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Testing to see if I'm 1.5?

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#1
MsTCB

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Can someone tell me what tests I need to get to see if I'm 1.5? I know about the GAD 65, but is there anything else I also need?
The more I read about 1.5, the more I feel like that describes my experience with Diabetes.
As I read the forums, I find that I have very little in common with T2s, but I can relate to everything in the 1.5 forums.
I might have to ask a Physician friend of mine to order these tests for me, so I will need to know the specific names.
Not sure if my Endo will order them for me b/c he tends to think he knows everything already.
I gained 18 lbs in my first 18 days on Insulin and he tried to get me to accept his explanation that I must be eating too much.
I knew that was wrong b/c I've never been a big eater.
My physician friend said it was fluid and prescribed a water pill. And, sure enough, I lost all 18 lbs in just 3 days on the water pill.
And, since then I've been losing weight following a low-carb diet.

Thanks!
Theresa

#2
jwags

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A GAD antibody test will tell you if your body is producing certain Antibodies that attack your pancreas. But there is some disagreement in the medical community whether everyone who tests positive will develop Type 1. You may also want to have a C Peptide test to test your insulin levels. I am one of those thin type 2's, but I know I am insulin resistant because Metformin does work for me. There are a lot of Type 2's who also have to use insulin. I do think there is a lot of crossover with symptoms of type 1's and type 2's. It really doesn't matter what the diagnosis is as long as you are using the correct insulins to bring down bgs to normal levels. As far as weight gain on insulin, that is common. As you have found Low Carb diet is one thing that will prevent that. The more carbs you store as glycogen in your body the more water you will retain. That is why initially when you go on a LC diet you lose a lot in ther first few weeks. It is all water weight.
HbA1c 5.3 3/11 , HbA1c 5/12 6.1
metformin 2550 mg
Moderate carb diet 40-75 carbs a day
3 T of Coconut Oil daily

Vit D, CoQ10, Melatonin, Multi vitamin, zinc, B 12
Chia Seeds , Flaxseeds

Exercise- Tennis - 2 hours/week, Power Walking- 2 miles most days, Hiking in the summer on trails and in the mountains

diagnosed Feb 2007
Age 64

#3
Subby

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Here are a couple of articles, on John Walsh's site, that may help you work out how to check your diagnosis.

What Type of Diabetes Do I Have? | Diabetesnet.com
Type 1.5 | Diabetesnet.com
20 years T1. NPH and Novorapid.
Some essentials for my blood sugar control: dosing via i:c ratio and cf • basal testing when needed • daily 40 minutes moderate exercise (or close) • carbs somewhere below 120g currently • only eating carbs and carb/fat combos that do not cause a problem spike, with or without insulin.

#4
MsTCB

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Thanks Subby and Jwags!!

#5
MsTCB

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Thanks for the articles, Subby. I definitely fit all the criteria for 1.5. I was diagnosed at age 35 and probably had it for several years before that. My C-Peptide is 1.0 in a normal range of 0.8 - 3.5. I was on Metformin for 6 weeks and it didn't do anything for me, so my Doctor started the Insulin and that's what helped. I've always been on the thin side until a Cancer medication made me gain weight. I think the lack of Insulin has made it difficult for me to get those pounds back off, which is why I think I'm losing weight now that I'm on Insulin. I've never had a problem with Blood Pressure, or vascular problems or high lipids. I do think it's important to get the correct diagnosis so that the treatment is correct and I know what to expect as the disease progresses.

It looks like all I need is the GAD-65 test to make the final diagnosis.

Thanks again for your help!

#6
Jen-R

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I am so,so so so SOOOOOOO glad to see this (not that you are diabetic! - just your magnificent info).
I have gained 20 lbs in 6 weeks since starting insulin, and I am definitely NOT eating too much (700 - 900 calories daily right now). I am so beyond frustrated with hearing that it must be that I started eating more since starting insulin - just makes me want to rip my hair out - overeating has never been an issue for me. Everyone keeps asking me if I feel better now that by bgs are down, and all I can think is "no, I just feel fat".
Thanks so much for sharing about the water pill - I will definitely be checking this out for myself!!!

#7
Azurah

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I'm curious to find out if I'm a type 1.5, also. I just don't know if it's possible to produce lots of insulin in the early stages of 1.5. When I had my OGTT test, my insulin levels were also tested and my endo said that he would've thought I was a type 1, but since I had high levels of insulin I had to be type 2. Now I'm really not sure...
30 years old, thin type 2
Diagnosed: 6/30/11 (failed OGTT with bg around 260 at 2 hours)
A1C at diagnosis: 5.6
11/12/11 A1C (using A1CNow selfcheck): 5.2
12/19/11 A1C 5.5
4/9/12 A1C 5.5
10/22/12 A1C 5.5
Taking Metformin 500mg/3x day
History of gestational diabetes in '02

#8
Peter_V

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I'm curious to find out if I'm a type 1.5, also. I just don't know if it's possible to produce lots of insulin in the early stages of 1.5. When I had my OGTT test, my insulin levels were also tested and my endo said that he would've thought I was a type 1, but since I had high levels of insulin I had to be type 2. Now I'm really not sure...


As I understand it, high insulin levels pretty much means type 2. High glucose levels and high insulin levels means that you are insulin resistant, not insulin deficient. Insulin resistant is type 2.

Type 1.5 causes high glucose levels because those who have it don't produce enough insulin. They have normal insulin response, but can't produce enough insulin to clear the glucose out of their blood.

#9
algarve7

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  • I am a:Type 1.5

Can someone tell me what tests I need to get to see if I'm 1.5? I know about the GAD 65, but is there anything else I also need?


Apart from Anti-GAD antibodies, you can also test Anti-IA-2 antibodies, Insulin antibodies, ICA-IgG (Islet cell antibody-IgG) and ICA CF (Islet-cell antibodies-CF). I think Anti-GAD antibodies and Anti-IA-2 antibodies are most important. If you are positive for IA-2 in addition to GAD, then onset of type 1.5 diabetes is likely to be much faster.

I tested positive for GAD and ICA-IgG, but was negative for IA-2.

Normally I test my blood sugars, C-peptide, insulin, HbA1c, zinc and copper when I do a blood test. Zinc and copper imbalance are very common in many diseases. You will see it in diseases such as cancer, diabetes, autoimmune and mental illness. Copper levels tend to increase as disease progresses and becomes advanced and zinc deficiencies can be found. Sometimes the zinc level tends to be at the low end of normal and the copper at the upper end. While normal, the imbalance of the two is the key. A higher zinc to copper ratio is believed to be better for health.

#10
Azurah

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As I understand it, high insulin levels pretty much means type 2. High glucose levels and high insulin levels means that you are insulin resistant, not insulin deficient. Insulin resistant is type 2.

Type 1.5 causes high glucose levels because those who have it don't produce enough insulin. They have normal insulin response, but can't produce enough insulin to clear the glucose out of their blood.


Yes, that is how I understand it as well, but it is possible to have some degree of insulin resistance along with type 1.5. I know that doesn't explain how I could be producing lots of insulin though. I'm only 28 years old and quite thin and don't have a strong history of diabetes in my family. It's just so odd. It's somewhat hard to believe I'm a type 2.
30 years old, thin type 2
Diagnosed: 6/30/11 (failed OGTT with bg around 260 at 2 hours)
A1C at diagnosis: 5.6
11/12/11 A1C (using A1CNow selfcheck): 5.2
12/19/11 A1C 5.5
4/9/12 A1C 5.5
10/22/12 A1C 5.5
Taking Metformin 500mg/3x day
History of gestational diabetes in '02

#11
Subby

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As you say, insulin resistance can come along with any type of diabetes, it's definitely not exclusive to type 2. As such, I wonder if the following is possible:

You may be type 1.5 and have a somewhat reduced ability to produce insulin. However, given high insulin resistance, despite reduced ability your pancreas could still be pumping out insulin at a heightened rate.

