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Willywoo28

Please help alleviate the confusion

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Willywoo28

Hello!

 

i was recently in the hospital for a week with Ketoacidosis, BG 600+ and hypokalemia.  After 4 days my sugars were “regulated” and I was put on an insulin regimen of 16u humalog pre-meal and 46u of Tresiba at bedtime.  

 

I had had never had DKA before, and 6 months ago my A1c was at 5. This was an unwelcome surprise. 

 

The Endo in the hospital said i was a 1.5 with insulin resistance.  My C-peptide was at 3.7 and GAD was tested at <5. When I went to the Endo’s office I met with his partner and she said I was T2 with insulin resistance, only because of my family history, and she glossed over the GAD and won’t re-test it, or for any other antibodies.  She was certain she had the correct diagnosis. And even told me that I should just see her partner and not her. 

 

Now I feel so much better on the insulin. My waking BG is around 120, and my 2 hour post meal check is around 100, and pre meal check is usually around 90.  I am afraid to deviate from my insulin.  

 

Has as anyone else had a sudden onset with “conflicting” diagnoses?  

 

I have finally resigned that that the treatment, as long as it is working is better than a “title”.  But I just need to finally know. 

 

Thanks for for your input and feedback 

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adiantum

Hi Willywoo, Welcome to the forum.

Wow you have been sick havnt you.. I'm glad your feeling better now.

I'll have to look further into the GAD & C-peptide readings as I'm Type2 with insulin resistance although others  might  arrive sooner.

 

I hate conflicting diagnosis

 

This is all I found in a hurry but will look further.

 

" C-peptide is a peptide composed of 31 amino acids. It is released from the pancreatic beta-cells during cleavage of insulin from proinsulin. It is mainly excreted by the kidney, and its half-life is 3-4 times longer than that of insulin.

The reference range of C-peptide is 0.8-3.1 ng/mL (conventional units), or 0.26-1.03 nmol/L (SI). [1]

 

 

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meyery2k

Willywoo - Welcome!  I am sure someone with similar experience will post about this.  I am Type 2 but there are some posters here that struggled with diabetes believing they were type 2 and then finding out they were type 1.5

 

Stick around, you will find no better advice than you will here.  ~ Mike

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JohnSchroeder

Hi and welcome!  I feel like I should put a huge neon sign up that says "I"M NOT A DOCTOR"... so take this with a grain of salt..

 

Ketoacidosis occurs when there is none or not nearly enough insulin in the body.  When the sugar level of a T2 diabetic goes high they generally have a huge excess of insulin.  So the very fact that you went into DKA tells me its T1.5.  Your pancreas just isn't producing insulin.

 

I also don't have handy a reference chart for the C-peptide and GAD antibody tests... but those are pretty black and white.  If they are not in range, it pretty much says your antibodies are attacking your beta cells in the pancreas.  Hence 1.5.

 

That does not mean that you could not ALSO have insulin resistance from a family history of T2.  Re-reading your post, it seems that is exactly what the endo in the hospital was saying.  T1.5 with insulin resistance.

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Willywoo28

Thank you for Kind words John.  That is what I was leaning towards myself.  The diagnosis process from what I have been researching is a rather tangled web, that at times I don’t think the dr’s are 100% certain, and end up treating for the best course possible.   

 

Right now I am doing good on insulin, so I think we have a good road ahead.  Just not looking to a honeymoon phase....    

 

thanks again! 

 

Will

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JohnSchroeder

Eh, honestly you'll probably have better control when the so-called honeymoon phase ends.  Which it may have already if you went into DKA.

 

The honeymoon phase is when your body is somewhat producing insulin... which seems like a variable you can't predict or control.  IMO it would interfere with you learning the appropriate insulin dosages.

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