Type 2, but Could i be a Type 1.5?

[tiffanyfaith86]

I was diagnosed in June 2007 with Type 2 diabetes. In Dec 2007 i went back after being on just Metformin 1000mg and Glyburide (dont remember the mg) and my a1c was 5.5 so i was doing great but the glyburide made me go to 60s to much and doc was worried about me going so low so he changed me to Metformin 1000mg and Januvia cant remember the starting mg i believe it was 100 by end of taking it. And it seemed forever i was doing great with that. No lows except if i didnt eat enough and very few highs. Then it didnt work no more. my sugars were going up to 200s and 300 and so he changed me to metformin 1000mg and 15mg actos. it worked for like a month then he uped it to 30mg. it didnt work to good still going to 200 so he added byetta, it didnt work for me at all. so he put me on lantus 12u and the actos 30mg and metformin1000mg. It seemed to work again for a couple months this time then i slowly started going back up, so he uped the actos again to 45mg which is the max, this is now November 2008. He also gave me Humalog prescription so that i could use it if i needed to. I have been hesitant to use it until last week when i started getting high 300s i got it filled. and yesterday i started using it. last night it made me go to 95 which is one of the only times ive been that low since December. In February i went to the doc and he said my a1c was 7.5 but i know it has to be up already because now ive been getting up to 420. That is the times ive checked. Because honestly i havent checked every time i should have. My eyes feel like they are getting so bad i have to squint sometimes to make this text clear.

So back to lastnight, i went to 95 before bed so i ate a popsicle so i wouldnt go low by morning. I woke up and it was 212. I took 14u Lantus at 7am ate glucerna cereal with A slice of toast. I took my Metformin 1000mg, Actos 45mg, at 8am. at 10:30 i tested and got 502!! now before lunch at 11:45am i was 288 so i took the humalog 5u and now eating a soup while i type this up. So im waiting to see how it does.

So back to the question. Could i be not a true type 2 and be a 1.5??? Cant go to doc til Wednesday and he's only a general practitioner, so he dont really do any test but the a1c.
Is there any test i could ask him to do to see if he could find out if i am. He did a c-peptide before but the lab acted like they didnt know what it was and he said the results he got were for something else. So i really dont know the results yet for that.

:( frustrated and worried.

[foxl]

I think you need better care, and soon.

I am in the same boat as you but better-controlled --- for now.

Would you consider switching MDs?

[tiffanyfaith86]

I also do workout, 30 minutes on the treadmill 4 days a week. For sure i have done it sun-wednesday this week. so cant explain the 502 at all. and my diet is very good. usually very low carb and no hamburgers or pizza or chocolate or chips for weeks and weeks now. and i eat apples and oranges and bananas and love veggies. but i dont over do the fruits and im even afraid to drink to much milk even in my cereal.

[pands45]

I seem to be in the same boat. Metformin, glyburide, januvia. I too have been having a hard time trying to control this. I work out ( ran 5 K this A.M.)and watch the amount of carbs I eat. I don't know where you live but I think you need a decent endocrinologist.Also, my endo tod me that if you do all the above( diet, exercise, take meds) and you still cannot control it then you are a 1.5. I jut took the c-peptide but have to wait 2 weeks for the results. Good luck!!!

[tiffanyfaith86]

i am going to have to find another doc in June because he is leaving. But he is very cute so i dont mind going to him few more times before he leaves.

[sugardumplin]

Hey, wow that was lots of info and yet still not enough.

If I had to throw something out there, I would definately think you need more insulin. and more testing. you need a basal insulin for your fasting numbers so u dont wake up in the 200's. and you need the humalog for ur mealtimes. u need to test when u wake up. before mealtimes and 2 hours after mealtimes and before u go to bed.

I had a c-peptide and a GAD test. I was diagnosed with Type 2 and do not fit the characteristics of a Type2. My bloodwork also suggests that I am LADA a.k.a Type 1.5. Therefore i recently changed my group to 1.5

I had just turned 29 and was not overweight. I am a very active person when it comes to exercising. I cant eat fruit without going into high numbers like that. If I were you I wouldnt have the fruit for right now. My diabetes could not be controlled by diet and exercise alone and the pills didnt work for me.

You might want to see an endocrinologist instead of your PCP.

PM if I can help you with any other questions.

Not a professional, just a fellow D friend trying to make it as well...

best wishes

[mortis505]

First off, tell us about the conditions regarding your diagnosis. Whats your D story? Were you skinny, overweight, always thirsty????

Request a referral to an Endocrinologist as many GP's dont know much about D. You should have a C-peptide and a GAD antibody panel done.

[lorilei]

Yes, i agree...get an endocrinologist who will run the right tests, especially since your doctor hasn't been able to help you control your BG for any length of time...sounds like your body is definately struggling...

[xMenace]

First off, tell us about the conditions regarding your diagnosis. Whats your D story? Were you skinny, overweight, always thirsty????

Request a referral to an Endocrinologist as many GP's dont know much about D. You should have a C-peptide and a GAD antibody panel done.


I also have to ask if you are overweight. Don't worry about telling. We all leave our egos at the door. I'm trying to lose up to 50 pounds myself. If obesity is an issue, then it's most likely type 2. If you are skinny, then I'll vote type 1.5. It doesn't sound like a MODY.

[foxl]

X -- Wait a minute ...

... regarding weight ... I was just BARELY in the obese range, per BMI calculation, when I began noticing symptoms.

My BP was elevated at Dx, but, geez, I was UPSET! And in DKA.

My LDL has always run high, but my Trigs are middle- to low-normal.

Oh, and I am 51. Which is over 50.

So my MD is presuming type 2, but I am not convinced ...

Point being, I think the line is a bit blurrier, than overweight, or NOT. And I think with the issue of obesity today ... most people ARE overweight!

