[glomaster]

So I was diagnosed "type 1" and presented with DKA. However all my blood tests showed that I am negative for the main auto-antibodies. Does this mean I am type 2? Does it matter what you are? I have had one doctor tell me he would be aggressive and put me on oral and insulin therapy at the same time while my own endo seems to be impressed with my ability to maintain good blood sugar using intensive insulin therapy. Does it really matter what you are diagnosed as? Another doctor told me that 25 years ago the diagnoses was simple. Older than 30 = type 2, younger than 30 = type 1.

What do you guys think? Am I type 1 or type 2? I took a c-peptide test today results should be in by next week. according to my c-peptide at the hospital I was just below the border of the lowest figure that can somewhat be considered normal. One doctor told me that most type 2s (if any) don't present with DKA. What do you guys think?

BTW I am 24 years old, 165 pounds, 5' 8" and I exercised regularly

 

[foxl]

Are you African American? There is a genetic syndrome, called Ketosis-Prone Diabetes which is more common in African Americans. It is a form of Type 2 and might not progress.

I turned out to have GAD antibodies, but was DKA and not insulin-dependent at diagnosis. Now, 2 yrs later, insulin-assisted, only. Many of the papers on KPD were very informative, to me. Try googling it!

Another thing often pointed out is, we can have antibodies not detected by testing ... but, conventional Type 2 can ALSO present (if rarely) in DKA.

So, unfortunately, there is no easy answer.

 

[Shanny]

So, unfortunately, there is no easy answer.

And the simple "Older than 30 = type 2, younger than 30 = type 1." is ABSOLUTELY not the answer!

 

[foxl]

Oh, and your c-peptide might be low, because the injected insulin is suppressing your manufacture of more.

The papers I read on post-DKA therapy indicated that up to 6 mos of insulin therapy "rests" the beta cells, thereby optimizing your recovery of function.

Another thing that matters -- sulfonylurea meds stimulate insulin release by beta cells -- thereby leading to earlier burnout, documented by the Cochrane group. You might look at the Blood Sugar 101 website on that.

I went to earlier insulin therapy -- along with metformin (which is pretty innocuous), because of those concerns. Wish I could've done more insulin therapy in my first 6 mos, though.

 

[glomaster]

I'm not an African American and I don't know whether the insulin they were injecting me with was causing a suppression of C-Peptide. An endo told me that very high blood sugars can suppress c-peptides. I guess we won't know until results of most recent c-peptide come back. One thing I do know is that from what I can tell measuring my BG it seems as if my own production of insulin has dropped since november.

 

[foxl]

I'm not an African American and I don't know whether the insulin they were injecting me with was causing a suppression of C-Peptide. An endo told me that very high blood sugars can suppress c-peptides. I guess we won't know until results of most recent c-peptide come back. One thing I do know is that from what I can tell measuring my BG it seems as if my own production of insulin has dropped since november.

Well, then perhaps you are a Type1b ... ie, non-autoimmune cause of beta-cell loss.

My point on the C-pep was, the first 6 mos after DKA you are going to run a lower c-peptide, anyhow ... and ANY exogenous, injected insulin does lower your production. And yes running a high BG does suppress insulin production, part of the physiology of going into DKA in the first place.

 

[glomaster]

foxl thanks so much for the great info! Just curious do you think really knowing the difference between whether you are T1 and T2 makes that big of a deal? I know it does but I guess what I'm trying to ask is, why don't they use insulin therapy for aggresively for T2? It seems like the easy and perfect way of doing things?

 

[onaughmae]

So I was diagnosed "type 1" and presented with DKA. However all my blood tests showed that I am negative for the main auto-antibodies. Does this mean I am type 2? Does it matter what you are? I have had one doctor tell me he would be aggressive and put me on oral and insulin therapy at the same time while my own endo seems to be impressed with my ability to maintain good blood sugar using intensive insulin therapy. Does it really matter what you are diagnosed as? Another doctor told me that 25 years ago the diagnoses was simple. Older than 30 = type 2, younger than 30 = type 1.

What do you guys think? Am I type 1 or type 2? I took a c-peptide test today results should be in by next week. according to my c-peptide at the hospital I was just below the border of the lowest figure that can somewhat be considered normal. One doctor told me that most type 2s (if any) don't present with DKA. What do you guys think?

BTW I am 24 years old, 165 pounds, 5' 8" and I exercised regularly

Thats really hard to answer. i was diagnosed at 16 as a T2 because I did not have antibodies and was still producing insulin. Several years later I had to go on insulin and my c-peptide was nearly nothing. I think what matters most of all is that each person find what they need to do in order to manage their disease. Labels of T1 or T2 just make it a bit easier to understand what you have to do. I do know it is possible for a T2 to have DKA, it is just more likely that a patient in DKA is T1. It is more common for a T1 to have blood sugar high enough to cause it. Although, my blood sugar has peaked over 600 before and that is certainly high enough to cause it.

 

[glomaster]

this kind of sounds like you were on your honeymoon period which can last up to 1.5 years. I would think with no c-peptide you would really be considered a T-1. I guess it doesn't really matter, like my endo says, there is no test that tells you if your T1 or T2. The only test that matters is whether your blood sugar is in control. If you master that your good

 

[foxl]

foxl thanks so much for the great info! Just curious do you think really knowing the difference between whether you are T1 and T2 makes that big of a deal? I know it does but I guess what I'm trying to ask is, why don't they use insulin therapy for aggresively for T2? It seems like the easy and perfect way of doing things?

Check out Blood Sugar 101 website -- she -- and many of us! -- ask the same question!

Many people believe it comes down to profit motives, relating to the oral medications. MD's are sold on the stuff by very effective salespeople.

Some people also believe though that using insulin in greater than needed amounts leads to weight gain -- or even cardiovascular damage.

 

[onaughmae]

this kind of sounds like you were on your honeymoon period which can last up to 1.5 years. I would think with no c-peptide you would really be considered a T-1. I guess it doesn't really matter, like my endo says, there is no test that tells you if your T1 or T2. The only test that matters is whether your blood sugar is in control. If you master that your good

I dont think I had a honeymoon period...I went without insulin for a good 20 years. Of course, I really needed it before that...but survived without it. I just suffered from beta cell burnout basically.