Why isn't T2 detected earlier?

Something I’ve been wondering about for while. Maybe I don’t have my facts straight…

As I understand it, most T2’s don’t get their diagnosis until they start having issues, which is often 5 - 10 years after the insulin resistance problems start. So, why don’t routine annual exams check for levels of c-peptide (and hence insulin production) to make sure they are not elevated? That way the person with indications of early insulin resistance has a choice to alter their diet before insulin resistance/insulin overproduction starts to take a toll on their body.

Am I oversimplifying? If it were me, I’d want to know as early as possible.

I heard two years, but would have to say it comes from not getting tested, skipping exams, etc. I think the rise of people who are prediabetic shows that catching it early is on the rise. I am a T-1 who before DX I never went to the doctor you a yearly and looking back I was showing signs about a year to a year and a half before DX. When I finally went to my GP, well I was dieing. It just shows how really important it is to go get a check up.

While that may catch many cases earlier, what about the types who don’t see a doctor until there is a problem?

I read stories all the time of people who hadn’t seen a doctor in 20 years or more before diagnosis… and unfortunately it usually is a complication of diabetes that ultimately leads them to seek medical care.

That’s what I thought too Sarah. I know I hadn’t seen a dr for 4 years b/f I was diagnosed with Type 1

True, we can’t help people who never see a doctor.

You must have had a slow-onset (LADA)? My T1 hit me like a bolt of lightning. One day I was fine, the next I was T1. I was having monthly blood panels done for a different condition, no signs prior, not a one.

It’s not the protocol to test most people before the age of 40, no matter what their health profile is. And then the test done is usually fasting blood glucose, which can be one of the last things to go bad for a T2 person.

I thought I was doing all I could to protect my daughter from having Type 1 by getting her blood drawn every 3 months and tested for the chance she might get it. When she got Type 1 it was like an over night deal (just like her mom) They had told me eariler that month that she looked good to go for the next 3 months.

Hi Julie -

I’ll give my wife’s case as an example. She has Type 2 in her family and for years she regularly had slightly high fasting glucose readings at her annual physical (100-109). One day she used my meter so that she could see what a finger stick was like. Out popped a 119. She didn’t think anything of it - but I was freaked. She had an A1c with her primary and it came back 6.2. When her doctor called her with the result, he said that it was fine. It wasn’t fine. She actually went to see a very good CDE at the local hospital and was able to get on track by losing 15 pounds, making some modest changes to her diet and increasing her exercise. Here A1c has come back at 6 the last few times.

If she didn’t have a T1 husband, she would have believed her doctor and happily gone along until she couldn’t feel her feet. And he’s a pretty good primary. Now that she has taken charge, he follows up.

If the doctors don’t look for early T2 they won’t find it.


Maurie - this is what I’m talking about. To even start showing signs of elevated bg, that means that the person’s insulin resistance is already outweighing their insulin overproduction. Imagine if, instead of relying on fasting bg or A1C, we tested c-peptide instead. If a c-peptide showed that you were producing way more insulin than usual, that’s a BIG sign that there’s a problem. You could catch this long before we do currently.

I know people that have had A1Cs come back in the mid-6’s who’ve been told that they’re fine by their doctors too. Very frustrating.

You would think that they would but the stuff they do doesn’t really make sense. They changed the criteria for getting diagnosed so now people that would have been told they were diabetic are now waiting longer to hear they have a problem. Besides people that don’t go to doctors very often, some doctors don’t bother to check basic stuff. My sister’s PCP had not done any blood work for several years. She started having some problems & the PCP sent her to a cardiologist & didn’t even take one drop of blood.

Yep, talk about ‘reactive’. My mother had an A1C of 6.3 several months ago and the doctor wanted to wait a few more months and retest before she was given a ‘pre-diabetes’ diagnosis. 6.3 is an average bg of over 130. Not sure what’s ‘pre’ about that.

Why isn’t T2 detected earlier? Because the symptoms creep up on you, a tiny bit every day, just a tiny bit. You fall asleep too much, especially after a meal. You’re tired, too tired to exercise. Maybe you’re getting older? you say to yourself. Well, aren’t we all. And so one day, you just happen to be at the doctor’s getting a blood test… Maybe everybody over 40 – or 30 – should get a meter and test once a week, just for the fun of it. Might catch a T1 sometime, too.