[jillrapp]

I also have a few questions - you said the following: "usually very low carb and no hamburgers or pizza or chocolate or chips for weeks and weeks now. and i eat apples and oranges and bananas and love veggies. but i dont over do the fruits and im even afraid to drink to much milk even in my cereal."

How many carbs do you eat total each meal and how many total per day? I honestly don't know of one person who's a controlled diabetic that can eat a bowl of cereal (even glucerna) with milk and not go sky high. Mornings are also often the worst time of the day for tight control as your body could be releasing it's own stored glucose to get you ready for the day. Also, fruits are loaded with carbohydrates. A medium sized banana has about 30g of carbohydrates - that could be a whole meals worth. If you were eating hamburgers, pizza, and choc chips just a few weeks ago changing up your meds wasn't going to help much anyway. The only way to cover that many carbs is a rapid acting insulin - used by Type 1's, 2's, and 1.5's.

I think it might be too early to take a vote without more info from you, and weeks of tight control by you. No matter what your type, you could be bouncing all around because of the amount of carbs you are consuming. Still think the C-peptide test should be done, and probably by anyone that's been diagnosed with diabetes. That will give the doctor some insight on how to treat you. Insulin is usually the easiest way, no matter what type you are, but a low carbohydrate diet will also help you immensely. If you haven't done so already, maybe getting an endo or see a Certified Diabetes Educator about helping you to put meals together that work for you but will help you to be more stable too!

I wish you much luck, it's not easy when you're up and down all the time!!! Many of us have been right where you are and feel your pain!

On a second note, glad to have you around and welcome to the DF!

Good Luck!

[tiffanyfaith86]

i was really overweight at 18 i weighed 227 the last time i saw my pediatrician. and at that time he acted like i didnt have diabetes or anything wrong but asthma. That was in 2004. in 2005 i started losing weight and by June 2007 when i saw doc i was down to 194 and i was peeing alot and just didnt feel right. He diagnosed me with Type 2 and Hypothyroidism, which is obviously the reason i was heavy pry. So ive been taking my thyroid meds now too, and thats ok, its just my sugars now i was able to get control for awhile with just oral meds and now with the 24 hr insulin it wasnt helping. Last night i was pretty good. was 131 before treadmill, and 124 after. and i didnt eat anything from 6:30 on and i fell asleep around 11pm.. and this morning i was 181.

So im 22, weigh 178lbs now, so close to 50lbs. If i was type 2 wouldnt that much weight loss cure it.

[tiffanyfaith86]

when i was diagnosed my a1c was 12.1 and doc was shocked cause i was only 17 days from my 21st birthday when found out. and i gotta be honest my pediatrician always told my mom i was healthy even with my weight but never did check my sugar or thyroid or anything that we can remember. So like my doc told me i pry had it for awhile but just didnt know it. I had appendix out at 12 and it got infected and had to stay in bed for like 2 weeks and i slowly gained weight up til 18 from then. but now i only have about 38 - 48 pounds to lose for my goal weight

[tiffanyfaith86]

oh and my blood pressure is very good usually around 110 or 70 and pulse around 80s or lower.

and i dont have many of the classic type 2 signs

and how could i go from good control with 1000mg of metformin to needing insulin so much within less then 2 years.

Usually they say it takes type 2s 20 years to need insulin this much

[EeyoreButterfly]

That much weight is certainly a risk factor of type 2, but in and of itself is not a determinant. You can be overweight and have type 1.5 just like you can be underweight and have type 2. Contrary to popular belief, type 2's can end up on insulin. Your beta cells burn out as your pancreas must produce increasing amounts of insulin to do the same job. Here is what you need to do:

1.) Make an appointment with another doctor now. The sugars and symptoms you are posting are very dangerous. I don't care how cute your current doctor is, that is not a good reason to go to him if he is not helping you gain control.

2.) Start keeping a food diary. Record what you eat and how many carbs you have per meal. If you continue to go high, lower your carbs. If a food spikes you up, don't eat it.

3.) Determine your insulin requirements. Have you done any basal testing? Make sure that you are taking your bolus insulin in response to the number of carbs you eat. I believe most people use a ratio of insulin to carbs. Also, it sounds like you were using your lantus to bring you down quickly. If I remember right, Lantus is a long acting insulin and will not bring you down rapidly, but taking it in that matter might cause you to go lower later. Hopefully somebody on insulin can comment further on that.

Nobody can tell from your post if you have 1.5. You certainly have many characteristics of a Type 2, especially the weight, but you also have many characters of 1.5, such as the quick progression and lack of control. Your best bet is to go to another doctor, preferably an endo, and ask for the GAD antibody and CPeptide testing. That will give you a more definitive answer.

[UpNorth]

I have a feeling you might be 1.5. You really need a new doctor and have the right tests taken!

[tiffanyfaith86]

:o i am going to my GP tomorrow, and ill ask him whats up, give him one more chance to see what he can do for me or tell me to do. But i will ask him to refer me to an endo also. I have a question tho.

:confused: This morning i woke up 136 after doing 12u Lantus before bed. I did my normal 16u this morning, took my metformin 1000mg and actos 45mg. Went and took a shower, took my BG again and it was 164, how does that happen? i didnt eat anything but drink water to take my pills. I did my 5u Humalog and now eating a sandwich.

:o Oh and no im not using my lantus as my fast acting. I only take it 16u in morning (i just uped it from 14u in morning) and i take 12u Lantus at night because even with humalog before meals, and going to sleep with good BG i would still wake up between 180-300

I read it is ok to split your lantus like that.

:confused: I was wondering even if i am a TT2, would it be good to start the pump? Like the omni pod maybe. Because im sick of the needles already. I even felt nauseas this morning doing the humalog