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
"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
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.