feeling a bit stupid..!

[buzzborne]

I have read in some peoples posts that they were first diagnosed with T2 and then were told that they actually had T1... was this misdiagnosis or can ppl actully change types through out the years either from T1 to T2 or the otherway round... Sorry if this is a bitof a stupid question, but I was just curious :rolleyes:

((Also I was wondering if anybody had any good diabetic websites with info on them... trying to educate a newly found bf...!))

Thanks :)
Sarah

[MarkMunday]

Sarah,

T1 and T2 are two related but very different conditions. So there can be no switching between them. But a newly afflicted T1 will often present with T2 symptoms. During this "honeymoon" period, the pancreas still procduces some insulin. So blood sugar can be controlled by diet, exercise and medications that increase the pancreas' output of insulin. Which is how T2s can usually be controlled. But this situation doesn't last. Eventually, the pancreas gives up the ghost and the honeymoon comes to an end. The now fully-fledged T1 diabetic becomes completely dependent on injected insulin.

The transition from what initially may appear to be T2 to being an insulin dependent T1 is a one-way street. Once the pancreas closes down completely, there is no way to restore it's insulin manufacturing ability. And there is no going back ... Or not at the moment anyway.

A good site for basic information about diabetes is the diabetes section of the Howstuffworks (http://health.howstuffworks.com/diabetes.htm) website. It is written for the layman, there are some good illustrations, and on the last page there are lots of links to other useful sites.

Cheers,

Mark

[rzrbks]

Nice, simple article. Good posting Mark.

Sarah, Mark nailed it.

When I was 1st diagnosed, by the Dr., he thought it Might be Type 2, when I went to diabetes classes, the Certified Diabetes Educator, took one look at me, smiled and told me I was Type 1 and she gently let me know there was no change of just getting by on oral Meds and that I was on insulin forever. Dr. is fairly new to diabetes treatment and diagnoses whereas CDE has been working with diabetics a LOOOOng time. Plus, she is diabetic too, a pumper, so she really knows her stuff.

Very Serious shock to me, I had been expecting to go to strictly oral Meds.

Ah, well. The trade off is I get to eat a whole lotta stuff that people like Harold have given up. Although, Harold does have an excellent appetite.

[am1977]

Type 1s often present in a state of DKA or diabetic ketoacidosis when diagnosed. There usually is weightloss, extreme thirst, frequent urination, exhaustion, and ketones in the urine (hence the word ketoacidosis). Many times, by the time they are diagnosed blood sugar levels are very, very high. Mine was in the 600 range :eek: It can be very dangerous when that happens and is very hard on the body too. The food that has been taking in( eaten) has not been able to enter the cells of the body and though the body tries to rid them through frequent urination, it cannot successfully bring sugar down to normal levels w/o insulin. That is the key. For one reason or another, insulin is not made anymore and w/o it sugar levels climb. That's why Type 1's are dependent on insulin to live. There is no other way about it, unfortuantely. I'm sure you know what happens when sugar levels stay too elevated for long periods of time...a diabetic could face a whole lot of complications.

Type 2's often do exhibit similar symptoms, but many times they still produce insulin. It's just that their bodies do not utilize the insulin as it should which also results to blood sugar being elevated. Some type 2s have a treatment plan of diet and exercise alone, some include meds, and some have to use insulin. I must state that a Type 2 cannot become Type 1. They might have to be treated with insulin, but that does not make them type 1. Also, type 1's may need meds as well as iinsulin, but that does not make them type 2 either. It's just something they need in their management of the disease. I know that can be confusing, but just b/c you use insulin or take meds doesn't classify you as a Type 1 or Type 2.

I'm sorry if I have over simplified or repeated anything you already know, but I hope that this helps a little. Don't ever feel stupid about asking questions, that's how we learn. I know it's cliche, :p, but there are no stupid questions :)

As for Diabetes web sites, have you checked out www.diabetes.org. It has a lot of good info there. Also, www.childrenwithdiabetes.org. It's called children with diabetes, but it is a great website for everyone. it's got a section called "Ask the Diabetes Team" that really is helpful. They answer a lot of questions regarding Diabetes quite often and it's worth checking oujt.

