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Discussion Starter · #1 ·
Hi, everyone, been away for a while with Thanksgiving duties and a Florida vacation (Key West = perfectly nice but WAY overrated).

Wanted to share a few things that have come up over the past few weeks...

Firstly, I had a meeting with my endo's "educator". My doc, despite the fact that I've had two lengthy (and question-heavy) appointments with her during which I communicated (and demonstrated) that I was entering this new world with a decade's worth of "spring training" and as such was not a beginner by any means, was nonetheless insistent upon my attending a four-session education program called "Think Like a Pancreas". She even made it a "requirement" if I wanted to start taking the Levemir we decided would be a smart next step. OK, fine, I figured I'd go...couldn't hurt and there's always the chance I'd learn something new. The classes turned out to be very inconveniently scheduled, and I already knew ahead of time that I was going to miss two of them due to prior plans. So they said to come in for a one-shot one-on-one "class" with their educator late last week. Perfectly nice woman, and was sufficiently informed about most things...we had a nice chat. The only thing I could say I learned from her - and this is what I wanted to share with you all here - was her "official" definition of Type I vs Type II:

Type I is diabetes that "starts right away", and is commonly known as Juvenile. Type II is any form of diabetes that begins later in life.​

So, according to her, there is no such thing as adult-onset Type I.

Type I has nothing to do whether or not your pancreas still makes any insulin, whether or not you inject insulin, whether you take Metformin, whether the islets have been attacked by the immune system, they ran out of insulin or whatever.​

Now, I'm not necessarily disputing this, and I'm not discounting her knowledge, experience or belief...I'm just saying that for me, with the exception of the Juvenile part, this is a new way of defining things. I'm not sure if this particular distinction has been made here in this Forum or not...but it's not what I've been led to believe, here and via other sources, the differences are between the two varieties. I'm not really all that sure it matters - I mean, call it Type I, call it Type II, call it a probable twelve-to-seven, I don't care; I just care about managing it and surviving without complications. Take insulin, walk the dogs, cut back on carbs, learn to live without cake, thank the heavens for Splenda, etc. That's all that matters to me, not whether I'm officially Type XVII or Type Purple.

Secondly, I have started on the Levemir. Started with ten units, which turned out to be just as ineffective as was predicted. Have increased it two units a night and now am up to 16, still with no discernible effect. Who on here takes Levemir, and how much? Just wondering how long before I hit a dosage level that actually does something.

Third, I was on drugstore.com getting some unrelated items this morning and needed a couple more bucks in my cart to get free shipping, so I went to the diabetic section to browse a bit. Noticed they had some meters, and noticed how the rankings for mine (FreeStyle Lite) were strangely low. We used the Lite with Dad for years, and it's also been mine - one of my endo's recommended devices - since this all started in September, and our experiences have all been positive, so seeing the low ratings was surprising. For the most part the comments suggested that the accuracy was poor. Normally I wouldn't put much stock in just three ratings, but it got me thinking...Consumer Reports has it down in the lower third, due to poor "Consistency" (not "Accuracy", that rating was "Excellent")...does anyone on here use the FreeStyle Lite (not the Freedom, just the Lite)? I know meter accuracy isn't particularly great and isn't supposed to be - ± 20 is considered 'acceptable' - but is the Lite any better or worse than any of the others?

Sorry for the tome...and thanks in advance for your input!
 

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Sounds like an interesting meeting. Did she ever talk about low carb diet or did she recomend the diet most CDE's give out. As far as the definition of Type 1 or Type 2. I always thought Type 1's have very low insulin levels usually due to an autoimmune attack. Type 2's have insulin resistance or signaling problems which lead to poor insulin production or utilization of insulin. I have seen children dx'd with type 2 and people as old as 80 dx'd with type 1. So age on onset has nothing to do with it. I really wonder what else she is not up on.
 

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As far as the definition of Type 1 or Type 2. I always thought Type 1's have very low insulin levels usually due to an autoimmune attack. Type 2's have insulin resistance or signaling problems which lead to poor insulin production or utilization of insulin.
Aren't some cases of diabetes caused by a viral attack on the pancreas?
 
