[kidrio1957]

Hello All. When I first visited a doctor just a little over a year ago (suspecting mightily that I was a diabetic), he sent me home with an oral med thinking I was a type II (this was, of course, before my blood work came in). At the time, the nurse did a meter test right there in the examining room and as I recall, my (fasting) BG was something like 280. Classic symptoms were everywhere, btw - weight loss, always thirsty, peeing all the time, grouchy and a voracious appetite (I was 49 then, 51 now). Just a few days later when the blood work arrived, he called me in and put me on insulin right away (Levemir and Novolog). The oral med (which I don't recall), was not working after just two or three days as my fasting BG's were still in the 280 range. As for the blood work, my initial Hba1c was 12.8. and my c-peptide 1.1 (from a "normal" range of 1.1 - 5.0). Also included in the lab work, there was an "insulin" result of < 2 uiu/ml (from a "normal" range of 6-27). Am I a bonafide type 1? Reason is, I see on this forum people with higher initial Hba1c's than mine who are on oral meds (e.g., metformin). Should the doc have given me a little more time on oral medication, perhaps tried another? or is my Type 1 diagnosis a slam dunk. Being on the Omnipod makes dealing with diabetes, for me, very manageable with excellent control - my last A1c was 6.2. I do just about everything I want to do. I exercise quite a bit and eat fairly low carb. But insulin has made weight loss difficult. And of course, like all those who need insulin, imagine taking a pill a couple of times a day as an easier existence. Thanks for listening!

[mortis505]

Hello and welcome to DF!


Sounds like he may have put you on metformin. This is an oral medication for T2 and takes about a month for full efficacy. Its quite common for doctors to assume that an adult diagnosis of diabetes will be for T2. Some cannot wrap their heads around the possibility that T1/1.5 can happen to an adult.

Was an AntiGAD antibody test run? The positive presence of GAD indicates a diagnosis of T1/1.5 in an adult.

From Wiki...

Latent autoimmune diabetes in adults (LADA) is a genetically-linked, hereditary autoimmune disorder that results in the body mistaking the pancreas as foreign and responding by attacking and destroying the insulin-producing beta islet cells of the pancreas. Simply stated, autoimmune disorders, including LADA, are an "allergy to self."

In its early stages LADA typically presents as type 2 diabetes and is often misdiagnosed as such. However, LADA more closely resembles type 1 diabetes and shares common physiological characteristics of type 1 for metabolic dysfunction, genetics, and autoimmune features, but LADA does not affect children and is classified distinctly as being separate from juvenile diabetes.

Linkage here

[xMenace]

Welcome.

The low c-peptide seems telling, but I'm no doctor. I find it kind of refreshing that he'd put you on insulin right away instead of possibly putting you through misery for a number of months or years with ineffective drugs.

Was your progression sudden? Or were you possibly battling this for a number of years? Make sure you get checked out for any complications too: foot exam, dialated eye exam, and full bloodwork (kidneys).

[BrianSCohen]

Kidrio,

Welcome to the forums. It is really hard to second guess your situation. Lots of things can be going on, and diabetes manifests itself in a number of ways. In any case, you had fairly high blood sugars, and the insulin has enabled you to get things under control. Perhaps you still have some insulin production left, and it may be possible to reduce/eliminate your insulin given careful diet, exercise and use of oral medications. Given the situation, who knows? Are you 1.5 or 1? Who knows. Maybe you can get some tests to confirm, but perhaps you were just have type 2 and have lost pancreas function. In either case, if you are seeing weight gain with insulin, you may want to consider more tightly limiting your insulin use and being a little stricter in your carbs.

[fgummett]

Also included in the lab work, there was an "insulin" result of < 2 uiu/ml (from a "normal" range of 6-27)

Surprised no-one else has mentioned this... isn't this significant

And of course, like all those who need insulin, imagine taking a pill a couple of times a day as an easier existence

... not so... I would rather be on the insulin and have better Blood Sugar control than currently possible with pills.

[davef]

Originally Posted by fgummett

... not so... I would rather be on the insulin and have better Blood Sugar control than currently possible with pills.

You have a point there Frank, I'm just using Met and at times (hasn't happened in a few months) I have had a high and nearly wished I could sort it out with a shot of insulin. That said I'm not sure I could get my head around calculating a bolus etc, my hat is off to all you folks working with insulin!