Good luck and please feel free to ask your questions anytime. :)

[Harold]

Originally posted by am1977
I must state that a Type 2 cannot become Type 1. They might have to be treated with insulin, but that does not make them type 1. Also, type 1's may need meds as well as iinsulin, but that does not make them type 2 either. It's just something they need in their management of the disease. I know that can be confusing, but just b/c you use insulin or take meds doesn't classify you as a Type 1 or Type 2.
May I take the liberty to clarify this statement before someone jumps all over it? What I believe your trying to say here is that people do not switch from one type to the other type. However there are some people that have both types at the same time. They may start out with one or the other then develope the other one later. This happens to type 2's who lose the ability to produce insulin. Sometimes through over use or for any of the same reasons anyone developes type 1. A type 1 with a genetic predisposition for insulin resistance may develope type 2, but due to the nature of type 1 diabetes it does not happen often, but it does happen. In either case they do not switch types, but aquire the other type and have both.

[am1977]

Thanks for clarifying that, Harold. I appreciate it :)

[Shalyndria]

Originally posted by Harold
They may start out with one or the other then develope the other one later. This happens to type 2's who lose the ability to produce insulin. Sometimes through over use or for any of the same reasons anyone developes type 1.
Actually Harold, what defines a Type 1 as such is the autoimmune aspect of the condition (in most cases - a primary disease can also be a peripheral cause), which excludes Type 2's from becoming Type 1 (unless of course their immune systems were to suddenly start attacking b-cells). Essentially, the initial Dx remains the same, while the mechanics of the condition are slightly changed.

Shy

[rzrbks]

Let's see if I have it.

Type 1 can be misdiagnosesd as Type 2 because of several factors but they are, in fact Type 1. Period.

Type 2 can become insulin dependant and thus in treatment be as though Type 1 but can Never Become Type 1. Period.

Would that be the short of it, Shy?

[Shalyndria]

Depends on whether we're discussing semantics or not, rz! ;)

Yeah that's pretty much the gist of it, if we keep it uncomplicated.

Shy

[rzrbks]

Thank you.

You know me, I ain't too bright, so the simpler it is the happier I is.:D

[Shalyndria]

Originally posted by rzrbks
Thank you.

You know me, I ain't too bright, so the simpler it is the happier I is.:D
Well I wouldn't say that :) Maybe you could be my translator from now on lol.

Shy

[buzzborne]

Thank you all for all the replies... I just wanted to clear up that bit of uncertainty...

Thank you also for the site info.. I shall be looking them up! :)

Sarah

[SunniD]

Noticed you were from the UK and thought you might like to
check out this site:

www.wddty.co.uk it means: 'What Doctors Don't Tell You.'

People get diabetes for a variety of reasons and causes. There is no age limit anymore either as young children are coming down with Type 2 and people in their 80's are coming down with type 1 nowadays. I let the experts above give you their very good
interpretations of types. I personally like the simplified one<smile>.

Thought you might be interested in the following cases:

My girlfriend(age 50 and overwt.) had chemotherapy which got rid of a "wild cell cancer' but also killed her islet cells. What type do you suppose she is??

My sister(age 50 and overwt.)had a multi organ shutdown and lost her adrenals and her islets. What type do you suppose she might be??

A male friend (60 and not overwt.) has a disease called hemochromatosis. Hemochromatosis is a disease in which deposits of iron collect in the liver and other organs. Diabetes
often presents itself in these pts. Which type is he??

An older friend of mine in her 80's and thin just got dx'd
with diabetes. Her C-peptide indicated she had which type
of diabetes?? Most type ones are young when diagnosed usually.

Answer: All 4 are type 1's.

SunniD

[Shalyndria]

Originally posted by SunniD
"My girlfriend(age 50 and overwt.) had chemotherapy which got rid of a "wild cell cancer' but also killed her islet cells. What type do you suppose she is??

My sister(age 50 and overwt.)had a multi organ shutdown and lost her adrenals and her islets. What type do you suppose she might be??

A male friend (60 and not overwt.) has a disease called hemochromatosis. Hemochromatosis is a disease in which deposits of iron collect in the liver and other organs. Diabetes
often presents itself in these pts. Which type is he??

An older friend of mine in her 80's and thin just got dx'd
with diabetes. Her C-peptide indicated she had which type
of diabetes?? Most type ones are young when diagnosed usually.

Answer: All 4 are type 1's.
And there's an example of semantics :) ;) Of course these are all initial Dx's.

Interesting, SunniD.
Shy

[JasonSmithMT]

Originally posted by SunniD

People get diabetes for a variety of reasons and causes. There is no age limit anymore either as young children are coming down with Type 2 and people in their 80's are coming down with type 1 nowadays. I let the experts above give you their very good
interpretations of types. I personally like the simplified one<smile>.

Thought you might be interested in the following cases:

My girlfriend(age 50 and overwt.) had chemotherapy which got rid of a "wild cell cancer' but also killed her islet cells. What type do you suppose she is??

