[Jeremymc1]

So, back on Feb 10th, I was diagnosed with Type 2 diabetes. My BGL was in the high 300's and my A1C was at 15.4. I came on to this site and others and tried to learn as much as possible about it. I changed my diet to where I was taking in about 25-40 carbs per day. No sugar substitutes. I saw my BGL go from the 300 range in the beginning, down to the 160 range on average now. I cannot seem to get any lower. I am doing diet and exercise alone. I went to see my dietitian on Monday and she was almost certain that I was not Type 2. She had me get another blood test done and this time ordered some sort of anti-body test. The results came back today and sure enough, I am Type 1. I will be picking up my insulin at the pharmacy and making an appointment with an Endo. I guess I am at least glad to know what I am, so I can address it. I will still continue eating healthy and working out as that makes me feel better anyway. The wonderful people on this forum do make me feel that I can handle any form of diabetes. Any advice on Type 1 challenges is much appreciated.

Thanks,

Jeremy

 

[onlymep]

wow Jeremy... I'm glad you now know what you're dealing with. Did you get diagnosed by an endocrinologist to begin with? Where I live you get referred to an endo to make a diagnosis... our GPs (PCD) do not make the diagnosis even though they order the initial HbA1c test, etc. I also questioned what type of diabetes I have... I'm definitely type 2... although I'm glad I asked for those tests again as my pancreas is not the same as it was when I was first diagnosed and produced all of my own insulin. I'm still producing a small amount of my own insulin but not enough for what I need... so now on insulin full time.
Now you're being put on insulin you should notice those BGL numbers improving considerably. I think if you are generally healthy that shouldn't be a problem getting consistent numbers most of the time. I'm having troubles with getting my BGLs consistent during the day as my stomach doesn't work properly... it just makes it harder when taking insulin as I can have a hypo in less then 2 hours after eating these days.

 

[Shanny]

I went to see my dietitian on Monday and she was almost certain that I was not Type 2. She had me get another blood test done and this time ordered some sort of anti-body test. The results came back today and sure enough, I am Type 1.

Sounds like somebody made a knee-jerk diagnosis based on your age. When will they ever learn to just run the tests & let your blood speak for itself?! I'm glad for a correct diagnosis and thankful it didn't take any longer for someone to wake up & pay attention! Kudos to your dietitian!

Keep us posted & ask all the questions you want . . . I think Josh excused himself when you first came, saying he'd defer to the type 2s among us. Well Josh? We need you over here now! heheh!

 

[Jeremymc1]

wow Jeremy... I'm glad you now know what you're dealing with. Did you get diagnosed by an endocrinologist to begin with? Where I live you get referred to an endo to make a diagnosis... our GPs (PCD) do not make the diagnosis even though they order the initial HbA1c test, etc. I also questioned what type of diabetes I have... I'm definitely type 2... although I'm glad I asked for those tests again as my pancreas is not the same as it was when I was first diagnosed and produced all of my own insulin. I'm still producing a small amount of my own insulin but not enough for what I need... so now on insulin full time.
Now you're being put on insulin you should notice those BGL numbers improving considerably. I think if you are generally healthy that shouldn't be a problem getting consistent numbers most of the time. I'm having troubles with getting my BGLs consistent during the day as my stomach doesn't work properly... it just makes it harder when taking insulin as I can have a hypo in less then 2 hours after eating these days.

In my case, my family practitioner diagnosed me. No Endo involved. Now I have an Endo! I am glad to know what I am dealing with though. I have read about your stomach issues and they do sound tough. Keep hanging in there!

Jeremy

 

[Jeremymc1]

Sounds like somebody made a knee-jerk diagnosis based on your age. When will they ever learn to just run the tests & let your blood speak for itself?! I'm glad for a correct diagnosis and thankful it didn't take any longer for someone to wake up & pay attention! Kudos to your dietitian!

Keep us posted & ask all the questions you want . . . I think Josh excused himself when you first came, saying he'd defer to the type 2s among us. Well Josh? We need you over here now! heheh!

Thanks Shanny! Yep, my doc saw my high blood sugar and instantly said, yep, you have type two diabetes. That was even before my A1C test! Not sure why, but I am a bit nervous about the insulin. I did not inject myself tonight...I know I should have. I think doing it for the first time just solidifies it in my mind and maybe I am scared of that. Guess I need to just toughen up and accept it!

Jeremy

 

[foxl]

Maybe yes, and maybe no.

Here's the deal: you MIGHT be Type 1 temproarily, or permanently. I was diagnosed Type 2 in DKA, initially. Turns out longterm, I was NOT insulin-dependent, once my BG's were under better control.

What happens is your glucose levels soar and shut down your beta cells -- temproarily. Over the next 6 mos after DKA, your beta cells come back online and produce insulin again. Insulin can be therapeutic in the mean time, as the beta cells rest and regenerate.

