So, how do you go from type 1 to type 2 or vice versa?

[Nada]

I see many of you have switched dx'es.

Do they figure it out through bw? What do they look for to determine whether you are type 1 or 2? I was under the impression it was all about insulin resistance... but now I'm not so sure.

[Funnygrl]

You don't change diagnosis type, what happens is some people are misdiagnosed because of stereotypes, ie, all young people are type 1, all old people are type 2.

It is all about insulin resistance for the most part. They usually figure out type by measuring c-peptides and antibody testing.

[DazedSheep]

I was in hospital and put on insulin via drips, then woman gave me a big talk about how to inject and whether I was planning on having children. Stayed on insulin til Easter when clinic said my habc1 meant I was type2(was on small dose but had alot of hypos) Now i'm constantly high even if I up my metformin. Diabetes is horrid whatever the type

[Keezheekoni]

Like FunnyGrl said, a lot of people are misdiagnosed because of stereotypes. My story is a little long, but suffice it to say that I was finally diagnosed correctly after being mis-labeled for 12 years, because of being overweight.

[ladytaz]

I was in hospital and put on insulin via drips, then woman gave me a big talk about how to inject and whether I was planning on having children. Stayed on insulin til Easter when clinic said my habc1 meant I was type2(was on small dose but had alot of hypos) Now i'm constantly high even if I up my metformin. Diabetes is horrid whatever the type

Since when do they determine your type of diabetes upon an A1c test? Hun, I think your medical team at the clinic needs to go back to medical school and learn a thing or two!

I really feel for y'all there "across the pond" ... seriously! From what most of you keep saying, it seems most your doctors and nurses are SO uneducated about diabetes! That's just sad! Not saying we don't have our share here, cuz we CERTAINLY do!!

[ladytaz]

Like FunnyGrl said, a lot of people are misdiagnosed because of stereotypes. My story is a little long, but suffice it to say that I was finally diagnosed correctly after being mis-labeled for 12 years, because of being overweight.

Ha Ha! I like that one Rikki .... cuz your "fat" it MUST be Type 2!! *rolls eyes*

[seacomp]

Since when do they determine your type of diabetes upon an A1c test?

Perhaps the doctor made two statements;
1) You are a type 2, and
2) Let's stop the insulin, the A1C shows that you are stabilized
and somehow the message was sent that you are a type 2 because of the A1C?

[DazedSheep]

Ladytaz, it was 7.5 so they took me off insulin. I'm starting to think they made a mistake. I resd about a man with a reading of 1337 who now says he's cured.

[ladytaz]

Ladytaz, it was 7.5 so they took me off insulin.

Again, your A1c has nothing to do with what "type" you are! Plenty of Type 1's have super wonderful A1c's, plenty with crappy! That goes for ALL diabetic types. All the A1c really shows is how well it's being controlled, or how badly it's been out of control! It is not a diagnostic tool to determine which "type" of diabetic one is.

I'm starting to think they made a mistake.
What do you mean? Like how, about what exactly?

I resd about a man with a reading of 1337 who now says he's cured.

Sorry to inform the "cured" man .... um ... no such a thing! He may be in VERY good "control" but he is NOT cured! :) Let him do a GTT test and see how his body reacts to that!! :wink: If his BG doesn't rise, then he was NEVER diabetic in the first place! He may have been sick and his BG rose incredibly high BECAUSE of being sick. That or a miracle was performed! :wink:


Perhaps the doctor made two statements;
1) You are a type 2, and
2) Let's stop the insulin, the A1C shows that you are stabilized
and somehow the message was sent that you are a type 2 because of the A1C?

Now, yes, I can see that, if someone didn't know or understand the A1c and differences in types.

[Dewey]

I see many of you have switched dx'es.

Do they figure it out through bw? What do they look for to determine whether you are type 1 or 2? I was under the impression it was all about insulin resistance... but now I'm not so sure.

Nada, in answer to your question, they do have various blood tests to determine the type of Diabetes you have. Some doctors do not run tests due to financial reasons (i.e. insurance won't cover), or because they are "sure" of a person's initial diagnosis.

Also, the reason some of us aren't sure or have "changed diagnosis statuses" over the years is cause when we were initially diagnosed (i.e. almost 25 years ago for me), they didn't have tests to determine the type.

As for insulin resistance, I truly believe a multitude of factors come into play. It's part of it, but I'm sure there are other factors as well.

[am1977]

I think there definitely is confusion over this issue :confused:.

I think many assume that if you are on insulin, you have T1 and if you are on diet or meds, it means you are T2...

This is so not the truth.

