1.5 ?? maybe

[kimbo]

The more I read the more I think I could be slow inset t1.I dont think the term t1.5 exist in the uk and they do not do antibody blood test to confirm types.
18 months ago I was diagnosed t2,I had lost about 20 lbs.I was put on gliclazide and metformin,my numbers came down quickly but at best my hba1c was 7.3.
A few months ago while I was on max doseage of the meds my hba1c results started to creep up again so avienda? was introduced,that did not change anything.
Since I was diagnosed I have continued to lose weight,about another 8 lb,Iwas told because I have lost more weight it is likely I am not making enough insulin.3 weeks ago I started on insulin and my numbers are very good compared to what they have been in the past,though I have still lost a couple more lbs.
I am now weighing just under 8 stone,now blood pressure cholesterol problems,taking novarapid , levermir and metformin.

[seacomp]

The more I read the more I think I could be slow inset t1....
now blood pressure cholesterol problems,taking novarapid , levermir and metformin.
It's good to hear that you are making progress by using insulin. That's important.
Given your age and the other problems that you mention, you appear to have the typical X syndrome. Read this post: http://www.diabetesforums.com/type-2/13385-type-2-syndrome-x.html#post155478. or others in the forum for more info.
The fact that you no longer successfully respond to oral medications is not a sign in itself of 1.5. Rather it is (unfortunately), a stage that many Type 2s eventually reach. I've followed that progression myself.

[kimbo]

Hi,
I had a look at the report,I dont know if I have the wrong end of the stick here, I read it,and concluded you would be over weight and have high cholesterol and insulin resistant ( am I correct ? ).I was told I was not making enough insulin,my cholesterol is fine and I am more under weight than over.??
I dont grasp all this indepth stuff very well

[seacomp]

I'm sorry if I misunderstood you. I saw "8 stone,now blood pressure cholesterol problems" and understood that to say that you had high closterterol and I thought (as an American, a "stone" does not compute) that 8 stone was a lot of weight. I expect that when people mention weight there's some problem, usually too high.
Anyway, I take back what I said. You hopefully will stop lossing weight now that you BG is under better control.
For the immediate period, it likely doesn't matter what type you are as long as your BG gets under control. Not having Syndrome X is a big plus.

[Funnygrl]

I'm guessing now what a typo for no?

How old are you? How much insulin do you require?

[kimbo]

ooops, sorry I was rushing it,meant to say NO cholesterol,blood pressure problems.:stupido

I take 4 novorapid before breakfast and evening meal and 10 levemir before bed.Though my numbers are better in general they are not so good before the evening meal so I may need to take something at lunch ? Its looking like I cant handle a meal too well without insulin.
I test a wake up then have a coffee,the coffee alone always puts my bg up by a full number (if thats the term ) I can go from say 6.2 to 7.2 with the coffee,dont know if thats acceptable or not ?
I am 49

[Funnygrl]

It sounds like using novo at lunch too, and maybe counting carbs would benefit you.

My type is still pretty much NEITHER but my endo says a correct diagnosis is less important than treating accurately.

[kimbo]

I agree with all your comments. I go in a couple of weeks to learn how to carb count,I will no doubt do better still then.

Thanks.

[seacomp]

I test a wake up then have a coffee,the coffee alone always puts my bg up by a full number (if thats the term ) I can go from say 6.2 to 7.2 with the coffee
You might want to check if you have the Dawn Phenomenon where BG goes up in the morning even without food. Just skip the coffee one day and see if it still goes up. Your better off if it's the coffee - that's easy to correct; DP is something else.

[kimbo]

I will try skipping the coffee,I thought dp was just waking up higher than bedtime bg,I have always had that problem.It will be interesting to check the coffee thing out.

[seacomp]

My BG goes up after I wake up not while I'm sleeping, others have it rise before they wake.

[NoraWI]

My DM diagnosis progression was comparable to what you describe. I was dx'd at age 62. My A1c's came down into the 5 percentiles for a year and a half before they started to climb again. End of honeymoon? I refused more orals. The only difference was that my nurse practitioner was adamantly opposed to prescribing insulin. I dumped the NP, went to a young endocrinologist and got both the insulin plus a GAD65 antibody test that confirmed my status as LADA (Latent Autoimmune Diabetes of Adults). If I am not mistaken, the term LADA is interchangeable with the nomenclature "T1.5" used on this board. After starting on Lantus and Novolog, the A1c's began to drop on very low doses. I tried Levemir shortly after it came on the market here in the U.S. early last spring but found that, unlike Lantus, the duration of Levemir is dose dependent. The small dose of basal my body required did not last me long enough even with split dosing. To achieve a 24-hour basal with Levemir would have required that I take 4 shots of it per 24 hours. Not something I was willing to do. I returned to Lantus.

Normal (or even sub-normal) body weight, NO blood pressure problems and a good lipid profile are hallmarks of T1.5 (also known as LADA). Initial loss of weight (from a near-normal) just before or at diagnosis is also indicative. However, at this point, your medical professionals are correct in saying that it does not matter what DM type you are as you are already on insulin and getting good results.

