Unusual T2

[Jennyninja]

Hello there! I'm T2 for nearly 13 years currently on Metformin and Alogliptin. I'm unusual in that I'm 7.5 stone, very active and strict with my diet yet control is not good. I'm due to see a specialist next week. Anyone else out there similar ? It's quite lonely being 'atypical '.

 

[Inka]

Have you had tests to rule out Type 1? Far too many adults are misdiagnosed as Type 2 when they’re actually Type 1. Type 1 can come on more slowly in older adults.

 

[Jennyninja]

I've had C peptide. Did another one a couple of weeks ago. Should have that result when I have my appt. What type are you Inka ?

 

[Inka]

I've had C peptide. Did another one a couple of weeks ago. Should have that result when I have my appt. What type are you Inka ?

I’m Type 1 🙂 Have they not done the Type 1 antibodies test too? That’s usually done alongside the C Peptide when there’s a doubt about Type or something odd about presentation.

 

[Jennyninja]

Not.this time around but had them about 18 months ago. Thanks for the question. I'll ask it. Got to walk the dog now Inka. Thanks again

 

[Ljc]

Hi. Their are some folks with T2 who are slim at diagnosis.
Their is a genetic link too .

However I am wondering if you might have LADA ( latent auto immune diabetes in adults) instead. It’s like a slow onset T1 it often initially responds to T2 medications then eventually insulin is needed.
Sometimes the tests for T1 are not conclusive, so it’s good to hear one is being repeated.

Please let us know how you get on

 

[trophywench]

Well the C-pep tells them that can interpret the results, how much insulin is evident - I think and whether that amount is actually of any use to you. Many many T1s still actually produce some insulin themselves well into their old age - but simply not anywhere near enough to serve any useful purpose - except it may be a contributory factor towards avoiding long term 'diabetic' complications; think the jury's still out on the latter. Anyway - hear the bearer of the results out before we all try to second guess a. the result and b. the prognosis !

 

[Jennyninja]

Hi. Their are some folks with T2 who are slim at diagnosis.
Their is a genetic link too .

However I am wondering if you might have LADA ( latent auto immune diabetes in adults) instead. It’s like a slow onset T1 it often initially responds to T2 medications then eventually insulin is needed.
Sometimes the tests for T1 are not conclusive, so it’s good to hear one is being repeated.

Please let us know how you get on

Thanks Lin. I'll ask about LADA and tests next week. I'll keep you posted

 

[Jennyninja]

Well the C-pep tells them that can interpret the results, how much insulin is evident - I think and whether that amount is actually of any use to you. Many many T1s still actually produce some insulin themselves well into their old age - but simply not anywhere near enough to serve any useful purpose - except it may be a contributory factor towards avoiding long term 'diabetic' complications; think the jury's still out on the latter. Anyway - hear the bearer of the results out before we all try to second guess a. the result and b. the prognosis !

Thanks! This is all useful background. As you said, let's see what they say next week.

 

[Jennyninja]

Thanks! This is all useful background. As you said, let's see what they say next week.

 

[everydayupsanddowns]

We have a few on the forum who were diagnosed initially largely on the basis of age, and then reclassified when it became clear that they were a different shade of diabetes.

We’ve also a few glamourous niche types like LADA, MODY, CF, and 3c to add some extra flavour, alongside some confirmed T2s who just don’t fit the standard model (eg TOFI, thin outside, fat inside).

So whatever box you end up having a tick put in, you’ll be in good company here 🙂

 

[Jennyninja]

We have a few on the forum who were diagnosed initially largely on the basis of age, and then reclassified when it became clear that they were a different shade of diabetes.

We’ve also a few glamourous niche types like LADA, MODY, CF, and 3c to add some extra flavour, alongside some confirmed T2s who just don’t fit the standard model (eg TOFI, thin outside, fat inside).