[sprzepiora]

Originally Posted by davef

You have a point there Frank, I'm just using Met and at times (hasn't happened in a few months) I have had a high and nearly wished I could sort it out with a shot of insulin. That said I'm not sure I could get my head around calculating a bolus etc, my hat is off to all you folks working with insulin!

Trust me, it's not that hard, if you had to you would be able to do it because the alternative sucks.

[fgummett]

Originally Posted by sprzepiora

Trust me, it's not that hard, if you had to you would be able to do it because the alternative sucks.

Sounds like the way I learnt to use chop-sticks: went out for a Chinese meal with friends... got rid of all the silverware/cutlery on the table... food in front of me... me hungry...

[lilituc]

How many units of insulin do you take?

[kidrio1957]

Hello All. Thanks for all the feedback so far. I use just under 50 units of Novolog with my Omnipod a day (basal and bolus). Seeing my doc (not an endo) in two weeks and will discuss my concerns and report back. He's a Type 1, too, btw, and a very good listener! Perhaps I should inquire about a AntiGAD antibody test since I don't see it anywhere on my initial medical report results. Thanks!

[kgm0612]

Welcome to the forum. Glad you found us!

Karen

[UpNorth]

Welcome to the forums

[kidrio1957]

Hello All. Okay, here's the update on my initial post "wonder sometimes..." During the last visit with my doctor nine days ago, I asked if I could give Metformin a try (I had been on insulin for over a year, on a pump for most of it, using less than 50 units of Novolog a day). I reminded him of my initial 1.1 c-peptide result and we discussed a few other details and he said sure. But he gave me Janumet 50/500 to try (twice a day). After a solid week, my 7 day bg average was 122, numbers that were better and far more consistent than I ever had with my pump. (my last A1c btw, which I just got in the mail today, was 5.8). So I call him and ask if we can give Metformin a try as it's waaay cheaper than Janumet (he said yes). After two days, my bg average is about 116. I take two a day (1000mg), one with breakfast and one with dinner. I have had only one reading over 140 (which oddly came after strenuous exercise) since I started on the orals. BTW, my docs reaction was "Wow" and "amazed". When I first went to him over a year ago I was a fairly long undiagnosed mess and insulin was probably the right treatment at the time, but we're both surprised the orals have worked so well and of course now I wonder (a little) if I could have gone on them sooner. If I can maintain these numbers with Met I'll be pleased to ride it out as long as I can. And even though I know all Type 2's eventually will need insulin, I'm now stuck with 25 Omnipods and the controller (known as a PDM). Of course, if the Metformin quits working, I have a pump in the drawer. I eat fairly low-carb and exercise every day, btw. Thank you listening.

[cyberus]

Originally Posted by kidrio1957

Hello All. Okay, here's the update on my initial post "wonder sometimes..." During the last visit with my doctor nine days ago, I asked if I could give Metformin a try (I had been on insulin for over a year, on a pump for most of it, using less than 50 units of Novolog a day). I reminded him of my initial 1.1 c-peptide result and we discussed a few other details and he said sure. But he gave me Janumet 50/500 to try (twice a day). After a solid week, my 7 day bg average was 122, numbers that were better and far more consistent than I ever had with my pump. (my last A1c btw, which I just got in the mail today, was 5.8). So I call him and ask if we can give Metformin a try as it's waaay cheaper than Janumet (he said yes). After two days, my bg average is about 116. I take two a day (1000mg), one with breakfast and one with dinner. I have had only one reading over 140 (which oddly came after strenuous exercise) since I started on the orals. BTW, my docs reaction was "Wow" and "amazed". When I first went to him over a year ago I was a fairly long undiagnosed mess and insulin was probably the right treatment at the time, but we're both surprised the orals have worked so well and of course now I wonder (a little) if I could have gone on them sooner. If I can maintain these numbers with Met I'll be pleased to ride it out as long as I can. And even though I know all Type 2's eventually will need insulin, I'm now stuck with 25 Omnipods and the controller (known as a PDM). Of course, if the Metformin quits working, I have a pump in the drawer. I eat fairly low-carb and exercise every day, btw. Thank you listening.

Another case of finding whats right for YOU (IMHO)

Good job .. and good luck