Yes, T1s have no choice but to have to inject insulin (as our bodies do not produce any). T1 is a autoimmune disease, which means that for some reason our bodies turn on themselves and attack the cells that produce insulin. W/o insulin, we end up pretty sick and it could become pretty serious... namely DKA. Anyway, it means we need to inject insulin to make up for the insulin we don't produce. Also, some T1s also need to take some type of med as well... b/c they have built up some type of insulin resistance as well.

T2s also have problems with insulin, but not b/c they aren't making any. Usually, they make insulin but their bodies don't use it as they should. Insulin Resistance is usally a factor. It is thought that it's due to lifestyle choices...diet, exercise, etc. Many start out on diet and meds. BUT... some T2s need to be on insulin too. Usually, their bodies aren't responding that well to diet/exercise or meds, and that is when insulin is brought into the picture.

I guess what I'm saying is how our diabetes is treated doesn't change our status as a T1 or T2, whatever the case should be.

Hope that helps.

[grace girl]

It seems to me, unfortunately, that what type they call you is largely dependent upon the knowledge of the doctor you are seeing. In 6 years I've been told:
1. you're type 2 (no actual blood work done, simply based on the fact that I was over-weight.)
2. No, you're type 1 (results of c-peptide and antibody test)
3. OMG-I'm confused, I don't know what you are, you need an endo
4. You're type 1.5 (because of age of onset-32)
5. No, really you're type 1 (because of c-peptide and antibody test)

My personal opinion...it was type 1 all along...I don't think I've jumped back and forth over the proverbial fence. The first doc I saw shouldn't have simply assumed that a 32 year old woman who was overweight with a fasting bs of 360 was type 2. Simple blood work would have saved me two years of misery.
As to insulin resistance, my current endo told me that type 1's can have it, too. It is particularly common with pre-menopausal women (cough, cough) and menopausal women....whether they are diabetic or not. Those aren't the only factors, just the one's I'm MOST FAMILIAR with at the moment. (don't mean to yell, touchy subject!)

I think EVERYONE who is dx'ed with D should DEMAND a c-peptide and the GAD antibody test. It would make treatment so much simpler in so many ways, and avoid so many problems that so many people needlessly go through.

[DazedSheep]

Again, your A1c has nothing to do with what "type" you are! Plenty of Type 1's have super wonderful A1c's, plenty with crappy! That goes for ALL diabetic types. All the A1c really shows is how well it's being controlled, or how badly it's been out of control! It is not a diagnostic tool to determine which "type" of diabetic one is.


What do you mean? Like how, about what exactly?



Sorry to inform the "cured" man .... um ... no such a thing! He may be in VERY good "control" but he is NOT cured! :) Let him do a GTT test and see how his body reacts to that!! :wink: If his BG doesn't rise, then he was NEVER diabetic in the first place! He may have been sick and his BG rose incredibly high BECAUSE of being sick. That or a miracle was performed! :wink:



Now, yes, I can see that, if someone didn't know or understand the A1c and differences in types.
If your habc1 keeps coming down the less medication you're on they probably change your diagnosis.Seems like they make it up as they go along. Am I allowed to say that? Diabetes is complicated and is different for each person. Even a Dr can't know your body better than yoursef

[ladytaz]

If your habc1 keeps coming down the less medication you're on they probably change your diagnosis.Seems like they make it up as they go along. Am I allowed to say that? Diabetes is complicated and is different for each person. Even a Dr can't know your body better than yoursef

No hun, that's not how it works. When/If your A1c comes down, that just means you're in better control :wink: Which of course is a good thing! :) And just because your A1c comes down, doesn't necessarily mean the less meds you will be on. Yes, sometimes Type 2's are put on insulin initially, and when they get in better control, the doc will discontinue the use of the insulin. In the beginning, when first diagnosed, it's all a mix and match kind of game ... figuring out what mix of meds and dosages of that mix works for an individual .... as each person is different, meds and dosages will be different with each person. What works for one, may not work for another :wink:

It seems to me, unfortunately, that what type they call you is largely dependent upon the knowledge of the doctor you are seeing.

SO true!! And apparently, there are a LOT of docs out there who haven't a clue! I'm appalled at what I read on this forum what some of y'all say your docs have told you!

I'm appalled that my first doc NEVER did an A1c test on me!! So I have NO clue what I started out at, yanno! I'll FINALLY find out where I'm at now on Jan 9th, almost a year and a half later!! :( I'm appalled that he was of NO help to me when it came to eating properly! He gave me one of those stupid exchange list things! UGH! Even I already knew that wasn't the way to go these days!! I was never set up with a DE or a nutritionist. And NO help finding these services for free either! I DID ask about it!! I'm also appalled that he was only concerned with my morning numbers! I informed him that I am/will be testing before and after every meal, until I learn how different foods affect my BG! He was good with the meds, and getting them worked out. I still need some adjustment of those. I saw him for 3 months.(up until I couldn't afford to go and see him anymore!)

