Replies to This Discussion

Permalink Reply by Ellie on May 29, 2009 at 6:35am

From what I understand of 1.5, sounds like your doc might be right.

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Permalink Reply by Duncan on May 29, 2009 at 7:41am

Firstly, forget what you see and hear in the news, thin and active at diagnosis is not really atypical for type 2, it just doesn't get reported on. There is a sizable percentage of type 2's who fit into this category, 20-25% is the estimates I've seen.

Anyway. Missing your medication for a day or so is unlikely to really do much. Neither januvia and metformin are rapid acting drugs, you need to take them for a couple of weeks for them to get going and then it could be another few weeks before they really get going, same thing when you skip them. Both will continue to work for a while even if you don't take them, same things with avandia and actos. Drugs like sulfonylureas, byetta to a certain extent, prandin and starlix are the opposite. They are rapid acting and you have to take them every day or the y will do no good. When are you testing? What are you eating? How are you excercising? All these things will play a part. You may be seeing the sub 100 numbers but that's not to say you are not going much higher than that and then coming down. Have you had your c-peptide and insulin levels checked? If so, where do they fall? Personally I think if you have had blood sugar issues and have seen numbers in the 200's then there is little doubt that there is a problem. Simply put, it's hard to get non-diabetics to spike up to 140 and even then it's for next to no time. The only study I read that they got this to happen was to use large amounts of IV glucose. A bad meal will not spike a non-diabetic to 200+

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Permalink Reply by EsMom on May 29, 2009 at 9:29am

Yes, I know there's a bigger group that most think that are type 2's and thin. It's not the norm, but it IS more common than most think.

I try to eat less than 30 g of carbs per meal and less than 10 or 15 for a snack. Sometimes I cheat though and lately my numbers have still been good. I check 2 hours after I eat but as I mentioned in my first post, I've been kind of careless lately and sometimes it's at the 3 hour mark when i check. But, even when i do remember to check at 2 hours I've been at 100 to 110 consistently for the past two weeks.

I haven't been exercising as much lately but I'm still pretty active - I work at a desk but I do move around a lot, play outdoors with my daughter, etc.

I don't remember what my c-peptide was but it was on the low side of the normal range but my BG at the time was 76 so he said it was "normal" for that BG.

As my doctor says, it's just "par for the course" with me because nothing with me is "typical". : )

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Permalink Reply by Sarah on May 29, 2009 at 10:14am

I would suspect 1.5... not everyone with a classic presentation of T1 has antibodies, and it would make sense to think that could hold true for 1.5 as well. Usually the distinction between T1 and T1.5 is the presence of GADA, but not ICA... GADA alone seems to represent a much slower process of beta cell destruction than when combined with ICA.

I spent a few months being misdiagnosed as a T2, and during that time I had a very wide range of BG levels (from near normal to weeks of 300+), tried a variety of oral meds with mixed results, and was even off everything for a short stretch when I switched doctors without exceptionally crazy #'s. It's part of how the honeymoon process works. I would honestly suspect that's part of what you're going through now - a lot of T1/T1.5 go through that, because it can for a while almost seem like everything went away. Unfortunately, it doesn't last.

I was originally diagnosed without DKA or any of the truly "classic" symptoms of T1, so everyone just assumed I was probably a latent T2 because I was pregnant, and diagnosed relatively early in that pregnancy (more than 2 months before the typical glucose screen). It wasn't until several months after I had my baby that I found a doctor willing to consider the possibility I was a T1 (the one I saw immediately after my pregnancy flat out told me there was no possibility, I was just wasting her time arguing, and I needed to give the oral meds more time to work - I strongly believe if I had stayed in her care, I'd have ended up in the hospital!), though in my case my antibody tests my new doc did were VERY positive, so there wasn't really any questioning it. That was 11 months after my initial diagnosis during my pregnancy... so almost a year to get the final ruling on just "what" I really was. Not that it really mattered, all I really wanted was for someone to tell me it was okay to use insulin - my prior doctor had actually yelled at me for "self-medicating"!

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Permalink Reply by Anthony Holko on May 29, 2009 at 10:44am

Dear Sarah

Waiting for medication to work. I was told and I think the doctor was serious that the avandia needed 1 year to work (it never did). Think about this! You wonder if one was put on insulin promptly if this would prevent the beta cells from being totally destroyed?

