Do I have type 1 or type 2?

[exackerly]

Hi all, this is my first visit to this forum. I hope this post isn't too long but I'm not sure what all is relevant.

I'm a 61 year old man. I was diagnosed with type 2 10 years ago due to obesity. At first I was on oral meds, then when they weren't working the doctor put me on Lantus. I'm now up to 68 units a day.

As of March I've been seeing a new doctor who wants to put me on Humalog. He took me off Amaryl and my glucose shot way up. He also took me off Actos, because of his concern about side effects, so my only oral med is Metformin (4 tabs a day).

My latest A1C is 8.3 -- the previous one was 6.7. At the moment I'm supposed to be testing 7/day to establish baseline info for the Humalog. (Sorry if I'm not using the right terminology.)

Anyway, I guess I have 2 questions. The first is, am I type 1 or type 2?

The second is, what kind of records should I be keeping about food? I test pre-prandial and post-prandial, and write down what I ate. But I'm not sure which information about food is relevant. Number of calories? An exact description? (A lot of times it's just a big salad whose contents vary.) Naturally I want to get it right.

Also, I haven't been taking a bedtime reading because I'm usually asleep within 2 hours after finishing dinner. Is that going to mess things up?

Thanks for any info.

[sarahspins]

It sounds like you are simply a T2 who uses insulin to manage your condition - it can take some time to work out the correct dosages, especially if you have removed some oral meds. T1 is an autoimmune disease - it's not simply the usage of insulin.

If you are supposed to be keeping a food log, the imporant thing to track is carbs.. insulin doses for meals are linked to carb intake.

[EeyoreButterfly]

Welcome! You do not suddenly switch from being Type 2 to Type 1. I'll try ot explain it as simply as I can.

You are still a type 2, merely a type 2 who is insulin dependent. You see, with Type 2 diabetes the mechanism at work is insulin resistance. This means you need more insulin to do the same about of work as somebody who does not have insulin resistance. Overtime, your pancreas simply becomes worn out. I once read a figure that many Type 2's have already lost about 50% of their pancreatic function when diagnosed. It is at this point that high blood sugars develop because the pancreas cannot keep up with the load.

Overtime the pancreas will continue to burn out despite attempts at control. If you live long enough with Type 2 you will be on insulin. Some of the oral medications than stimulate insulin production actually may accelerate the pancreatic burn out.

Type 1 is quite simply an autoimmune response. Type 1 happens when the immune system attacks the beta cells in the pancreas killing them off. No amount of oral meds will help a true Type 1 because there is no insulin to be produced. They must go on insulin immediately. There are several other types, but for the purposes of this discussion, they are irrelevant.

The fact that you controlled for 10 years on oral meds speaks volumes. This means you are a Type 2 who overtime has experienced beta cell burn out as all type 2's eventually will and now need insulin to control.

[viranth]

Hello, welcome to the forums!

I think you'll need to check the anti-gad numbers to see if you have Type 1 or 2.

My food log, contains of date, time, BG, how many units of insulin I've injected and what I eat. I always weigh my food, but only the carbohydrates. They're the ones that will give you problems.

If you fall asleep two hours after dinner, check you BG 90 minutes after dinner ;)

Chances are you go to bed with slightly high BG, and sleep through the night with that number will rise you hba1c for sure.

Control the night, makes it easier to control the day.

[exackerly]

Thanks, that clears it up for me. I'll post my questions on the Type 2 forum from now on.

[EeyoreButterfly]

Now on to your other questions. I cannot answer about the insulin because I am not on it, hopefully somebody else here can.

As far as what to look for in foods: It's a shame that you have been into this 10 years and do not know. And that is not meant to be a slam against you but against your doctors.

What you need to worry about are the carbohydrates. That is where your blood sugar comes from. You need to go on a low carb diet as this will greatly decrease your risk of complications. Carbs are in essentially every food but meat. The guideline my endo gave me was that for any traditional "grain" based food that there should be 3 grams of fiber per every 100 calories. And to only have one with each meal. (Try to stick to 15-30grams per meal).

For a food journal, write down what you ate as well as how many carbs. Because it's not just the number of carbs but the types of carbs and everybody reacts to foods differently. So you could have 15grams of carbs in white bread and 15grams of carbs in a piece of fruit and have two very different reactions to it. A great resource is a carb counting book. You can find them in any diabetes section of a book store. I hope this helps!

[foxl]

Whatcha eatin'? :)

I am both ... combined-type. So I read ALL the sub-forums.

BTW, welcome!

[kgm0612]

Welcome to the forum!

I have kept a log book since being dx'd 6.5 years ago. I write down my BS reading, the foods that I ate, and how many units of insulin I took. I used to write down the # of carbs I was consuming, but my pump stores that info for me.

Karen