[ladytaz]

Well, more so, I want to know opinions based on personal experience and observations and such. This is a long post, and I'm sorry, I just wanted to give as much of the facts as I can for y'all!

History:
.:Sept. 1986 - Feb 1987 Gestational D with my last pregnancy. After daughter's birth, all back to normal.

.:August 1993 2 Hr GTT - 140 - "borderline" Diabetic (back in THOSE days - now would automatically be called T2, I know)

.:2002 - buy BG Meter and do random testing. Numbers never below 200 and most often above 25 (range: 200 - 350+) Tested different times of day and usually 3 or so days in a row, 3 or 4 times a day.

.:August 2005 have kidney stones, BAD, go to ER, dx'ed T2.

I started out on oral meds and did reasonably well for about 18 months with that. Still always had issues with DP (rarely ever below 130) but PP numbers were doing well. About 13 or so months in, I started seeing a rise in DP as well as PP. The rise continued. I hadn't seen a doc in a while, and decided to switch from my Internist to an Endo, due to things I'd learned here on this forum, that I wasn't being properly cared for (NEVER getting an A1c for one thing!!).

So fast foreward a couple months to Jan. 2007 (took me that long to get "in" with the Endo). I informed him, and showed him in my log book, of the continuing trend of my numbers on the rise. I was already maxed out on the meds I was taking. As well as limiting my carb intake even more! By the time I got in to see him, FBG 140 - 180. PP Lord, you don't wanna know! LOL often +200, sometimes +250 even!

He decided to change one of my meds dosage and time of day taken (split it in half, and take twice a day). He said to try this for a month, if it doesn't work, on insulin you go. Ok. Fine. Tried. Failed. Numbers got worse infact!

Ok, Feb. 2007. On insulin I go. Novolin 70/30 mix 20u AM and PM and Novolin R (sliding scale) when needed. Worked like a charm from the get go! Instantly had good numbers! No real problems at all, besides the occasional low due to my not really being a morning meal eater (never really have been). So if I wasn't hungry when I got up in the moring, I'd take my meds, my insulin and go on about my business for the day and never once think about eating. Result: go low in early afternoon. During this time I rarely needed to use the R insulin! So rarely infact, that I am STILL using the same (original) vial I bought in Feb!

So I began thinking about switching to MDI, hoping that would alieviate those early afternoon lows. I thought long an hard on this. I asked my docs opinion, and had his blessing. Tho that really didn't matter much to me, if I wanted to do it, I was gonna no matter! LOL My body, my life!

Ok, been a couple weeks now on MDI. All is going VERY well!! I've had one low so far, unexplained. But as we all know, Diabetes is just "pissy" like that! LOL I am currently taking 15u of Novolin N and use a 1:10 ratio of Novolin R with meals, when needed. I may use 10 to 15 u of R in a day.

Questions:
Based on the above information .....

Does this indicate "insulin resistance" to anyone? Cuz it doesn't to me! I don't feel that I'm using lots of insulin. And I'm STILL using that original vial of R from Feb!! Used about 1/2 of it so far now, ALL together! If I required a lot of insulin, then I'd say my body was "resistant" to it, right? But I don't, so in my mind, I don't think it is. But, I could be wrong!!

Ok, so my next question. Does anyone think I "may" be T1.5 instead? I DO realize that I need the tests to determine this, but I don't have insurance, [hopefully will soon, but ain't holdin my breath LOL] therefore I'd have to save up to have them done. I just wanted to get y'all's feelings on it.

BTW, I am still taking Metformin, 1000mg 2x daily. Tho he said to aid in not having weight gain from the insulin [so much for that! LOL] and never mentioned it being for "insulin resistance". OH and my daily carb intake is an avg of about 120g.

Thanks so much for taking the time to read my mini-novel LOL and for your responses.

[Cyborg]

I was mis-diagnosed as a type 2. After going through a similar deteriation of my diabetes, I had the C-Peptide and GAD Antibody tests done and found out I was actually type 1 (type 1.5 MODY). I do exhibit insulin resistance (probably due to excess weight) and my immune system has shut down my pancreas. I always suggest now that people get the tests done soon to find out for sure what type they really are. I suppose initial treatment is the same, but it's nice to really know what's happening to your body. I know not all type 1.5's experience insulin resistance, so why take the drugs if not really needed? Insulin alone gets me along just fine...

