal to go to. I’ve got my latest blood work and prescription from my GP (I finally have a GP after going to clinics for last 21 years - yee! haa!) - so I’ll be faxing all that paper work off tomorrow. I was told by the nurse at RV that it could be a 3-6 months wait - but they have a good team of doctors with pump knowledge and a CDE (certified diabetic educator - which are very rare here in Canada I might add).
Looks like you are doing a good job tho’ with bringing down your blood sugars! After awhile you’ll be a pro at this!

Actually, I am in Saint Eustache. The waiting list for the royal vic is a joke. They told me that I would have an appointment next April. I ended up going to the Laval Diabetes center. The good news is that the endo that I got does speak english, but the nutritionist does not. Lucky for me the French lessons I took came in handy!

Sorry for the repeated comment here, not sure what happened.

I am on Levemir 20 units a day, and Novo-Rapid with a sliding scale. I usually bolus? 1 unit for every 10g of carbs. I am scared about that though… I never try and go higher than 5. (This is using a pen of course.)

I also exercise daily. I try and burn about 600 calories per workout.

Wow, great accomplishment with your A1C! It’s good you are being conservative with insulin, I find results are unpredictable if I get close to 50 carbs.

Without the tests, what did your endo base the diagnosis on? Blood sugar doesn’t generally indicate type. It can be theorized from factors such as body type, other autoimmune disorders and sensitivity to insulin, but it can only be confirmed by c-peptide and antibody testing.

My guess is that you probably have access to c-peptide tests - I even got one of those in Guatemala - but antibody tests might be less likely. I’m not sure if you think the tests are unavailable because they don’t know about it (that would seem surprising to me in Canada) or just don’t cover it on your free medical service. I don’t know how that works. In Guatemala they just had never heard of the antibody tests such as GAD, but then that is a developing country.

I wouldn’t worry too much about the nutritionist, you will probably learn a lot more on here!

Hi Chef,

What your doctor is describing is sometimes referred to as LADA or 1.5. My story is much like you. Thought I was a two and honeymooned getting great control and then one day the honeymoon was over and bg skyrocketed, you rally should insist, however, that the doc test you for GAD antibodies and c-peptides. The presence of GAD antibodies is the only way to be absolutely certain. It is Type 1. Why guess? Find out for sure,

Donna

She told me that with my blood sugar being at 36 mmol at diagnosis, and how I was losing weight indicated that I was a type 1. I had some keytones present as well, but they went away right after. I also did not respond to the Metformin either. She told me that I am also insulin resistant, and she sees this all the time with her Type 1 patients who are on insulin all the time.
Should I demand a test then? Just to make sure?

In the Endo’s opinion, it is better that I am a type 1, not sure why. I was too shocked to understand her reasoning on that.

Good to hear that you are doing so well. An A1c of 5% is spectacular. I would be nice to know for sure you are a type 1 but really is it going to change anything. If the honeymoon last good and if it last longer even better. I don’t think there is much you can do to make it last beyond keeping the blood sugar in the normal range 4 to 6mmol/L

Fabulous A1c! Kudos on your success!

Her statement about you being insulin resistant is confusing. Your 1:10 ratio doesn’t indicate insulin resistance especially at 50 carbs per meal, or your 20 units of Lantus. Also don’t understand her saying that she sees insulin resistance in her T1 patients.

T1 & T2 each have their own set of challenges. One isn’t “worse” or harder than the other.

True that.

I just recieved a phone call from the nutritionist. She tells me that given my diary, I need to do the following:

Bolus .6 units / 10 g carbs BREAKFAST
Bolus .7 units / 10 g carbs LUNCH
Bouls .8 units / 10 g carbs SUPPER

I will be rechecking that on November 25th

Does anyone else have any idea about this?

I am curious, do I ask the Endo for the test, or my regular family doctor?