Luckily I'm the type that doesn't take a docs word as gold, and go and research to find out about things for myself! Else I'd never have learned what to do, and never would have been on the road to good control!!

[JediSkipdogg]

Does type really even matter? For the patient (us) I personally believe no. If the treatment method works, then that's fine.

The people it matters for is a common language between doctors and for insurance companies. Basically just the medical industry. What good is it if you are a type 1 in the US but in Britain you are a type 74 (if they had that many)? That's why there is still a huge debate over type 1.5, type 3, etc.

Technically, there are only 4 types that are nationally recognized and accepted. Those are Type 1, Type 2, Gestational, and Pre-Diabetes. All of those other ones, LADA, 1.5, etc. are not really types yet, so if a doctor has no idea what that type is, it doesn't mean they are stupid, just that they aren't in line wiht non-nationally accepted terminology.

My main point is, I think a diagnosis type is only good if they hit it dead on the first time. If you are type 1 and they try diet and meds alone and say you are a type 2 cause you are 45 and weigh 300 lbs and refuse to change your treatment, then there's a problem.

[Funnygrl]

My doctor has me labelled as type 1.5. For prescribing and testing purposes, he seems to alternate between the icd-9 code for type 1 and type 2. I really and truly don't fit in to either category nicely, and I think a lot of this has to do with a complicated medical history. I was diagnosed fairly young (19), had a slow onset with intermittent extremely high blood sugars, couldn't control it with just diet and exercise, never tried oral meds, and responded well to insulin. I take around 30-40 units a day, and seem to be pretty insulin sensitive. Blood work shows I still make some insulin, though not much. So where does this put me? Honeymooning seems to be a common guess, but type 1.5 is a pretty accurate label for me it seems.

[ladytaz]

My doctor has me labelled as type 1.5. For prescribing and testing purposes, he seems to alternate between the icd-9 code for type 1 and type 2. I really and truly don't fit in to either category nicely, and I think a lot of this has to do with a complicated medical history. I was diagnosed fairly young (19), had a slow onset with intermittent extremely high blood sugars, couldn't control it with just diet and exercise, never tried oral meds, and responded well to insulin. I take around 30-40 units a day, and seem to be pretty insulin sensitive. Blood work shows I still make some insulin, though not much. So where does this put me? Honeymooning seems to be a common guess, but type 1.5 is a pretty accurate label for me it seems.

Personally, in my UNeducated opinion :wink: That's how I'd see it. That if your pancreas is still producing some insulin, but not enough, I would call that 1.5, since well, it's kinda in between Type 1 who doesn't produce any insulin, and Type 2 who does produce insulin, but the body doesn't properly use it. :)

Then if and when a pancreas stops producing any insulin at all, THEN at that time Type should be changed to Type 1? Does that happen with 1.5's? Do ya know? That eventually the pancreas stops producing insulin all together?? Is that what "slow onset" means?

I wish they did have definitive tests to determine what type a person is. Sure seems it would make it a whole heck of a lot easier!

[seacomp]

You can diagnosis a disease in terms of its symptoms or in terms of its cause. The same symptoms can be caused by different diseases or a single disease can have different symptoms.
Ladytaz is looking at diabetes in terms of its symptoms; the amount of insulin produced. It is absolutely true that a type 2, a MODY (1.5), and a type 1 "on honeymoon" may seem the same and require the same or almost the same treatment. And as the disease progresses, if it does, the treatment for all three moves in the same direction.
However, the causes of each condition is separate. That may not effect the treatment, but is of vital importance in terms of preventing the disease and or curing it.

[Funnygrl]

You can diagnosis a disease in terms of its symptoms or in terms of its cause. The same symptoms can be caused by different diseases or a single disease can have different symptoms.
Ladytaz is looking at diabetes in terms of its symptoms; the amount of insulin produced. It is absolutely true that a type 2, a MODY (1.5), and a type 1 "on honeymoon" may seem the same and require the same or almost the same treatment. And as the disease progresses, if it does, the treatment for all three moves in the same direction.
However, the causes of each condition is separate. That may not effect the treatment, but is of vital importance in terms of preventing the disease and or curing it.
I look at diabetes in terms of cause. Type 1 is usually autoimmune (though there is type 1 B), and type 2 is caused by insulin resistance. 1.5 is also autoimmune, but a slow onset. I have no insulin resistance, I'm totally insulin sensitive. Therefore, type 2 doesn't make sense. I don't have immune markers either though, however, studies show only 60-80% of type 1s have these.

[Tatermom]

I don't have immune markers either though, however, studies show only 60-80% of type 1s have these.


What are immune markers??? :ahhhhh:

[Funnygrl]

What are immune markers??? :ahhhhh:
GAD65 is the big one- antibodies

[seacomp]

What are immune markers??? :ahhhhh:
Most type 1 diabetes is an autoimmune disease; the body's own defenses destroy the pancreas' ability to produce insulin. When this is the case, certain specific antibodies to insulin and insulin producing cells can be found in the blood. These are the "immune markers".
Surprisingly often, however, these markers can not be found. It is not clear whether or not, the same or a different disease process is involved here comparing to the straightforward autoimmune situation.
As of now, there does not seem to be any meaningful difference in treatment for type 1 between the case where the markers are found, and where they are not. The difference between the two may be very important in terms of prevention and/or a cure.

[Sapphire]

Ladytaz, it was 7.5 so they took me off insulin. I'm starting to think they made a mistake. I resd about a man with a reading of 1337 who now says he's cured.


Maybe you can contact DeWayne McCulley and ask him to show you the results of his blood sugar levels and his GTT tests. :hmmmm2:

Death to Diabetes -- Reverse & Cure Type 2 Diabetes (http://www.deathtodiabetes.com)

[rzrbks]

So, how do you go from type 1 to type 2 or vice versa?

Take Edgeware Rd to the M1 then just past Aldenham pick up the M25 til you get to M40 follow that until that turns into the M42 then use M42 until the M5, M5 to M6, M6 to A74(M), A74(M) to A71, A71 to A738, A738 to A737, A737 to M898, M898 to A898, A898 to A82, A82 to A9, A9 until you come to Thurso, park your car at the corner of Paterson's Ln and Barrock's St.

Voila Vous êtes là, Version premier.


If you reverse this route, you get Type 2.

[Nada]

Take Edgeware Rd to the M1 then just past Aldenham pick up the M25 til you get to M40 follow that until that turns into the M42 then use M42 until the M5, M5 to M6, M6 to A74(M), A74(M) to A71, A71 to A738, A738 to A737, A737 to M898, M898 to A898, A898 to A82, A82 to A9, A9 until you come to Thurso, park your car at the corner of Paterson's Ln and Barrock's St.

Voila Vous êtes là, Version premier.


If you reverse this route, you get Type 2.


Aha! Now *that* makes sense! :stupido2:

[rzrbks]

Start here(near Gladstone Park)>>>>>>>>> http://www.google.com/maps?ie=UTF-8&oe=UTF-8&hl=en&tab=wl&q=



rzrbks
So, how do you go from type 1 to type 2 or vice versa?
Take Edgeware Rd to the M1 then just past Aldenham pick up the M25 til you get to M40 follow that until that turns into the M42 then use M42 until the M5, M5 to M6, M6 to A74(M), A74(M) to A71, A71 to A738, A738 to A737, A737 to M898, M898 to A898, A898 to A82, A82 to A9, A9 until you come to Thurso, park your car at the corner of Paterson's Ln and Barrock's St.

Voila Vous êtes là, Version premier.


If you reverse this route, you get Type 2.

[BriOnH]

I thought you just subtract or add 1.

[dgrilli]

Since I did make a 4.0 on my C-Peptide Test. I'm making way to much insulin and therefore I'm Extremely Insulin Resistant.

Also a Gad Test said that I had those critters that destroys the b cells. I'm positive.

One Endo looked at me and said I was a Type 2. When I questioned him he got indignant with me and tried to force Extended Release Metformin on me.

I told him this wasn't doing any good and he all but looked at me and shrugged his shoulders and started to walk away in his office. Oh he wanted me to take Byetta. ( Hint I shoot Insulin and had been). I must be a fat lazy twinkie eating couch potatoe that does nothing but watch television all day. If only hadn't eaten all that candy and twinkies.

Only when I agreed to take the Prescript for Metformin XL he then sent me for some tests. The results are a 4.0 C-Peptide and Positive for Gad 65 Antibodies. Oral meds have no effect on me but some bad side effects.

The First Endo that I saw in 2001 said that I was a type 1 because of tests. He said I would need to inject insulin forever. Cigna in Arizona.

I should be able to take my insulin pump off and take a handfull of those oral meds, gets some exercise and eat responsibley, maybe even inject Byetta that should help. By the way I tried this and ended up very sorry and in the hospital. Not The Byetta I have never tried that.

I'm a Type 2. So my next endo I told him I don't need the insulin and he said your positive for GAD Antibodies and would quickley fizzle out the pancreas.

I guess what ever.

[Funnygrl]

You sound like a prime example of double diabetes.

[dgrilli]

Yes it sounds like I have been blessed with the double D. What an achievement.

When I'm not feeling well it does seem like I'm extremely insulin resistant. But when I feel good not so bad.

I just seems like when your sick the BG's hoover between 180 and 210 and nothing brings them down.

[BriOnH]

I knew someone that was a double D once. Her back hurt all the time (rim shot).

(no offense dg, I just had to bite. Hope you aren't)