Hello, I am a newly diagnosed diabetic

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Permalink Reply by Melitta on June 13, 2009 at 11:27am

Hi Steve: I am sorry you find yourself in this boat of diabetes. At 43, and your height and weight, if I were you I would want to make sure that you have been correctly diagnosed. As you will find on this site, many of us have been diagnosed with adult-onset Type 1 diabetes (sometimes called latent autoimmune diabetes in adults (LADA) or Type 1.5). On these site, take a look at the Type 1.5/LADA groups and forums. You are being treated for Type 2, and those treatments will not control your blood sugar if you indeed have Type 1. I would suggest that you get a definitive diagnosis which would clarify what treatment is necessary. The definitive test for Type 1 autoimmune diabetes (at any age of onset) is antibody testing (glutamic acid decarboxylase antibodies (GADA), islet cell antibodies (ICA), and insulinoma-associated (IA-2) autoantibodies). Also, a c-peptide test is useful to see how much insulin you produce. An endo (or any doctor, but endo is best) can order all these tests for you, but you may have to be really insistent. Best of luck to you.

Melitta

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Permalink Reply by Steve Carithers on June 13, 2009 at 11:40am

Melitta,

Thank you for responding.

I was given a Blood Glucose Test by my doctor, who himself is a type 2 diabetic, and it topped out around 300. I was diagnosed that way.

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Permalink Reply by Melitta on June 13, 2009 at 2:19pm

Hi Steve: What I am trying to say (but wasn't clear enough!) is that frequently people who are diagnosed as having Type 2 diabetes, but don't fit the typical profile for Type 2, have been misdiagnosed and in fact have Type 1 diabetes. Doctors assume if you are an adult you are Type 2--bad assumption. But, if you are not overweight and don't fit the typical profile for Type 2, and you don't respond all that well to Type 2 meds, you may have adult-onset Type 1 diabetes. Yes, based on the 300 mg/dl blood test you have diabetes, but what type? A blood glucose test is not enough to distinguish between the two types. That's why I suggested antibody testing and a c-peptide test. I was diagnosed at age 35, and I was initially misdiagnosed as having Type 2 strictly based on age (I certainly don't fit the typical Type 2 profile). A week after the incorrect diagnosis I was correctly diagnosed as having adult-onset Type 1 diabetes and put on insulin. I hope I have not confused you. I would check with your doctor. Best of luck. Melitta

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Permalink Reply by Steve Carithers on June 13, 2009 at 2:47pm

Melitta,

Thanks for clarifying. So far, I have responded extremely well to the Type 2 drugs. I have been on pills and have even started to cut back on them. My blood sugar has ranged from a low of 84 to a high of 136, mostly between 100 and 115. My good friend whom I know and has been a long time diabetic has instructed me well. He told me that if I stick to the plan, he assures me I will be off the pills and able to eat semi normally. I will still have to watch the carbs and mostly avoid sugars. He is considered a lay expert on diabetes and has even had some doctors come and seek his advice..NO KIDDING...LOL. I consider myself lucky to know him. BTW...his name is Mike Kemp. He lives in Mississippi. He said it was ok to mention his name on a site like this one.

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Permalink Reply by tmana on June 14, 2009 at 4:54am

Melitta: one of the difficulties in diagnosing LADA is that at the start, and during the honeymoon stage (before the immune system has killed off the beta cells), a blood test for GADA will come back normal -- as will a blood test for c-peptide, and possibly also a test for serum insulin levels. (I have been told this by medical doctors when we were discussing initial diabetes diagnosis in general.) Genetic tests may show genes for either, or both, Type 1 and Type 2 diabetes, without showing which gene(s) have been activated. Current medical science and practice suggest treating with diet and oral medications unless and until they are found to be insufficient to maintain normal blood glucose levels.

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Permalink Reply by Melitta on June 14, 2009 at 9:01pm

Hi tmana: Actually, there is little difficulty in diagnosing LADA using antibody testing. But sadly, few medical doctors have knowledge of the correct diagnosis, appropriate care, and treatment of adult-onset Type 1 diabetes (sometimes called LADA/Type 1.5). We are an ignored but significant population. However, recent scientific studies do shed light on the phenomenon of adult-onset Type 1. In new onset Type 1 in adults, autoantibodies are present in the vast majority of cases and intensive insulin therapy is the appropriate treatment.

Jerry Palmer MD, a leading Type 1 diabetes researcher, states that “autoantibodies that are reactive to islet antigens are present at the time of diagnosis in almost all patients with Type 1 autoimmune diabetes” (“Type 1 Diabetes in Adults,” Informa Healthcare, 2009). Antibodies indicating that the immune-mediated destruction of the beta cells is occurring are typically present in a patient many years prior to the onset of hyperglycemia. At diagnosis in either childhood or adulthood, antibodies (GADA, ICA, IA-2) are detected in the vast majority of those with autoimmune diabetes.

In the DCCT, all subjects with adult-onset Type 1 diabetes had some residual beta cell function (Bernard Zinman MD, DCCT). Those who were assigned to the intensive insulin therapy group were slower to lose residual beta cell function than the conventional therapy group (risk reduction 57%). Clearly, early intensive insulin therapy has enormous benefit. As demonstrated in the DCCT, “intensive therapy for Type 1 diabetes helps sustain endogenous insulin secretion, which, in turn, is associated with better metabolic control and lower risk for hyperglycemia and chronic complications.” LADA researchers in Japan (Kobayashi et al, 2002) have conclusively demonstrated that better preservation of beta cell function occurs with exogenous insulin compared to sulfonylureas, and that sulfonylureas hasten beta cell destruction. In other words, doctors may inappropriately use Type 2 therapies in new-onset Type 1 diabetes, but all scientific studies indicate that the correct therapy is intensive insulin therapy.

Undertreatment of Type 1 diabetes at any age of onset hastens the onset of complications and causes needless suffering and potentially death. The appropriate treatment for Type 1 diabetes is exogenous insulin, with intensive treatment begun as early as safely possible after Type 1 diabetes is diagnosed. People who have immune-mediated diabetes should not be treated as if they have Type 2 diabetes.

Melitta

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Permalink Reply by Kristin on June 13, 2009 at 3:01pm

Welcome to our community Steve! Sounds like you have responded to your diagnosis with a great attitude! I think you will enjoy connecting with others here as well :)

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Permalink Reply by Steve Carithers on June 14, 2009 at 7:30am

Kristin,

Thanks for your response! I don't know if it is my attitude or my stubbornness that just will not allow me to lay down and take it...LOL.

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Permalink Reply by Gordon Paul Jones on June 13, 2009 at 3:49pm

Welcome Steve,

It sounds like you have things pretty well under control, thanks to your friend, Mike. Why don't you encourage him to join Tudiabetes? He could probably help a lot of us.

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Permalink Reply by Steve Carithers on June 14, 2009 at 7:17am

Gordie,

Thanks for your respones! I have indeed invited my friend Mike to come on the board. He said he will. He is quite the character..LOL. He is 62 and was diagnosed at age 8. He has come back from blindness, and some bad infections in his past to survive and now really thrive with his type 1. Along the way, he has learned about all the kinds of Diabetes and is very free and helpful with the information. When he does make his appearence on here, I think many will be suprised. He has told me that he can work with type 1 or 2 and also that if there is not any damage done to the organs because of it, he can definitely help. He said with type 2's ..he can cure them and he says he has done it with many. All I can say is that with me, his instructions have sent my blood sugar down to normal faster than my doctor has ever seen in his professional career. I have known him for about 3 years now on other issues and now, we work on the one we really have in common.

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Permalink Reply by Sheila Green on June 23, 2009 at 10:45am

I would like to meet your friend, Mike. I have had type 1 for 55 years and I am 58 now. I am still going strong and I wonder what his theories will be with people who have never had all the advances in medicine readily available to them, and they are still going. Yes, now the information is available to me and I use it well, with the pump and GCM - is it just luck, or better judgement or maybe its in the genes that we are still around ?
Sheila

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Permalink Reply by Steve Carithers on July 4, 2009 at 5:53am

Sheila,

Thanks for responding. Sorry I have not responded sooner. I have not been on here in awhile. If you would like the contact information for my friend Mike, email me at cboocat@aol.com. Just let me know where you are contacting me from. Mike said it is OK to give the information out if it is regarding Diabetes.

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