Regarding the proposed name changes for T1 and T2 diabetes...

My thoughts are this...

It seems to me that it would serve all of us better, if our diabetes was referred to as either

"Insulin Dependent", or "Non-insulin Dependent" 

 

Insulin dependent diabetics would have a medical ID that states their need for insulin, instead of saying T1 or T2. Therefore, those who need insulin would get it right away if they were in an accident and unconscious. No nurses or doctors arguing about treatment!  The stigma might gradually disappear as well.

I have read on a website for endocrinologists, that most T2's will require insulin within 5 years of diagnosis regardless of what they do about their diet and exercise routine, because the beta cells have already been so severely damaged. (At the time of diagnosis most T2's have lost over 80% of their beta cell function). (I wish I had made a PDF of the article because I can't find it now).

If you are lucky enough that your doctor catches it in the so called "pre-diabetes stage" you might have longer. Otherwise, you can look forward to starting insulin fairly soon no matter what you do. This doesn't mean that you shouldn't change your diet and get more exercise, but if doctors and diabetics faced the REAL facts, if endocrinologists were more honest with us, then more people would be put on insulin sooner, which might preserve more of their beta cell function and prevent a lot of the damage that T2 diabetes causes.

When I was diagnosed I had to be put on insulin immediately, as I was in DKA. My beta cells weren't functioning, my blood sugar was sky high, and it nearly killed me. Right from the start I've had to rely on multiple daily injections to stay alive. I already had multiple complications and extensive nerve damage at the time of diagnosis.

Yes, I have insulin resistance, but that is not the main problem.

I am completely insulin dependent and have been since diagnosis. This disease nearly killed me because my doctor failed to diagnose it even though I told her over and over I think I have diabetes. She kept saying no, (I suspect that she misinterpreted the test results).

Only when I insisted on an A1c test, did we get the correct diagnosis, but by then it was nearly too late. She didn't even call me to tell me the test results, and things got very serious before anyone told me what was going on. It was a nightmare!

If all of us were diagnosed as either Insulin Dependent or Non-insulin Dependent, there would be a lot more clarity, especially in emergency situations.

Also, as the disease progresses for those who were not insulin dependent at diagnosis, the diagnosis would shift to Insulin Dependent Diabetes, as it should and the priorities would shift accordingly. It would not be an issue to get insulin when you need it. Some T2's desperately need insulin, but their doctors don't understand diabetes and refuse to prescribe it, necessitating a visit to an endo to get proper treatment!

Diabetes is not all that well understood in spite of all the studies and theories making the rounds. Even doctors and nurses are not well informed, much to the detriment and harm of diabetics, the world over.

 

For example, one thing that most people are not aware of is that many T2's also have many auto-immune problems. This isn't exclusive to T1. In fact, a study done recently proved that inflammation and auto-immune problems do exist in T2, not just T1.

 

We just don't understand diabetes well enough yet and the current labels aren't helping, but they need to be replaced with ones that reflect the changes that happen in T2 rather than focusing on the differences in onset. The emphasis needs to be on everyone getting the treatment they need, including those for whom the required treatment changes from diet, exercise and oral medications, to injected insulin.

 

Autoimmunity and T2

http://med.stanford.edu/ism/2011/april/engleman.html

"Type-2 diabetes is likely to have its roots in an autoimmune reaction deep within the body, according to researchers at the Stanford University School of Medicine and the University of Toronto...."

 

On another note, did you know that there are over 60 known genetic factors that can contribute to developing T2 diabetes?

Ten new genes for T2 bring total to more than 60 genetic factors

http://www.wellcome.ac.uk/News/2012/News/WTVM056115.htm

Ten more DNA regions linked to type 2 diabetes have been discovered by an international team of researchers, bringing the total to more than 60. The study provides a fuller picture of the genetics and biological processes underlying type 2 diabetes, with some clear patterns emerging.

 

 

Views: 309

Tags: 1, 2, T1, T2, Type, auto-immune, classification, diabetes, endocrinologist, genes, More…inflammation, name

Comment by Stemwinder (Gary) on April 21, 2013 at 3:35pm

It is true that more T2's could benefit from insulin. Doctor have been brainwashed into believing that pills are the only way. There are studies that say insulin treatment for T'2 is no better than pills but I believe that is because few General Practitioners are well versed in this treatment option.

Comment by Christel on April 21, 2013 at 6:13pm

Emmy, it wasn't too long ago that the medical community was calling it exactly that: Insulin Dependent Diabetes Mellitus (IDDM) and Non-Insulin Dependent Diabetes Mellitus (NIDDM). Before that, it was Juvenile Diabetes and Adult Onset Diabetes.

Some people and medical professionals still call it IDDM and NIDDM, despite the latest name changes to Type 1 and Type 2. The education component is crucial and much needed.

Great post!

Comment by nel on April 21, 2013 at 9:19pm

I wear a Medical necklace ...should all of us not wear ID?? ...it says : diabetes, pump user ??

Comment by Emmy on April 21, 2013 at 9:40pm

Nel, I agree we should ALL be wearing medical ID indicating we have diabetes, but most of the people I ask say they don't have any. Sad, as it could someday save their life.

Comment by Emmy on April 21, 2013 at 10:02pm

Yes, they may have been used in the past, but somewhat differently. I propose that they be used based on method of treatment, (which can and usually does change for T2's as the disease advances and people age).

The main thing would be that no one would question the use of insulin if your medical records state that you are Insulin Dependent. This is a big issue for anyone dependent on insulin, whether currently classified as T1, T2, or another type.

I have more in common with most adult T1's than most early onset T2's, as I have to take insulin or I'll end up in the ER with DKA again. My blood sugar rises pretty dramatically in a short period of time if I forget or am late with a dose.

I would just like to see more clarity when dealing with the medical community, schools, employers, family members, etc. Currently, I tell nurses in the ER that I'm insulin dependent, rather than using the current nomenclature. It just leads to confusion while the term "Insulin Dependent" is pretty clear to everyone I have to deal with.

I also want to see less division between the types, after all, we are all people, just trying to manage this disease as best we can. We should be supporting each other, not fighting over who has it worse as I have often seen in the past. We ALL have it worse! We need to stick together!

Of course there are those who have it much much worse: they may be on kidney dialysis, have had amputations, blindness, or other physical disabilities, or who also have cancer or another serious disease, and must battle on more than one front.

My grandmother went through much of this, and I'm dealing with many other things besides just diabetes. I know many who are in the same boat. When your life is on the line, all this "who's got it worse" argument seems pretty trivial and childish.

The names should be changed to make it easier to deal with those who are ignorant, including those in the medical community who aren't up to date on treatments. It should simplify things for everyone and bring unity. If it doesn't, then its not worth the trouble.

I hope this debate will lead to better understanding, rather than division. Its time we moved on to unity, don't you agree?

Comment by Ren on April 22, 2013 at 8:25am

This was my thought, also.

I am unable to find the original "Petition" thread.

Comment by Emmy on April 22, 2013 at 4:33pm

I can't find the post that was on here, but here's the petition
http://www.change.org/petitions/revise-names-of-type-1-2-diabetes-t...

Comment by Emmy on April 22, 2013 at 4:34pm
Comment by Emmy on April 22, 2013 at 4:35pm
Comment by shoshana27 on April 23, 2013 at 5:51pm

i always felt that t1 & t2 should have different names. they are treated so differently & our lives as far as blood testing & insulin & pump & etc...are so more complicated with t1.

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