You still MIGHT be a Type 1, however ... I turned out to have GAD-65 antibodies, an indication of a slow autoimmune destruction of beta cells.

But I may also have insulin resistance due to some other metabolic deficiency. WHO KNOWS. I try to keep an open mind about the whole thing, but I am much better-controlled on insulin!

And I STILL WISH that the endo who dishcarged me from that DKA incident had kept me on low-dose insulin, those first 6 months!

 

[Jen]

Hi Jeremy, and welcome to our little T1 club. It's a lot to take in. I have to say that if you are a T1, you cannot miss taking at least your basal insulin - that will lead to trouble. There are two great books that will help you get over your concern about insulin: Using Insulin by John Walsh and Think Like a Pancreas by Gary Scheiner. They each explain the differences between long and short-acting insulin and how to set the appropriate doses of each. Doctors sometimes don't have the time or inclination to teach you how to use this powerful tool in the best way.

Let us know which insulins you're using. I'm sure you'll get a lot of very helpful suggestions.

Best,
Jen

 

[Chesney]

Maybe yes, and maybe no.

Here's the deal: you MIGHT be Type 1 temproarily, or permanently. I was diagnosed Type 2 in DKA, initially. Turns out longterm, I was NOT insulin-dependent, once my BG's were under better control.

What happens is your glucose levels soar and shut down your beta cells -- temproarily. Over the next 6 mos after DKA, your beta cells come back online and produce insulin again. Insulin can be therapeutic in the mean time, as the beta cells rest and regenerate.

You still MIGHT be a Type 1, however ... I turned out to have GAD-65 antibodies, an indication of a slow autoimmune destruction of beta cells.

But I may also have insulin resistance due to some other metabolic deficiency. WHO KNOWS. I try to keep an open mind about the whole thing, but I am much better-controlled on insulin!

And I STILL WISH that the endo who dishcarged me from that DKA incident had kept me on low-dose insulin, those first 6 months!

You can't be type 1 temporarily... When I was diagnosed my doc said I was type 2 but after the test he wasn't sure he was right so he sent me to an endo and the endo diagnosed me as a type 1... The first time I saw him I was on 10 units of levemir...and humalog only when I had lots of carbs... He said I was in a honeymoon period... I'm now up to 16 units... He still says I'm probably still in a honeymoon phase but that my case could also just be a mild case since I'm in my mid-30's... He said they sometimes find the further you are from 20 when diagnosed the milder the case. I hope he's right

 

[foxl]

You can't be type 1 temporarily... When I was diagnosed my doc said I was type 2 but after the test he wasn't sure he was right so he sent me to an endo and the endo diagnosed me as a type 1... The first time I saw him I was on 10 units of levemir...and humalog only when I had lots of carbs... He said I was in a honeymoon period... I'm now up to 16 units... He still says I'm probably still in a honeymoon phase but that my case could also just be a mild case since I'm in my mid-30's... He said they sometimes find the further you are from 20 when diagnosed the milder the case. I hope he's right

Mindy, I was using the term my internist used -- to describe the temporary shutdown of beta cells, in referring to "temporarily Type 1." And this shutdown and resumption phenomenon, imperfect terminology and all, is well-documented.

Jeremy I posted before coffee -- so missed that you are antibody-positive! my bad ... Yes you need to learn insulin use, and the sooner the better. If you are apprehensive about hypos, inject 1/2 the dose you were told, the first 3 days. And set your alarm for every 2 hrs to test ... BUT, do it!

Amazingly my Endo got the dose right for me, the first time -- both my basal, and then my rapid, 9 mos later!

 

[onlymep]

Mindy, I was using the term my internist used -- to describe the temporary shutdown of beta cells, in referring to "temporarily Type 1." And this shutdown and resumption phenomenon, imperfect terminology and all, is well-documented.

Jeremy I posted before coffee -- so missed that you are antibody-positive! my bad ... Yes you need to learn insulin use, and the sooner the better. If you are apprehensive about hypos, inject 1/2 the dose you were told, the first 3 days. And set your alarm for every 2 hrs to test ... BUT, do it!

Amazingly my Endo got the dose right for me, the first time -- both my basal, and then my rapid, 9 mos later!

that interesting about beta cells repairing... I was never told that is the case by my endo. I'm type 2 also. I was told I will now have to remain on insulin as my pancreas no longer produces enough insulin for my needs. So if beta cells repair, why do type 2's progress to having to use insulin then?

 

[Chesney]

that interesting about beta cells repairing... I was never told that is the case by my endo. I'm type 2 also. I was told I will now have to remain on insulin as my pancreas no longer produces enough insulin for my needs. So if beta cells repair, why do type 2's progress to having to use insulin then?

I was never told that either...

 

[foxl]

Some MAY even regenerate, though not back to their previous levels.