My sister(age 50 and overwt.)had a multi organ shutdown and lost her adrenals and her islets. What type do you suppose she might be??

A male friend (60 and not overwt.) has a disease called hemochromatosis. Hemochromatosis is a disease in which deposits of iron collect in the liver and other organs. Diabetes
often presents itself in these pts. Which type is he??

An older friend of mine in her 80's and thin just got dx'd
with diabetes. Her C-peptide indicated she had which type
of diabetes?? Most type ones are young when diagnosed usually.

Answer: All 4 are type 1's.


Ok – I’ll make things a little more complicated. Just remember I didn't start it :rolleyes:

Beware, medical jargon to follow.

The first three would actually be classified as “Secondary Diabetes.” This is definitely semantics as Shy says and from a clinician’s point of view insulinopenic patients will most often be classified as type 1 as treatment for the resulting hyperglycemia is the same. As such, I wouldn’t say classifying these patients as Type 1s is necessarily wrong. Scientists in the area, epidemiologist, and etiologist however will be more of a purist in the classification. It is common in medical literature to run across type 1 diabetes being broken into autoimmune etiology called Type 1A and idiopathic in origin called Type 1B.

From Ellenberg & Rifkin’s Diabetes Mellitus, Sixth Edition (2003, McGraw-Hill) 266-268:

“Type 1A diabetes refers to the form that is associated with such immune markers, although it should be noted that as permanent islet cell destruction is established, antibody titers may dissipate or disappear entirely. A less common second subtype, Type 1B, is idiopathic in origin, and may not have an immune-mediated etiology.”

“Several forms of diabetes result from or are related to another specific disease process or genetic disorder. According to current classifications, these conditions are considered neither T1DM nor T2DM and are grouped together under ‘other specific types,” sometimes referred to as ‘secondary diabetes.’”

Examples of secondary diabetes included:
Genetic defects in Beta-cell function
Genetic defects in insulin action (Leprechaunism,Rabson-Mendenhall syndrome)
Exocrine pancreatic diseases (cystic fibrosis, hemochromatosis, chronic pancreatitis)
Other endocrinopathies (Cushing’s syndrome, endorcrine tumors)
Drug- and Chemical-Induced Diabetes
Infections
Uncommon Forms of Immune-Mediated Diabetes (Stiffman syndrome)
Other Genetic Syndromes (Down’s syndrome, Turner’s syndrome, etc.)

Jason

[Shalyndria]

Great reference Jason :thumbsup:

Shy

[gettingby]

Wow Jason. Your post just made my head explode!!!!!!! To much info for my small brain!!!!!! LOL. I'm j/k.
:D

[Harold]

Okay, since this threads title is about feeling a bit stupid I have another question. Why does it make a difference in how one came about in aquiring diabetes in how it relates to what type one has other than if you don't make insulin or have insulin resistance?

Since I'm playing really stupid here KISS, Keep It Simple Stupid. :confused:

[Shalyndria]

I'm not sure if I understand exactly what your question is, Harold, but I'll try to answer it :)

As it relates to secondary Diabetes, the cause will establish the required treatment. For example, adolescent CF (cystic fibrosis) can cause secondary Diabetes. Extinction of functional islet cells is gradual in this case, which is similar to the progressive condition of Type 2, and decides the timeline of injected insulin use. Another example is secondary to Rabson-Mendenhall syndrome, and affected children are asymptomatic regardless of mutations in the insulin gene. Glucose intolerance or mild diabetes does not occur until adulthood.
Essentially, if the cause is unknown in such cases then the proper therapy might not be advised.
Aside from that, without a known cause it's difficult to cure or reverse a condition. And hey, curiosity is inherent especially upon intial Dx; ppl want to know 'WHY'.

Hope that helped some.
Shy

[Harold]

Actually no. :confused:

So when asked what type one has, one should respond with 1A, 1B, 2, or Secondary, and in the case of Secondary the cause and treatment. :whistling

[Shalyndria]

Originally posted by Harold
So when asked what type one has, one should respond with 1A, 1B, 2, or Secondary, and in the case of Secondary the cause and treatment. :whistling
Well I suppose that one would respond in whatever way one feels comfortable responding....ain't no rules, last I checked! :p :D Personally, I think that the more educated we are about our own conditions, the more equipped we are to properly answer or explain when someone inquires as to what type we are (I'm not talking a singles chat either lol). YMMV of course :)

Shy

[buzzborne]

Thanks for all your replies, that has cleared that up for me! :)

Was a great help :thumbsup: