Does it matter which type your treated for ?

kimbo · #1 (**permalink**) 11-04-2006, 04:09 AM

I was diagnosed as t2 but suspect I could be slow onset t1.The specialist nurse agrees this is possible.She explained the main concern was getting good control of my bg so after 18 months on oral meds I am now on insulin.
Should I be concerned that I do not know which type I am ? where its going ?
Do t2s get given the same insulins, advice on manageing with diet ect as t1s ??

levermir + novorapid + metformin

JediSkipdogg · #2 (**permalink**) 11-04-2006, 04:26 AM

Have you ever had a C-Peptice of GAD Antibody test done? Neither are 100% positive, but they help show which direction you are going in your type.

As for does it matter? Personally, no, just whatever works. I know insurance companies and doctors like to know what type one is. But this day and age, it doesn't matter. There are type 2s on insulin that test as much as a type 1 does. I don't know of any type 1s on oral meds, but there could be one out there. I think it's just up to what gets your numbers in control.

Cyborg · #3 (**permalink**) 11-04-2006, 05:09 AM

If they find out you are type 1 rather than type 2, I suspect they may reduce or eliminate the metformiin. When my endo discovered I was really type 1, he cut mine. I even asked him about it since I figured my insulin resistance didn't just disappear. He said I could go back onto it later after adjusting to MDI, but I never have...

Funnygrl · #4 (**permalink**) 11-04-2006, 08:07 AM

Yes, and no. Treatment doesn't matter a ton as long as control is good. But there are a few exceptions.

If you have type 1 and are treated with oral meds alone, then your honeymoon will likely be shortened as a result of the added stress on beta cells.

If you are type 1 and treated with oral meds, you may have extra side effects from a medication you don't need.

If you are type 2 and not given oral meds with whatever insulin you take, the effect may be added resistance and I read somewhere that it can actually increase your risk of heart disase.

But I think these exceptions apply mostly in clear cut cases. In the grey areas glucose control is what matters most.

kimbo · #5 (**permalink**) 11-04-2006, 08:53 AM

Once I have had more experience with the insulin and have more acceptable/stable hba1c results I am going to come off metformin and see how it goes.The metformin is my concern,they dont test for types in the uk.I cannot see the point of being treat as t2 and taking metformin for years knowing if I were 1.5 I might not need it.

lilituc · #6 (**permalink**) 11-04-2006, 01:26 PM

It matters to the insurance companies here (especially if you want to get a pump), and it might also matter if you need to have emergency treatment. IT matters to some doctors (whether they treat you or ignore your concerns, sadly). Other than that, probably not.

Mister Q · #7 (**permalink**) 11-05-2006, 01:57 AM

Quote:

Originally Posted by JediSkipdogg

Have you ever had a C-Peptice of GAD Antibody test done? Neither are 100% positive, but they help show which direction you are going in your type.

I asked my Doc for a c-peptide when my type was under question, he informed me that they don't do them in the area I live in!!!

Geoff · #8 (**permalink**) 11-05-2006, 02:38 AM

Hi Kimbo, I have been down some of the same road as you. I was diagnosed as type 1, but because of my age at diagnosis’s , 49, I do not fit into the NHS’s nice little box of being a classic type 1. I was put on insulin from day one, and have been able to achieve very good control . I have asked many times my GP, Diabetes specialist, and every one who would listen for a C-Peptide test and have been fobbed off each time that it is not important to have this test?

As goes the type of advice on insulin, most type 2’s in the UK are put on Lantus long acting insulin, usually as a single dose. After a period of several months to a year, they find out that it is not working very well and put you on MDI (Multi Dose injection) Rapid insulin with meals, base insulin Lantus one time per day or as a split dose. This is now the preferred method with all newly diagnosed type 1’s in the UK. The most important thing with this regerman is that you learn to count carbs, and adjust your insulin to suite. Try to get yourself on a DAFNE course (Dose Adjustment for Normal Eating) ask your diabetes specialist about this not your GP, as most have no idea what it is.

Funnygrl · #9 (**permalink**) 11-05-2006, 07:07 AM

Quote:

Originally Posted by Mister Q

I asked my Doc for a c-peptide when my type was under question, he informed me that they don't do them in the area I live in!!!

It's a really common test here. I think I have had a c-peptide at least 5 times. That's absurd.

Mister Q · #10 (**permalink**) 11-05-2006, 09:31 AM

Quote:

Originally Posted by Funnygrl

That's absurd.

When you take away the swear words that is the essence of what I said!!

Welcome to the National Health Service lottery, this operates within the UK and is based on your post(zip) code. Where you live can literally be a matter of life or death, hardley a week goes by without some story in the news over a patient taking a Health Authority to court as they are refused treatment others get elsewhere in the country.

OK for me it was no real biggie, but when people are refused life saving treatments then that really is s**t.

am1977 · #11 (**permalink**) 11-05-2006, 12:51 PM

Frankly, no, like other people have said... I don't think it matters so much with what your treatment is as long as you can control your disease, ultimately. Almost every type of treatment has it's benefits and drawbacks- it's really a matter of finding the thing that works best for you.

Good luck

Lex4153 · #12 (**permalink**) 11-05-2006, 01:02 PM

With me, it did matter. I was misdiagnosed as a T1 and taking insulin with no oral meds for 10 years. This didn't work very well!! Now that I'm correctly diagnosed as a T2, my blood sugars are stable and controllable for the first time on oral meds alone.

Does it matter as long as your blood sugars are good? Not really. But for me it did because I wasn't able to get the right treatment. Hopefully, what happened to me is pretty rare though.

kimbo · #13 (**permalink**) 11-05-2006, 03:48 PM

Geoff,what symptoms did you present to be diagnosed t1? I read your post " the best I have felt in ten years ". Just curious.

Thanks

Funnygrl · #14 (**permalink**) 11-05-2006, 04:09 PM

Quote:

Originally Posted by Lex4153

With me, it did matter. I was misdiagnosed as a T1 and taking insulin with no oral meds for 10 years. This didn't work very well!! Now that I'm correctly diagnosed as a T2, my blood sugars are stable and controllable for the first time on oral meds alone.

Does it matter as long as your blood sugars are good? Not really. But for me it did because I wasn't able to get the right treatment. Hopefully, what happened to me is pretty rare though.

Well, I think what people are saying is it doesn't matter, provided the treatment works. For you, it didn't work.

Geoff · #15 (**permalink**) 11-05-2006, 04:24 PM

Hi Kimbo, I had felt listless for about a year before I was diagnosed, always tired, used to get a lot of colds that lasted for a week or two. Then about six months before I was diagnosed I started to lose a lot of weight, over this time I lost some 15kg. Other symptoms were very dry skin, mostly on The backs of my hands, then I started to urinate a lot, getting up two times in the night, my eyesight started to get bad, and the final thing that made me visit the doctor was I noticed black spots in my urine which turned out to be protein. The rest is history has they say!!