Keeping a reasonably low carb diet (and small portions) has enabled me to also use small amounts of insulin which has kept my BG rises small and any errors easier to correct. Current BGs, while not yet back down into the 5 percentiles, are coming down nicely (6.2% from a 7.4% this time last year) and I try to keep within the BG window of 65 to 100 (divide by 18 for the U.K. values). No severe lows nor excessive highs are my goal and I am keeping pretty much within those parameters.

BTW, my morning cup of coffee with saccharine and a slosh of whipping cream raises me 20 points. That combination contains almost 2 carbs and I sometimes take 1 to 2 units of Novolog, especially if I am going to eat my breakfast of eggs soon after.

[David_S]

You sound like me and I had similar weight loss from a normal weight .. lost about 15 pounds. I am trying to get them back. Limiting carbs will get your numbers down. I met with a dietician but I need to eat less carbs then she suggested to get my numbers normal. Are you putting sugar in your coffee?

[seacomp]

If I am not mistaken, the term LADA is interchangeable with the nomenclature "T1.5" used on this board.
Does the Forum have an official definition of what 1.5 is? Or is it just a bucket to classify any diabetes that isn't the classic Type 1 or Type 2?
I know I initially used it incorrectly as an insulin using Type 2.

[NoraWI]

If your question is to me, David S., NO, I do NOT put sugar in anything at all! I moderately carb (trying to keep under 75 or 80 carbs per day) and avoid all the "whites" -- potatoes, anything with flour (any kind of flour), baked goods, pasta, rice, etc. I eat mostly protein with low glycemic load green veggies. I do occasionally have a sandwich made with an lc bread that contains 14g carbohydrate for TWO slices but even that is now giving me quite a spike so I eat a great many salads instead. As to the coffee and (whipping) cream in the morning, the combination of the two actually yields a touch less than 2g of carbohydrate and I find that I need to dose if my FBG is higher than 80. Dietitians seem to always specify way more carbohydrates than our bodies (at least MY body) can process. Insulin AND eating low carb have been my lifeline!

[David_S]

I asked about the coffee because it shouldn't really raise BS.. no carbs in it.. so I was curious why it took you up. Yes the dietician I saw prescribed 3-4 carb exchanges per meal. I found I need to drop that to get my numbers lower esp. at dinner. This is such a guessing game sometimes.. tonight I was 161.. last night 109.. at HS. Not sure what happened there.. I ate same carbs as yesterday.

[Funnygrl]

Caffiene can raise bs.

[Cyborg]

For a 24 oz coffee with 2 small creamers and some splenda, I bolus for 8g of carbs.

[NoraWI]

I don't drink that much coffee... just an 8 oz. cup with a slosh of whipping cream each morning for which I bolus 1.5 units of Novolog. I had figured that amount contains about 2g of carbs. Maybe there is a bit of Dawn Phenomenon happening there, too. Tea does not have any effect on me but I don't drink it with cream or milk. I drink plain tea (with substitute sweetener that contains no filler) the rest of the day.

To David S... I know that most of us are told initially by the dietitians to use the exchange system. It does not work for me nor for most other diabetics I know! Too imprecise for dosing insulin. I learned to gauge the actual carbohydrate content (better, yet, the glycemic load) and, initially weighed my food for greater precision. With time, I learned to eyeball the quantities quite accurately but go back to weighing portions as a reminder every so often. I also avoid all the "whites" -- anything made with flour, noodles, potatoes, generally all starches (even corn and peas) and eat green leafy veggies along with my portion of protein. It's the only way I can maintain control and even that lacks consistency because of varying factors like weather, stress, etc. It all never seems the same from day to day. Diabetes is a real challenge!

[xMenace]

Nora, it sounds like you have this.

Morning Madness - Those Darn Phenomenons! Complied by Barb Chafe (http://www.insulin-pumpers.ca/darnphenomenons.html)

The Caffeine Phenomenon
If you are accustomed to your daily cup of morning coffee (or a few daily cups
of coffee in the morning), then here's one more reason to break the habit:
Although caffeine has no carbs, some people have noticed that it causes their
blood sugars to rise. This may be due to the insulin resistance which caffeine
triggers in some people.

----------------------------------------------

Where is SW Wisconsin are you? I was born conceived in Wauzeka and delivered in Praire du Chien.

[shabbie6247]

The more I read the more I think I could be slow inset t1.I dont think the term t1.5 exist in the uk and they do not do antibody blood test to confirm types.
18 months ago I was diagnosed t2,I had lost about 20 lbs.I was put on gliclazide and metformin,my numbers came down quickly but at best my hba1c was 7.3.
A few months ago while I was on max doseage of the meds my hba1c results started to creep up again so avienda? was introduced,that did not change anything.
Since I was diagnosed I have continued to lose weight,about another 8 lb,Iwas told because I have lost more weight it is likely I am not making enough insulin.3 weeks ago I started on insulin and my numbers are very good compared to what they have been in the past,though I have still lost a couple more lbs.
I am now weighing just under 8 stone,now blood pressure cholesterol problems,taking novarapid , levermir and metformin.

hi kimbo,
just a question...
if you are only 8 stones, why has your doctor kept you on metformin?
i was mistaken as type 2 initally, but when i felt that the metformin wasnt helping they took me off it and introduced the levemir and novorapid.
isnt metformin traditionally used for over-weight or insulin resistant patients?