Two fictional comparisons:
If you had full ability to produce and was a typical T2, you might have high c-peptide.
If you have only 70% normal ability to produce but still had strong insulin resistance, you might still have hyperinsulinemia, and your c-peptide might still be high. Possibly less than the first scenario, but may still be high nonetheless.

I don't know if it can work that way or if they can diagnose around such complexity. I guess if I were suspecting I was T1.5, I'd also be looking at the various antibody tests to see if there are indications there.
20 years T1. NPH and Novorapid.
Some essentials for my blood sugar control: dosing via i:c ratio and cf • basal testing when needed • daily 40 minutes moderate exercise (or close) • carbs somewhere below 120g currently • only eating carbs and carb/fat combos that do not cause a problem spike, with or without insulin.

#12
Azurah

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Yes, those scenarios are exactly why I would like the tests done. Does it really matter what type I am? No, but if I'm not a type 2, I'd like to start insulin sooner rather than later.

I'm waiting until my next set of labs and GP appointment to discuss this with my doc. I have my doubts that she'll order those tests or knows about type 1.5. She had such an unconcerned attitude about my diabetes. Basically she saw my a1c and decided I'm barely diabetic and shouldn't be worrying about it at all, just eat healthy and exercise and I could stop the Metformin if I wanted. I think my endo would've been more receptive, but he doesn't take the insurance I'm on now (state-funded).

It's frustrating to be limited by insurance and finances. I'm not getting my hopes up that my doc will order the tests. I'll probably just have to see how my diabetes progresses within the next few years.
30 years old, thin type 2
Diagnosed: 6/30/11 (failed OGTT with bg around 260 at 2 hours)
A1C at diagnosis: 5.6
11/12/11 A1C (using A1CNow selfcheck): 5.2
12/19/11 A1C 5.5
4/9/12 A1C 5.5
10/22/12 A1C 5.5
Taking Metformin 500mg/3x day
History of gestational diabetes in '02

#13
foxl

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Oh, MsTCB, I see you were asking about testing on October 30 -- but I thought you said you had those tests, in Augusts. You must have been confused ... since you posted GAD-65 titre and c-peptide values, recently?
Linda


[B]Jan A1c 6.3/B]
Jul 09 ... C-pep 1.3, GAD-65 > 30
Mar 10 C-pep 2.8 (20 g carb); GAD 3.2
dx 02/09 in DKA


Levemir 12U per day; novolog PRN TDD ca 16U
MetforminXR 1000 mg BID
Ramipril 5 mg
T4 112 mcg
Chia oil
Vitamin D3, 4000 IU
Eating 20 - 45 g carb per day ovo-lacto-vegetarian
Walking 30 min 6x week

#14
MsTCB

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Oh, MsTCB, I see you were asking about testing on October 30 -- but I thought you said you had those tests, in Augusts. You must have been confused ... since you posted GAD-65 titre and c-peptide values, recently?


Nope - not confused at all. At least not about this. :) I've had testing in late August and again in early October and again in early November. The C-peptide test was done in August and that value has been posted in my signature since I joined this forum. You probably just didn't notice it. :)

Because I had the low C-peptide and nearly all the other indications for the Type 1.5 dx, I wanted to find out if there were more tests to make the definitive dx of Type 1.5. So, the Nov. labs were ordered and my Endo made the official dx.

Hope that clears up your confusion. :)
MsTCB

Diagnosed 1996 (at age 35)

Started tx w/ meds & insulin on 9/28/11:
Metformin ER - 2000 mg/ day
Lantus - 24 units every 12 hours
Humalog - approx 60 units/day
LC/HF diet (<60 gr carbs/day)
Ha1c 07.6 (12/28/11) :)
Ha1c 12.7 (09/28/11) :eek:

Grateful Thyroid Cancer Survivor :)
Armour Thyroid 300 mg (5 grains)/day




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