[ladytaz]

Originally Posted by Cyborg

I was mis-diagnosed as a type 2. After going through a similar deteriation of my diabetes, I had the C-Peptide and GAD Antibody tests done and found out I was actually type 1 (type 1.5 MODY). I do exhibit insulin resistance (probably due to excess weight) and my immune system has shut down my pancreas. I always suggest now that people get the tests done soon to find out for sure what type they really are. I suppose initial treatment is the same, but it's nice to really know what's happening to your body. I know not all type 1.5's experience insulin resistance, so why take the drugs if not really needed? Insulin alone gets me along just fine...

This is my "main thing" too .... I just want to know. Don't need to. I'm more curious about it than anything else! I'm on insulin now [and I know that won't change] and it's worked VERY well for me. Thankfully! Got it right on the first try too!!

[grace girl]

Similar story here... dx'ed at age 32 as type 2 with NO tests done by doc other than a meter. I was overweight at the time, so I'm sure they considered that into dx.
I was 360 fasting is all I remember. Was put on oral meds...and it helped for about 6 months...then numbers began to climb higher and higher...started dropping weight like crazy...then I stopped taking the meds...which I can only explain now as high blood sugar craziness...I can't to this day remember what my reasoning was or why I did it. a few months passed and I realized I was really sick, and I'd lost so much weight that I didn't have anything left to lose.
Went to a new doc, who did the c-peptide and gad anti-bodies test and told me I was type 1 and on insulin we went.
I have no insulin resistance.

I've since been told by one endo that I'm really 1.5 because I was 32 at original dx. Was told by current endo that I'm really type 1 because the results of c-peptide and gad-antibodies.

I personally think that it would be helpful if the medical community as a whole would come to an agreement of exactly what 1.5 is, and what it isn't. It would help.

[ladytaz]

Originally Posted by grace girl

Similar story here... dx'ed at age 32 as type 2 with NO tests done by doc other than a meter. I was overweight at the time, so I'm sure they considered that into dx.
I was 360 fasting is all I remember. Was put on oral meds...and it helped for about 6 months...then numbers began to climb higher and higher...started dropping weight like crazy...then I stopped taking the meds...which I can only explain now as high blood sugar craziness...I can't to this day remember what my reasoning was or why I did it. a few months passed and I realized I was really sick, and I'd lost so much weight that I didn't have anything left to lose.
Went to a new doc, who did the c-peptide and gad anti-bodies test and told me I was type 1 and on insulin we went.
I have no insulin resistance.

I've since been told by one endo that I'm really 1.5 because I was 32 at original dx. Was told by current endo that I'm really type 1 because the results of c-peptide and gad-antibodies.

I personally think that it would be helpful if the medical community as a whole would come to an agreement of exactly what 1.5 is, and what it isn't. It would help.

Yes, very similar grace girl!! I think I was 355 when dx'd and it would be considered fasting, as I'd not eaten in well over 8 hours. It may have been higher though, not sure. That's just what someone said, as I was just about to be released from the ER, when they came barging in through the door and said, NO! STOP! WAIT! We're admitting her!

I TOTALLY agree that the med. comm. outta have a family reunion and ALL get on the same ****ed page!! sheeeeeesh!

grace girl: May I ask how much the GAD and C-Peptide tests cost you, and how long ago was that?? It might at least give me an "idea" of how much to "attempt" to save up! I seriously want these tests done, it's just the financial part that's getting in the way!

[Emm]

Would be great for you to get the C-peptide & GAD tests done, if you can. Do be aware though that the longer its been since the D stuff started, the less reliable these tests are. The GAD especially wont show much - I guess the little antibodies run off to live somewhere else once they've done their job (and run out of beta cells to eat?!)

Sounds to me like type 1.5 is a possibility, although to me it stands out that you had Gestational so many years ago, and that your progression from 1993 to now is actually quite slow for T1.5 (it's normally a year, maybe 2 or 3... but what's 'normal'? There are of course extremes at both ends).

The answer is probably in your carb awareness, but it could also be that you're just not a type 1.

I dunno - wish I could answer your question with a more definite answer, but first I'll have to pop to medical school and get a flight to come see you. Can you hang on a few years?

[notme]

I would highly recommend the C-peptide test taz. KGM is on this forum and you should talk to her about progression of diabetes. She is type one with a pancreas that is slowly shutting down on her. Right now, I believe her pancreas has 3% function left. She is on an insulin pump and also metformin.