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Permalink Reply by Yvonne on May 29, 2009 at 11:30am

Anthony,

I dunno Anthony; what ifs are so painful to think about. Maybe it would have prevented your beta cell burn out but not necessarily. My good friend was put on insulin and Byetta right after being diagnosed with T2 last year. She's takes over 100 units of basal insulin daily and is still very insulin resistant. Here I am, having good success with a low carb diet and exercise plus metformin. I remember that your body can't tolerate metformin and I'm thinking that you were pretty active when when you were diagnosed with D. Maybe insulin plus a low carb diet would've helped you alot.

Have you considered using a different insulin?

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Permalink Reply by Anthony Holko on June 2, 2009 at 11:36am

Dear yvonne

I am sorry for friend that is a lot of basal insulin. Your friend must of had diabetes for a really long time if type 2 or it came on quickly. I have tried lantus and levemir and basically found no diffeence unit per unit. Levemir is more expensive in my case as I need about 60-70 units of basal per day. It only comes in cartridges and lantus comes in a vial.

It is a shame about the metformin as it does work somewhat and is dirt cheap. Wonder if it poisons the liver.

With high insulin resistance a very low carb diet is a must not a frivolity. Really don't like that do have to do it to survive.

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Permalink Reply by Sarah on May 29, 2009 at 8:19pm

That sounds crazy to me... to wait a full year. I could see maybe a month to 6 weeks to see some improvement, with the full effect taking longer, and it may be that I was impatient, but with #'s as high as I had been having (a lot of 300+, and I was nursing at the time, which lowers BG, so I often wonder just how much higher I may have been without that), I really didn't want to risk my health with a "wait and see" approach. I had been on insulin through my pregnancy so I wasn't afraid to use it... so to me it really didn't seem fair to be told "no, don't take any" when it was literally the only thing that would or could work for me.

The kicker? That doctor wanted me to WEAN my baby so we could try other oral meds. That was really what clinched it for me that I had to fire her and find someone else. Sorry, but it wasn't going to happen when I knew there was something that worked and was safe.

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Permalink Reply by EsMom on May 29, 2009 at 11:03am

Sarah -

I'm so glad to hear someone with a similar story! I've come across a few people that have up and down numbers but no one that has several weeks of highs and then completely normal numbers for a while like you and I. Makes me feel Iike I'm not completely going insane. : ) Did you have any problems when you started insulin since you had a pancreas that would kick into high gear sometimes? I worry about that. I used to want to be on insulin because I felt it was better for my body and better in the long run (plus, Metformin makes me feel horrible). But when I have weeks like I am right now with normal numbers I worry that insulin would make my BG crash during these times.

Thanks to everyone for the response!!

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Permalink Reply by Duncan on May 29, 2009 at 5:20pm

I didn't say but I'm very much like you except a little younger. I've tried pretty much every class of type 2 drugs, they all worked for a week to a few months and then my blood sugar went up. I started insulin in November and now take a few units of humalog at meals and 6 of lantus per day. I do have issues with crashing fr no explainable reason. A meal that would leave me at 100 normally may leave me in the 40s after an hour from time to time. You just have to take each day as it comes and keep getting tests done until something sticks. I still don't have an official type other than type 2 for now and its been over 2 years.

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Permalink Reply by Mindy Niles on May 29, 2009 at 7:26pm

I am very new here, someone from Yahoo groups recommended your site and I find it full of good info. I am like you guys. They say is she type2 or 1.5? honeymoon? I am thin, 53 but have lots of diabetes in my fam. I have been on a very tight diet since Christmas eve, and just recently started "splurgeing". I LOVED it. My numbers were FINE, I was shocked. I was doing alot of walking during that week which may have explained it.

So, I just cheated again with a hamburger and fries and was at 184 at 2 hours. Looks like it has caught up with me. I sympathize with your situation, and appreciate those above who have offered advice. It applies to me. Best of luck to you in this adventure.

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Permalink Reply by EsMom on May 30, 2009 at 6:37pm

Hi Mindy -

It's frustrating, isn't it?! I had a hot dog and half a cob of corn tonight and I was at 87 at 2 hours! And next week I could be in the 200"s after a meal like that . I just don't get it! How are you being treated?

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