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WV Mom said:
Aren't some cases of diabetes caused by a viral attack on the pancreas?
It is not a viral attack it is more like a case of mistaken identity where the bodies own immune system attacks the beta cells in the pancreas and kills them. It keeps killing them as they try to grow back. They do believe that a virus as simple as a cold can be the trigger that starts the attack. As a result just about all type1's have an elevated GAD-antibody level and no insulin production. This means they will need insulin for ever. Not just any insulin will do though. You need a long acting to take care of your bodies daily functions and a short acting one to take care of the food you eat. If it was me I would look for a doctor that knows cats from dogs.

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You would think a medical profession would know this.
 

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Discussion Starter · #6 ·
Did she ever talk about low carb diet or did she recomend the diet most CDE's give out.
No, she's firmly in the "eat whatever you want, just take enough insulin" camp. And while technically that may be a correct-ish statement, I personally feel as though that's a slippery slope. My favorite old adage: "Just because you can doesn't mean you should." I plan on discussing LCHF eating plans with her...

So age on onset has nothing to do with it. I really wonder what else she is not up on.
Yeah, it really wasn't an appropriate time to school the teacher. I'd like to maybe establish an occasional email relationship with her, sharing news and the like and kind of steer the conversation towards the debunking of certain concepts. She's really quite nice and hardly what I would call an idiot...which just proves that even the smart ones who mean well are still passing along misinformation... :(

If it was me I would look for a doctor that knows cats from dogs.
I agree. I'm still on the fence re: the actual doc, as she prolly knows she can't win 'em all and has to go with the message that helps the most people (think "bell curve")...but as for the "school", I'm bothered by the educating that's being offered. There are complete newbies going in there who don't know that they're getting some bad information...
 
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Type I is diabetes that "starts right away", and is commonly known as Juvenile. Type II is any form of diabetes that begins later in life.​
On Friday I was listening to this online interview while driving between libraries for work. Professor Cowley stated very clearly that the term 'Juvenile diabetes' had been discontinued some time ago because of the number of adults being diagnosed with Type 1. He also mentioned that some children and teenagers were diagnosed with Type 2, which is one reason why they are now universally known as Type 1 and Type 2 (he'd already explained the different causes of the two types). Unfortunately, I arrived at my destination library just after this and missed the rest of the interview, but intend to listen to the podcast linked to on the page I referenced above.
 

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Discussion Starter · #8 ·
Professor Cowley stated very clearly that the term 'Juvenile diabetes' had been discontinued some time ago because of the number of adults being diagnosed with Type 1. He also mentioned that some children and teenagers were diagnosed with Type 2, which is one reason why they are now universally known as Type 1 and Type 2.
Awesome. Couldn't ask for a better example to use as a "conversation" starter! :first:
 
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The summer of 2009 I was tested with a lot of bloodwork by an endo. Except for my hypothyridism everything was quite normal, included my BG.
The autumn 2010 I got sick, drank a lot, urinated a lot and I became thinner than ever before. I had got diabetes.
Some of the doctors had a bet if I were type 1 or 2. I was too old for type 1 sais some of the doctors, but the diabetes came suddenly and I am slim, ate healthy and was really active so they couldnt really say it seemed lika a type 2 neither.
The bloodwork came back. I was diagnosed type 1, even I were 45 year, because my elevated GAD-antibody.
 

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I know you think your CDE is a very nice women, but why would you continue your relationship with someone who clearly is behind on her medical knowledge. The Eat everything you want and just medicate it can be a dangerous recomendation to follow. I really don't think it is our job to educate medical professionals but you can find another doctor. I did one and only one visit with my CDE. She told me basically the same thing as yours did and told me all Type 2's end up on insulin. Well if I continued with her diet I would be on insulin now. Since I have to pay 100% for all my drugs, including insulin I decided to experiment with my own diets and I have lowered my bgs into the low 100's most of the day and HbA1c in the 5's. If this keeps me off insulin for 10 years, I will do it. It is a shame that CDE's don't give D's the correct info up front. If it weren't for forums like this many D's would be stuck with the incorrect info that the medical community gives out.
 

