How do you know if you have beta cells remaining and is there a lab test that you can do to see how much of it is left? I read that once your BG is at a certain level, 100-120, your beta cells are stressed and at one point they will start to die? Is this permanent? I guess so, since some Type 1's don't have any left (but don't despair, I heard they can be replicated - http://www.diabeteshealth.com/read/2010/04/09/6635/insulin-producing-beta-cells-can-be-reborn/)
I have been on diet and exercise alone without any meds for the past few years and have been able to keep my HBA1C at 5.3%. However, this alone does not tell the full story because when I measure my BG's, my fasting numbers are usually in the 100-120's range (in which case my beta cells are overly stressed or dead already) and I get very high spikes in the 150's-200's two hours post-prandial. I thought my A1C was pretty okay but am now concerned that I might not have any beta cells left (*big sigh*).
Since getting health insurance, I have started an aggressive treatment including Byetta, Metformin 750mg XR and acarbose. Well, I am phasing them in so I will start Byetta and Acarbose in the next two weeks, but I already see that my fasting numbers are in the 90's the past three days since I've taken Metformin.
Despite claims, most type 1s still have some residual beta cells left. They will test low on a c-peptide test, but not zero. There is evidence that high blood sugars are harmful to your beta cells (so called glucotoxicity), but there is debate on how high is damaging. Many people believe that the damage occurs with levels above 140 mg/dl. On the other side, there are people that believe that beta cells can recover. Unfortunately, things are more complicated than that. For many type 2s, they do not just “fix” things and regrow their beta cells. For some, they are actually autoimmune, and others there appears to be some additional processes going on which causes a continued loss of beta cells.
In either case, control your blood sugar and you will have the best chance of keeping those beta cells.
The c-peptide test (that bsc mentioned) measure how much insulin production you will have.
Also, I would have to agree with bsc, that we don’t know enough about beta cell loss in type 2 diabetes. In type 1, it is clearly caused by an autoimmune reaction, but some people retain some beta cell function (this was found by testing people who had type 1 for over 50 years). So we don’t know enough, but the things that you need to do for good blood sugar are the same things that may help your beta cell function. So keep it up!
There are a couple of recent studies that indicate if you are Type 2 & take insulin, you give your beta cells a “rest”, and they begin to regenerate somewhat.
Also, I read some research that says alpha cells in mice can “become” beta cells. Very interesting stuff!
The c-peptide is supposed to measure how much insulin you can make, but the reference ranges vary from lab to lab, so interpretation can be difficult.
Your c-peptide test should also be interpreted with your blood glucose level at the time. I higher blood glucose level naturally makes the c-peptide level higher.