I had the signs for a long time, should of been in to the doctors way before hand but pigheadedness almost killed me. A lot of it was refusal to admit I had a problem and not putting things together. I had always drank a lot of fluids, always had a thimble bladder so I didn’t notice those aspects till I was drinking a gallon of water an hour and hitting the bathroom every 10 to 15 minutes even then I put it off to working outside in the heat, same with the 60 lbs I lost. The numbness in my hands, mostly on my left side I put off to wearing my work ID on a arm band 14 hours a day. Passing out and weakness I blamed on working two jobs, going to school and having 2 toddlers at home who are daddies girls so I never got more then 3 hours straight sleep. I was disregarding the fact I only got off the sofa to feed and change them then I would sit down and pass out again. I started to get scared when I quit eating and couldn’t hold down food or drink.

Would probably not have made it to the doctor if my wife didn’t make me go. I remember my mother a few days before the appointment saying it sounded like I was diabetic. Well I wasn’t going to be like her (a badly controlled T-1), I was to old to get T-1 and didn’t fit the standard guidelines for T-2. Hell I remember hoping it was some kind of cancer, just so I wouldn’t be like my mother.

Doris you have lived through my greatest fear. I have wondered about getting my girls screened. I know of trialnet, but also wonder if insurance would cover the screening. My wife has PCOS and is showing sings of Thyroid issues(doctor visit soon), I have thyroid issues endo has yet to say if they are autoimmune related yet but assuming it is due to family history of autoimmune issues. I had mentioned screening to my girls doctor before I was DXed now if insurance will cover it I think I will demand it and more then just meter checking, of course the idea of drawing blood from a 2 and 4 yrold makes me squirm.

Part of the problem is ignorance in physicians, sad to say.

I had a decades-long diagnosis of reactive hypoglycemia, wildly irregular periods, a history of a dangerously large ovarian cyst and mild hirsutism starting where none existed before (signs of PCOS), adrenal hyperplasia and a sister already diagnosed with T2, but when I presented a fasting of 110 at my physical (previous fasting BG’s were in the 88 to 91 range) my doctor barked at me for even asking about it

"You’re normal. Normal." She was really nasty to me for even asking, treating me like a super-irritating hypochondriac about it.

Of course, less than two years later I was diagnosed with T2. If she’d done further testing, she probably would have found elevated insulin, elevated c-peptide, elevated post-prandials – all the reasons she’d need to at least start me on metformin, a lower carb diet and a serious walking program.

Who knows what damage happened to me in the five to ten years before diagnosis?

I don’t think we can assume that all the undiagnosed people out there couldn’t be diagnosed already – if their doctors were attentive to the signs already being presented to them.

Glad it wasn’t cancer, Anonymous Jim. Yikes. :-?

My first cousin was diagnosed T2 this past December via a retinopathy blow-out. He almost lost the sight in that eye, and the other was ready to blow.

He knew better. His father has T2, two of his first cousins have T2, he’s quite heavy and sedentary. He had to know something was up: thirst, waking over and over in the night to pee, exhaustion, blurry vision.

But he didn’t go in until he almost went blind – at 44. Yikes!!! I was shocked to find out that he hadn’t been tested. For goodness sakes, his father has test meters lying all around the house. My uncle and I talk about diabetes all the time, sharing tricks and ideas: cinnamon, low-carb diets, Lantus, walking programs. I know my cousin has heard it all.

He had to move in with his parents and almost lost his independence: no driving, living with his aging parents, being unable to work or read or walk anywhere by himself or even watch a movie. Three laser surgeries later, he’s much better, but boy did he ever dodge a bullet?!?!!

Why did he let it get this far? I guess he just didn’t want to know. How many people are like that? They know they should get tested, but they’re afraid to find out the truth.

I was diagnosed in 2002. I never had a doctor take the up-creep in my fasting values seriously until diagnosis at the magic number of 127. I don’t understand why they were so reluctant to see the trend before that.

LOL true. I do have a friend who just finished Chemotherapy that will point out no and then that at least he is in remission and after five years is considered cure, well I will always have to take shots. Of course I then just ask him how bad are his medical bills.