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Third, I was on drugstore.com getting some unrelated items this morning and needed a couple more bucks in my cart to get free shipping, so I went to the diabetic section to browse a bit. Noticed they had some meters, and noticed how the rankings for mine (FreeStyle Lite) were strangely low. We used the Lite with Dad for years, and it's also been mine - one of my endo's recommended devices - since this all started in September, and our experiences have all been positive, so seeing the low ratings was surprising. For the most part the comments suggested that the accuracy was poor. Normally I wouldn't put much stock in just three ratings, but it got me thinking...Consumer Reports has it down in the lower third, due to poor "Consistency" (not "Accuracy", that rating was "Excellent")...does anyone on here use the FreeStyle Lite (not the Freedom, just the Lite)? I know meter accuracy isn't particularly great and isn't supposed to be - ± 20 is considered 'acceptable' - but is the Lite any better or worse than any of the others?

Sorry for the tome...and thanks in advance for your input!
I was using the Freestyle Lite which I loved because they taught me to check on the palm of my hand by my thumbs. Didn't take much blood either. Then my insurance decided they would only pay for Accu Check or Bayer strips. So now I am using the Accu Check Aviva and getting higher readings by about 10 points. So either the Free Style Lite reads low or the Accu Check is more accurate. It is making me angry because I thought I was doing so well.
 

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Hi, everyone, been away for a while with Thanksgiving duties and a Florida vacation (Key West = perfectly nice but WAY overrated)


Third, I was on drugstore.com getting some unrelated items this morning and needed a couple more bucks in my cart to get free shipping, so I went to the diabetic section to browse a bit. Noticed they had some meters, and noticed how the rankings for mine (FreeStyle Lite) were strangely low. We used the Lite with Dad for years, and it's also been mine - one of my endo's recommended devices - since this all started in September, and our experiences have all been positive, so seeing the low ratings was surprising. For the most part the comments suggested that the accuracy was poor. Normally I wouldn't put much stock in just three ratings, but it got me thinking...Consumer Reports has it down in the lower third, due to poor "Consistency" (not "Accuracy", that rating was "Excellent")...does anyone on here use the FreeStyle Lite (not the Freedom, just the Lite)? I know meter accuracy isn't particularly great and isn't supposed to be - ± 20 is considered 'acceptable' - but is the Lite any better or worse than any of the others?

Sorry for the tome...and thanks in advance for your input!
Hi, I have just recently started to use Freestyle Lite I previously used an Accu Check Performa, when I first purchased the Freestyle I compared the results of each test for a couple of days to my Accu Check & found almost nil difference in the readings, hope this helps
 

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I take levemir... Started at 20 was upped over time to 28 then as time went along it went down to 12 and now I take 18
 

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Discussion Starter · #14 ·
I know you think your CDE is a very nice women, but why would you continue your relationship with someone who clearly is behind on her medical knowledge.
She's the educator for my doc. I'm kind of stuck with her. Besides, I don't anticipate being required to see her anymore. And getting another doc is not really something I want to do right now; I still hope we're only temporary residents here and can move back home soon, so establishing long-term relationships with doctors, hair stylists, even pizza joints just seems pointless. My doc does what I need, and that's prescribing my Lipitor and my insulin. I'll manage my diabetes the right way, in spite of her if necessary...

The Eat everything you want and just medicate it can be a dangerous recomendation to follow.
I have no intention of doing that...I know better and always have.

I really don't think it is our job to educate medical professionals
You're right, it's not our job, but I'm not harming anyone if I try to make a difference and open at least one pair of professional eyes...

It is a shame that CDE's don't give D's the correct info up front. If it weren't for forums like this many D's would be stuck with the incorrect info that the medical community gives out.
Sad but true.
 

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Discussion Starter · #15 ·
I take levemir... Started at 20 was upped over time to 28 then as time went along it went down to 12 and now I take 18
Thanks for the input, Chesney. May I ask what it was that allowed your dosage to drop so much? Was it an increase in exercise, a dietary change, etc?
 
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