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Appointment

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D

Doddy

Well-Known Member
Relationship to Diabetes
Type 1.5 LADA
My GP called me this morning..have an appoinment to see her at 10.40 Hoping and praying she has a plan for me!
At my retinopathy appointment yesterday, the nurse I saw was a bit shocked at my figures!
 
I'm not surprised! I hope that the appointment goes well and that you can get some appropriate treatment. I am wondering if you have been misdiagnosed and are possibly a slow onset Type 1. Gliclazide won't work if your pancreas can't respond to it by producing more insulin.
 
is there a way to know if it's late onset rather than t2?
 
I am so pleased you are getting to see someone Doddy - i hope you get the info / treatment you obviously need.

They have talked to me about late onset type 1, due to my age (apparently I'm a youngster for type 2) and my weight being relatively ok (bmi 26) they still can't decide. The addition of insulin to my treatment has seen the best improvement. It may sound silly but i'm quite looking forward to increasing the dose, and perhaps introducing the fast acting insulin at mealtimes, to get even better control. I certainly feel better in myself but can't quite decide if thats psychological or not - dont really care to be honest - just enjoying feeling a bit more human!!!!

I hope you get started on a treatment today that brings your levels right down - please believe me you will feel better!!!

Good luck and keep us informed!!!
 
Yes there's two tests that can give a clearer picture..

C-Peptide test and the GAD test..

C-Peptide is generally the one the will do first as it's checks actual insulin levels, and the GAD is quite an expensive test and the results can be tainted if insulin therapy has been started..

But if your GP isn't finding the right medication/therapy to control your levels, they should be referring you to the consultant, so perhaps ask to be referred
 
I asked my nurse on Monday if they could tell how much insulin your pancreas was still producing (which i assume is what the tests below would do pretty much) - she advised they wouldnt check? Still, as she was starting me on insulin anyway, i suppose she might have meant that the test would be flawed so they wouldnt get a real result.

The different things we are told around the country are amazing!!!
 
Emmaathome said:
I asked my nurse on Monday if they could tell how much insulin your pancreas was still producing (which i assume is what the tests below would do pretty much) - she advised they wouldnt check? Still, as she was starting me on insulin anyway, i suppose she might have meant that the test would be flawed so they wouldnt get a real result.

The different things we are told around the country are amazing!!!
Click to expand...

The C-Peptide test would show how much insulin of your own you were producing. C-Peptide is produced in equal quantities to insulin as it is one 'half' of proto-insulin (put simply!) - injected insulin does not contain C-Peptide. By measuring the amount of C-Peptide, therefore, they can tell how much insulin you are producing.

I'm in a similar position really, but they won't test me for it because it wouldn't change anything about my treatment which is working well. I am clearly still producing insulin 4 years on as I recently stopped needing basal (lantus) altogether - I was on 20 units when I was diagnosed!
 
I wonder if thats why they dont bother - they are treating me anyway, so i suppose it really doesnt make much difference!
 
Ok. The metformin has been increased to 2000mg a day, and Gliclazide has been stopped, and instead I have been put on 2mg of Glimipiride.
GP wants me to email her my figures over the weekend to see how I am getting on. If there is no change, she will start insulin :(

I had a blood test...the nurse said it was a GAD test, and that she had never heard of it! So what will it do!?

AND...I got strips prescribed! The GP told me "oh gosh, no you don't need to pay for them, we give them to you", yet she was the one whol told me not to bother testing! haha!!!
 
The GAD test tests for antibodies which can indicate whether your diabetes is due to an autoimmune attack on the beta cells of your pancreas. If this is the case, you will be a Type 1 or Type 1.5 (slow-onset Type 1) rather than a Type 2. It's good to hear that they are investigating this - some people can go for months or even years before such tests are performed 🙂 Good to hear you're now getting the strips prescribed too, silly GP! 🙂
 
It does feel like this is the last ditch attempt to get this under control before we take the plunge and enter the world of injections etc.

Will the GAD test give me an idea as to what my pancreas is doing?
 
Doddy said:
It does feel like this is the last ditch attempt to get this under control before we take the plunge and enter the world of injections etc.

Will the GAD test give me an idea as to what my pancreas is doing?
Click to expand...

I think it's normally done in conjunction with a C-Peptide test (but not sure), so GAD will show whether your diabetes is likely to be autoimmune and the C-Peptide what your pancreas is doing. 🙂 I know a few of our members have had it done so they will know more than me 🙂
 
I had the GAD test done and the Urine C-peptide test (this is different to the normal test, and more limited in what it tells you).

My GAD wasn't technically negative, but wasn't positive either 🙄 From what my consultant told me was that it is possible to be Type 1 even if your GAD is negative. There are about 6 or 7 different types of antibodies known but there are apparently only clinical tests for 2 of them.

Glimipiride is still a Sulfonylurea the same as Gliclazide, just a stronger one!
 
Thanks for the replies 🙂

Oooh good to hear glimipiride is stronger...fingers crossed it works!

Is the GAD test important in determining which meds will work?
 
Doddy said:
Thanks for the replies 🙂

Oooh good to hear glimipiride is stronger...fingers crossed it works!

Is the GAD test important in determining which meds will work?
Click to expand...

I would imagine if it shows you are a slow onset Type 1 then insulin will be the medication of choice 🙂 Don't be frightened by the thought of insulin by the way, it is a very different form of treatment to most Type 2 oral medications but it can give you great flexibility and control 🙂
 
Insulin may also end up being the choice even if type 2. But, its such a positive thing that they are now sorting you out, I wouldnt worry too much about what may happen next week.

Fingers crossed for you that the levels start to come down over the weekend!!!
 
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