Am I now Type 1?
I was diagnosed with diabetes almost 2 yrs ago. Put on oral meds than on insulin when they didn't work enough. Got my A1C down from 12 to 6.5 on insulin.
I lost my health insurance last year so I've been going to the Visiting Nurses Health Clinic in my area. They monitor my A1c, thyroid (another problem I have), high blood pressure now, and help me with my insulin & supplies. The doctor who is usualy there is on maternity leave. The PA who is filling in for her said I'm now T1 because I take insulin. I didn't argue with her because whats the point. Plus no doctor has ever said you are T2 just that I have diabetes. I just figured because it came on after I was prediabetic, got pregnant & was put on insulin in week 6 because my sugars where saying diabetes that I'm now T2.
So what does everyone think? Am I T1 because I now take insulin? I feel like it's not fair for me to call myself that when so many people are T1 because they where just born this way where as I was born this way but my weight contributed to it becoming such a problem.
I lost my health insurance last year so I've been going to the Visiting Nurses Health Clinic in my area. They monitor my A1c, thyroid (another problem I have), high blood pressure now, and help me with my insulin & supplies. The doctor who is usualy there is on maternity leave. The PA who is filling in for her said I'm now T1 because I take insulin. I didn't argue with her because whats the point. Plus no doctor has ever said you are T2 just that I have diabetes. I just figured because it came on after I was prediabetic, got pregnant & was put on insulin in week 6 because my sugars where saying diabetes that I'm now T2.
So what does everyone think? Am I T1 because I now take insulin? I feel like it's not fair for me to call myself that when so many people are T1 because they where just born this way where as I was born this way but my weight contributed to it becoming such a problem.
Replies to This Discussion
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Permalink Reply by Emmy on -
@ Peetie, This is the link, http://www.telegraph.co.uk/health/healthnews/7855093/Doctors-pinpoi...
or you can download the PDF attached to this post. - Attachments:
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38 GENES type 2.pdf, 104 KB
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Permalink Reply by Brian (bsc) on -
Actually, this just lists some 38 genes that have been implicated in T2 diabetes. Ralph DeFronzo suggests that there are eight separate defects that are involved in T2 diabetes. He describes them in his 2008 paper.
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Permalink Reply by Emmy on
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Yes, there are 8 areas where faults in function cause the problem, but there are still 38 known genetic defects that can be involved in triggering type 2, which is way more than previously thought. I'm sure they'll find even more in the future.
He's talking about how each of 8 areas which are involved in insulin production and use, and glucose's action in the body can be affected in type 2. Its not really the same subject.
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Permalink Reply by Peetie on -
Gosh this is all so confusing! Yesterday I read the "Joslin Type 1 Diabetes Study....Update" posted by Richard 157. I had no idea that people surviving for over 50 years with T1 could still produce insulin. What does it mean? Are there different types of Type 1 now? I found it amazing but no one else commented. Am I missing something?
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Permalink Reply by Emmy on
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@ Peetie, I've read the same thing. I think the amount they can produce at that point is probably minuscule.
Don't forget that there is research showing that type 2's can have antibodies too, so while the onset can be quite different timewise, the end result can be very simular.
There are endos who beleive that type 1 and 2 are the same thing, one having a rapid onset and the other having a long drawn out onset, just variations on the same disease. I'm not saying they're right, (or wrong).
We do know that there are many factors involved and that neither disease is very well understood yet. It'll be interesting to see what discoveries are made over the next decade or two. -
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Permalink Reply by Jen on
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@Peetie: If you look at the full study, the insulin production was minimal. The study says 67.4% had "detectable" c-peptide levels, which meant anything of 0.03 nmol/l or above. I'm not sure what the normal range is, but 0.03 nmol/l seems extremely low. Only 7.5% had a c-peptide level above 0.1 nmol/l, and only 2.6% had a level above 0.2 nmol/l.
I actually found the study a really interesting read!
The exciting part, though, is that the study provides evidence that in Type 1s the beta cells are continually being produced and then destroyed by the autoimmune attack. Theoretically, if there was a way to turn off the autoimmune attack, the cells might be able to regenerate themselves so that Type 1 would be cured or at least easier to control. -
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Permalink Reply by Jason Sandeman on -
See, I love this line of thinking. We get caught up in "what type am I?" etc, In the end, what matters is how we take care of ourselves. I left HOW I got diabetes back with my diagnosis. It doesn't help me now. Focusing on NOW, and what I need to do is what helps.
Keep my numbers consistent, exercise, and above all else, BREATHE.
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Permalink Reply by Peetie on
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Unfortunately it does matter what type you are. It matters in the treatment that you receive and to the insurance companies. One member was worried that she was turning 65 soon and wouldn't pass a C-peptide test so that the new insurance would cover her pump. If there are so many different reasons why one has high sugar, I wish that doctors (endos in particular) would find out the reason and treat accordingly. Presumably genetics would be helpful but....
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Permalink Reply by Jason Sandeman on
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I agree with you in the Medical context. The thing is, the OP was upset because a nurse called her a T1. Even from an Endo's point of view, the title doesn't matter, the treatment is what is important. If you are a T2 who is insulin dependent, that is what you are. You need the insulin to live, and diet and exercise will only take you so far.
It doesn't matter at that point whether you are a T1, T2, etc.
For insurance purposes.. that's a WHOLE nother boat.
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Permalink Reply by Zoe on -
Yes, I've read the same thing, that Type 1's can continue to produce some insulin, but not enough to make any difference. The main difference between type 1 and type 2 is not rate of onset but presence of antibodies (type 1) and presence of insulin resistance (type 2- but type 1's can develop it over time). Not all Type 1's have rapid onset, for example LADAs which are just a subset of Type 1 that has a much slower onset - months perhaps even years.
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Permalink Reply by Lila on -
The labels are only important in as far as getting the right treatment. The worst case scenario of getting the wrong label stuck on you, is if you were insulin deficient but called a Type 2 and being given a cocktail of pills, none of which are going to work if you are insulin deficient. Which would lead to the patient walking around with deathly high blood sugars, and at the same time, being blamed for being non-compliant. So if wrong label leads to wrong treatment, that's bad! Wrong label+right treatment is irritating but not ultimately life-threatening.
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Permalink Reply by Zoe on
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Then there are LADA's like me for whom the oral meds do work for awhile, but current wisdom states that it is not a good treatment for Type 1's because it hastens beta cell destruction.
My doctor told me recently that more and more the medical profession is leaning towards starting type 2's on insulin sooner rather than later. If this becomes routine it will eliminate the worst of the results of misdiagnosis, but there are also some insurance issues that would be impacted with the wrong diagnosis, such as the number of test strips you are prescribed and being approved for a pump or CGM. I still want to know my Type if for nothing else that I read about it and learn as much as I can, and much of the information from the opposite type would not be particularly helpful.
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