There is a group at San Antonio, TX, who did a study of a group of patients whom they defined as Ketosis-prone. You will be able to find several of their papers if you look up the term, "ketosis-prone diabetes," in Pubmed. It gave me a lot of insight into the physiology of DKA and recovery.

This regeneration is a limited thing -- an effect of removing the high glucose levels that led to the ketosis in the first place.

And constant or recurrent exposure to high glucose levels is what is believed to lead the eventual die-off of the beta cell population in Type 2.

 

[Jeremymc1]

Hi Jeremy, and welcome to our little T1 club. It's a lot to take in. I have to say that if you are a T1, you cannot miss taking at least your basal insulin - that will lead to trouble. There are two great books that will help you get over your concern about insulin: Using Insulin by John Walsh and Think Like a Pancreas by Gary Scheiner. They each explain the differences between long and short-acting insulin and how to set the appropriate doses of each. Doctors sometimes don't have the time or inclination to teach you how to use this powerful tool in the best way.

Let us know which insulins you're using. I'm sure you'll get a lot of very helpful suggestions.

Best,
Jen

Thanks Jen. I am taking 5 units of Lantus per night before bed. It is supposed to be a slower release. I went to bed at 150 at around midnight. As it was my first time taking insulin, I awoke at 2am to check my BGL. It was 155. Woke up this morning at 8am. It was 148. I think I was hoping for a bit of a bigger drop? That is all my doctor has put me on. I go to see my Endo this week, so we will see what he says as well.

Thanks!

Jeremy

 

[Jeremymc1]

Went to the pharmacy today to get some more test strips. They had my fast acting insulin there, Novolog. 1 unit per every 20 grams of carbs. I have been eating about 20-40 grams in an entire day...

 

[foxl]

Wow -- that is good -- and a low dose. I take about 3 units per 15-20 g carb.

 

[Jeremymc1]

Wow -- that is good -- and a low dose. I take about 3 units per 15-20 g carb.

Yep. Well this is what my family practice doc prescribed. We will see what my Endo says

I love my family doc, but not sure she has a clear idea on how to treat this.

- Jeremy

 

[foxl]

Jeremy have you gotte na recommendation for Think Like a Pancreas or Using Insulin, yet? In case you have not -- they both really put the control of your BG in your hands!

 

[Jen]

Thanks Jen. I am taking 5 units of Lantus per night before bed. It is supposed to be a slower release. I went to bed at 150 at around midnight. As it was my first time taking insulin, I awoke at 2am to check my BGL. It was 155. Woke up this morning at 8am. It was 148. I think I was hoping for a bit of a bigger drop? That is all my doctor has put me on. I go to see my Endo this week, so we will see what he says as well.

Thanks!

Jeremy

Hi Jeremy. Lantus is what's known as basal insulin. It is not used to decrease blood sugar per se - it handles background hormonal causes of blood sugar increase like cortisol, adrenalin, some of the glucagon released by your pancreas, etc. Your steady numbers mean that right now the Lantus dose you're taking is doing a fairly good job. You might try increasing it by a unit every few days until you get into your target range. No need to do this right now really....you can just wait to see your Endo.

Be sure to have some glucose tablets handy if you decide to adjust your basal; If you feel the symptoms of going low (sweaty, fuzzy-brained, shakey), test your BG - if you're lower than about 70, eat one of the tablets and test again after 30 minutes. You should be back into a more comfortable range. If not, try another glucose tab.

Jen

 

[Jeremymc1]

Hi Jeremy. Lantus is what's known as basal insulin. It is not used to decrease blood sugar per se - it handles background hormonal causes of blood sugar increase like cortisol, adrenalin, some of the glucagon released by your pancreas, etc. Your steady numbers mean that right now the Lantus dose you're taking is doing a fairly good job. You might try increasing it by a unit every few days until you get into your target range. No need to do this right now really....you can just wait to see your Endo.

Be sure to have some glucose tablets handy if you decide to adjust your basal; If you feel the symptoms of going low (sweaty, fuzzy-brained, shakey), test your BG - if you're lower than about 70, eat one of the tablets and test again after 30 minutes. You should be back into a more comfortable range. If not, try another glucose tab.

Jen

Awesome, thanks so much for the information Jen! Last night was my first night on the basal insulin. Glad to hear it is doing the job!

The Novolog should bring me down fairly quickly though right? I have it, but have not used it yet.

Thanks,

Jeremy

 

[onlymep]

Awesome, thanks so much for the information Jen! Last night was my first night on the basal insulin. Glad to hear it is doing the job!

The Novolog should bring me down fairly quickly though right? I have it, but have not used it yet.

Thanks

Jeremy

sounds good Jeremy
You are on a really low dose on Lantus. I'm on 17 units every night and my endo reckons that's low dose (he did start me on 18 units to start with as a minimum). I'm on quick acting too... Apidra... total 30 units daily. I think you will find better control on insulin generally... just be careful to treat the lows quick if you get them.