Maybe she will chime in on this thread and give you some idea of what could be happening.

[ladytaz]

Originally Posted by Emm

Would be great for you to get the C-peptide & GAD tests done, if you can. Do be aware though that the longer its been since the D stuff started, the less reliable these tests are. The GAD especially wont show much - I guess the little antibodies run off to live somewhere else once they've done their job (and run out of beta cells to eat?!)

Sounds to me like type 1.5 is a possibility, although to me it stands out that you had Gestational so many years ago, and that your progression from 1993 to now is actually quite slow for T1.5 (it's normally a year, maybe 2 or 3... but what's 'normal'? There are of course extremes at both ends).

The answer is probably in your carb awareness, but it could also be that you're just not a type 1.

I dunno - wish I could answer your question with a more definite answer, but first I'll have to pop to medical school and get a flight to come see you. Can you hang on a few years?

LOL Emm!!

I do know that I'm not Type 1. That's for sure. Type 2 most probably, but very unclear/unsure about the insulin resistance thing. T1.5 possibly, but of course, wouldn't know that without the tests, I know. Again, it really doesn't "matter". What's done is done. What is, is. What shall be, shall be! LOL I'm just a curious sort, and wanna know for my own self.

I didn't even see a doc about D between 1993 and 2005, no tests, no nuttin! (I know, I know!! I did not know THEN, what I know NOW, about complications and such!!) So yea, MAJOR grey area there on all of that!

In fact, the last time before 2005 I'd seen ANY doc for ANY reason, was at the ER cuz I'd fallen and busted my eye nice and wide open [very lucky to not have injured my eye they said!], and that was summer of 1996. Before then, another ER visit for kidney stones/kidney infection/UTI in Spring of 1995. So, who REALLY knows when I crossed that "line"? At least from Nov. 2002, I do know, from my own testing.

[ladytaz]

Originally Posted by notme

I would highly recommend the C-peptide test taz. KGM is on this forum and you should talk to her about progression of diabetes. She is type one with a pancreas that is slowly shutting down on her. Right now, I believe her pancreas has 3% function left. She is on an insulin pump and also metformin.

Maybe she will chime in on this thread and give you some idea of what could be happening.

Thanks for the reply Nancy! Hopefully she will. I just wanted to get others opinions on this. It's nothing detrimental. I don't believe anything would change. And in all reality, why should it at this phase? For now, all's well!

[grace girl]

Last summer they redid the gad antibodies and the c-peptide tests just for fun (after hearing my history they wanted to do them again to make sure I wasn't really type 2....HONESTLY)and the two cost around $350. It was done through labcorp. If you find a doctor in your area who can do in-house lab work the costs will be MUCH lower.
The first time I had those done it was in house and the total cost to me was only $120.

[ladytaz]

Originally Posted by grace girl

Last summer they redid the gad antibodies and the c-peptide tests just for fun (after hearing my history they wanted to do them again to make sure I wasn't really type 2....HONESTLY)and the two cost around $350. It was done through labcorp. If you find a doctor in your area who can do in-house lab work the costs will be MUCH lower.
The first time I had those done it was in house and the total cost to me was only $120.

LabCorp is who my Endo uses! At least I have an idea of what I need to shoot for! Thanks grace girl!!

[glashalful]

Never had the GAD, but did have the c-peptide. I asked for it again almost two years later, but they wouldn't do it because they said the results never change and it's "a very expensive test". Not sure what that means!

Can anyone take the GAD at any time? I wonder why some endos use it and some don't?

[ladytaz]

Originally Posted by glashalful

Never had the GAD, but did have the c-peptide. I asked for it again almost two years later, but they wouldn't do it because they said the results never change and it's "a very expensive test". Not sure what that means!

Can anyone take the GAD at any time? I wonder why some endos use it and some don't?

Because some know what they are doing, and some are just plain ignorant??? heh

Truely tho, I don't know!

Mine hasn't mentioned it (or the C-peptide) to me. But he also knows that I don't have insurance, and does his best to keep my costs at as minimal as possible. Honestly, the tests won't make a difference in my treatment at this point, so there is no real need for them. This could be why he hasn't mentioned them to me? I may bring the subject up with him at my next appointment in Sept. I won't have the money for it at that point, I already know that. Not unless some financial miracle falls down upon me! LOL