Chris and Betty have more or less summed it up. A T2 cannot become a T1 over time unless he was misdiagnosed in the first place. The reason why T2s may need to go on insulin jabs is the fact that the become so resistant to insulin over time that synthetic insulin must be injected into their systems to cope with processing glucose and such.
Daena, Dr Bernstein in his web casts has referenced Type 2 patients who where very poorly controlled for years coming into his clinic that killed their beta cells and were left with virtually 0 insulin production. He classified them as Type 1 because of this. Granted, they didnt have an auto immune attack and the markers but since they had no insulin production left he had no choice but to treat them as a T-1.
Permalink Reply by M on September 25, 2007 at 7:59pm
The names T1 and T2 are about the cause of diabetes - T1 has to have the antibodies, T2 the insulin resistance. T1 is a total lack of insulin production, T2 is overproduction but not so good at putting it in the right places. The cause is what matters when it comes to naming Diabetes. (Not forgetting, of course, LADA as a slower form of T1, MODY, etc...).
There are plenty of cases of people being misdiagnosed... I'm one of them! But I didn't 'progress' from T2 to T1, I was just incorrectly diagnosed T2 and had a year of mess until I was finally found to be a LADA T1.
If a T2 goes on insulin then they're still a T2. If a T1 develops insulin resistance they're still T1, although some people use the term 'double diabetes' so I guess in some way it's possible to have both at once.
T1 was thought not to produce insulin and the Pancreas but now there is a test (C-Peptide), which determins who is T1 or T2. In Type 1 we produce but not of any use. The determination for T1 is 0.5 anything over that is considered T2.
I still have C-Peptide (1.7) but I am diagnosed Type 1 because I have antibodies to my islet cells. I don't have insulin resistance. In England Type 2s who need insulin are called Type 1, but my understanding is that if the cause of your diabetes is insulin resistance you are Type 2 and if it is lack of insulin due to autoimmune disease you are Type 1. However, adult onset Type 1s like me may still produce some insulin and therefore have C-peptide.
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