So whatever box you end up having a tick put in, you’ll be in good company here 🙂

Thank you so much Mike. For the first time in nearly 13 years I don't feel out on a limb gnashing my teeth at people who stereotype type 2s or try to over simplify diabetic people in general. Why didn't I join this forum before? Better late than never eh
and I think the timing is great, as I am about to get investigated again

 

[Jennyninja]

Update for you kind people who responded to me previously: I had a GAD blood test and the diabetes nurse called me to say I am definitely T1. I'm seeing her this morning for a face to face to get started on basal and bolus insulin. I feel apprehensive about how precise I will need to be to do it properly and stay well. However my overwhelming feeling is relief that at last I've been properly diagnosed and I'm in the right category, if that's the right term, rather than not fitting anywhere. Thanks for your support. I expect I'll have more to share/seek advice /opinions on after today .

 

[Inka]

Phew @Jennyninja . I’m always relieved when somebody finally gets the correct diagnosis. I know it must be a shock but knowing will help you so much and mean you get the correct treatment. It’s not you - it’s them. You should have been correctly diagnosed before.

Yes, basal/bolus means a bit of calculating and thinking, and it’s important to say that it’s not always a precise art. So many outside things can affect our blood sugar.

 

[trophywench]

Phew @Jennyninja . I’m always relieved when somebody finally gets the correct diagnosis.

Yes, basal/bolus means a bit of calculating and thinking, and it’s important to say that it’s not always a precise art. So many outside things can affect our blood sugar.

Hear hear - and of course the folk that deal with T1 day to day know blooming well it ain't a precise art and are usually a deal more helpful and friendly because of that ! People I defo want on my side, thanks very much.

 

[everydayupsanddowns]

Update for you kind people who responded to me previously: I had a GAD blood test and the diabetes nurse called me to say I am definitely T1. I'm seeing her this morning for a face to face to get started on basal and bolus insulin. I feel apprehensive about how precise I will need to be to do it properly and stay well. However my overwhelming feeling is relief that at last I've been properly diagnosed and I'm in the right category, if that's the right term, rather than not fitting anywhere. Thanks for your support. I expect I'll have more to share/seek advice /opinions on after today .

Thanks for the update @Jennyninja - and glad you have a confirmed classification now. That should make your diabetes management much easier in the long run, because you will have access to the right tools.

My gentle suggestion would be to aim for ‘reasonable guesswork’ rather than expecting precise diabetes maths to always behave impeccably and reliably. Up to a point the more accurate you are with your carbohydrate estimation and dose adjustment the better, but at exactly the same time you will soon learn that the same meal eaten at the same time of day with the same dose will not always give you the same results. Because there are a lot more things in play than just dose and carbs.

If you take the time trouble and effort to calculate everything meticulously to the last half gram, this would be very frustrating and make the whole process seem pointless.

If on the other hand you are happy to put some early work in and blend a bit of precision and weighing with some estimating and guesswork it will be more sustainable long term, and allow you to be freer with using your experience and gut feeling.

 

[Jennyninja]

Thanks Mike. And everyone who has responded. Sound advice. I would not be exaggerating by saying the last couple of days have been somewhat fraught with getting to grips with the new gear, weighing and counting carbs and expecting to keel over after each insulin injection ! I've been started off very conservatively but BGs are still pretty high (also the fraghtness contributing?) So I'm hoping the insulin can go up and I can start to learn to flex it in relation to activity etc.

 

[Ljc]

Try not to worry. They start off conservatively for a few reasons
1. It’s not good to bring your levels down quickly, as tis can cause eye problems, which are usually temporary. But nit alway so.
2. It can cause false hypo’s, this is where your levels are often well above 4.0
3 . Though they have a formula to go by , they don’t really know how much insulin you actually need, as we are all different in this respect .
So do keep in close contact with your DSN as initially much tweaking us required.

In the not so distant future they will teach you how to carb count and match your insulin to carbs.this too is not an exact science as diabetes seems to have a mind of it’s own .

I know you won’t believe it right now, but it does become quite routine.