[singh]

hy people,
i have just come bak from 2nd a1c since diagnosed and its come to be 5.9 so thats good but i also had my insulin level checked and its 26.i am on only 12 units of 70/30 a day.Now when i got diagnosed i was at a1c 15 and insulin level 1.7. my doc now wants me to take off 70/30 for now and check my sugar levels every 4 hours and and do adjustment to sugar levels if needed using humalog.Then later on he will decide if he needs to put me on insulin or diabetic pills like matamorfin.Now i am not sure whats happ ?Is he trying to figure out if i am t1 or t2 ? i am still in honeymoon period i have been diagnosed 8 months bak? if i am t1 Can bg for t1 be controlled using pills?i have even heard this t1.5 , whats that?

Regards
Singh

[BlueSky]

In answer to your question, no, oral medication won't control T1. It sounds like the doctor now suspects that you are insulin resistant and T2. Taking you off insulin to test this idea seems a bit premature. I would have thought that the first thing to do should be a GAD antibody test. If the result is positive, you are definitely T1 or T1.5.

T1.5 is similar to T1, except that onset is lower and there is still some ongoing natural production of insulin. Insulin still needs to injected, but not as much.

[singh]

well to be honest he did ask me if i got tested for antibodies i said no ,so for now he has taken me off insulin and told me to mintor sugar readings closely and use humalog scaling.But is it possible that person can be wrongly diagnosed as type 1 eventhough he maybe type 2?

[TenderVittleS]

I would get a different doctor. This guy sounds stupid!!

[singh]

why do u think that tender.Actually i was diagnosed in india but now i am in US so i have just started goin to this doc and my treatment has started with him so i guess he is also trying to figure out my body and what its doing.

[BlueSky]

Originally Posted by singh

... But is it possible that person can be wrongly diagnosed as type 1 eventhough he maybe type 2?

Anything is possible. What did your doctor base the initial diagnosis on? If it was a positive result of an antibody test, there can be no doubt that you are T1. If you went into DKA and/or had high blood sugar with ketones, you almost certainly are T1. If the diagnosis was made on the basis of high blood sugar, age and body weight, then yes, you could be T2. Changing treatment without first doing an antibody test seems odd, but presumably your doctor has a good reason for wanting to do this. I would insist on an antibody test first.

[TenderVittleS]

Well first he prescribed you an old mix, the 70/30. Most diabetics have been using Humalog and Lantus for about 10 years now which is much more predictable and more flexible.

I don't understand why he would totally disregard your current doses and say just to correct with Humalog. If your A1c is is almost perfect why would he do that?

Here is the general rule: if you are older and overweight you are probably Type 2. If you are younger and thin you are probably Type 1.

[singh]

well he didnt prescribe 70/30 some other doc did ,he told me to take humalog etc .First thing he asked me was how come i was on so low dose and if i had started on pills initially which i hadnt but he told me let me do some tests of how much insulin level is in my body , so he did and it was 26 while normal no is 2.5-25. so he said for now take out 70/30 and do humalog sliding scale for few days and note readings every 6 hours and adjust using humalog.So maybe he thinks my current insulin level is high eventhough i was using only 10-12 units of 70/30 day.Could i still be inhoneymoon period though i mean i have been dxed 8 months bak only though most people say ur honeymoon period ends arnd 6 months for most

[singh]

problem is i havent got antibody test done till now only tests i have got done are insulin and cpeptide by docs in india.I didnt have DKA either but i might have ketones in blood sugar. this doc is in US and as i am in US now i have got in touch with doc here and he has exp of 30 years but i still dunoo

[BlueSky]

Originally Posted by singh

.... Could i still be inhoneymoon period though i mean i have been dxed 8 months bak only though most people say ur honeymoon period ends arnd 6 months for most

The honeymoon is normally 3-6 months but can last for up to 2 years with T1. And with T1.5, there can be continued insulin production for many years. The high c-peptide test result is an anomaly, but an antibody test would be more conclusive. For more info on this, read the page tendervittles refered to in another thread What Type Of Diabetes Do I Have?.

[TenderVittleS]

What Type Of Diabetes Do I Have?

I recently found this site so it may help you out. It answers alot of questions with a history also. Good luck!!

[singh]

thx guys i might just be t1 or t1.5 but who knows my doc hasnt said anythin to me about if he is thinkin terms of what type i am , i am just makin guess if he is going to put me on pills or thinkin of puttin me on it so i had that thought.Anyways one more thing ur insulin level test does it include insulin being produced by my body or insulin injected by me or both

[mortis505]

Originally Posted by singh

hy people,
i have just come bak from 2nd a1c since diagnosed and its come to be 5.9 so thats good but i also had my insulin level checked and its 26.i am on only 12 units of 70/30 a day.Now when i got diagnosed i was at a1c 15 and insulin level 1.7. my doc now wants me to take off 70/30 for now and check my sugar levels every 4 hours and and do adjustment to sugar levels if needed using humalog.Then later on he will decide if he needs to put me on insulin or diabetic pills like matamorfin.Now i am not sure whats happ ?Is he trying to figure out if i am t1 or t2 ? i am still in honeymoon period i have been diagnosed 8 months bak? if i am t1 Can bg for t1 be controlled using pills?i have even heard this t1.5 , whats that?

Regards
Singh

Singh, is this Dr a GP? I ask because you are on an exogenous insulin and he tested your insulin level.

Bluesky, wouldn't the injected insulin also show up on that as well? Or am I wrong here? A GAD test needs to be performed as part of a proper differential diagnosis.

[singh]

he is a dr for 30 years , ya i guess when i talk to him next or see him next will ask to take my blood sample for GAD test.But surprisingly last whole day i have only taken 2 units of humalog whole day and i have checked arnd 7-8 times a day

[Erin]

Well, I think the change away from 70/30 is a good one. You'll be able to correct much more easily using humalog. I also agree that you really should be seeing an endocrinologist. Some GP's think they can diagnose and treat diabetes, but you really get a much better standard of care by seeing a diabetes specialist. I would ask very politely, but firmly, for a referral to an endocrinologist. Also get the GAD test, and another c-peptide.

If you're type 1.5 (which is, as others have said, the slower onset kind of type 1) you'll burn out your remaining beta cells much faster if you're not taking a basal insulin. You want to keep your existing insulin production for as long as possible, it'll make controlling this disease much easier! So, insist that this doc refer you to somebody who can assist you in getting a firm diagnosis quickly.

Think of the GP as a general contractor. He is familiar with plumbing, electrical work, and carpentry. He's a great guy to call if your back door gets stuck, and you need somebody to sand it down so you can use it easily. He can even fix minor problems like a leaky sink or broken light switch. BUT if you're having a serious issue with your toilet you don't call the general contractor, you call the plumber. The endocrinologist is the plumber. He knows more about the pipes, drains and connectors in the bathroom, because that's all he does. He's an expert on broken toilets. That's the guy for this job.

Excuse the extended metaphor. It's that kind of day.