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Hubby now told he’s type 1 not type 2 Need help understand

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I

Ibby

Well-Known Member
Relationship to Diabetes
Type 2
my hubby just had a diabetic appointment and now their saying he’s type 1 now not type2 . He’s been diabetic since 2013 They want to put him on a rapid acting insulin at lunch as well as his novo mix 30 twice a day can people change from type one to type two.
they want to put something in his arm so he can use a libra app on my phone
to put weight on they say load anything with cheese and put cream in his cereals or on sugar free jelly .
live got him some salt and sugar free peanut butter
 
Ibby said:
can people change from type one to type two
Click to expand...
Not really, and going the other direction is possible (just because you have type 2 that doesn't mean you can't also have the autoimmune condition leading to type 1) but probably not especially common.

But much more commonly it seems to be misdiagnosis: they think you're type 2 because you're older and maybe a bit overweight, but gradually they decide that actually you're type 1. In older people type 1 can develop slowly enough that it's not obvious (it's more common in younger people, and then it usually happens quickly so isn't so easy to miss).

Someone recently posted a couple of links, Differences between type 1 and type 2 diabetes and Type 1 diabetes.

On the positive side, having the right diagnosis should improve the care available.
 
Ibby said:
my hubby just had a diabetic appointment and now their saying he’s type 1 now not type2 . He’s been diabetic since 2013 They want to put him on a rapid acting insulin at lunch as well as his novo mix 30 twice a day can people change from type one to type two.
they want to put something in his arm so he can use a libra app on my phone
to put weight on they say load anything with cheese and put cream in his cereals or on sugar free jelly .
live got him some salt and sugar free peanut butter
Click to expand...
Type 1 diabetes is an autoimmune condition, where the body attacks its own insulin producing cells. You don’t change from one to the other, but a lot of people who develop it later in life (when it tends to develop more slowly), are misdiagnosed as having Type 2, sometimes for years. If he’s Type 1, he needs both long acting and short acting (mealtime) insulin with every meal, which is what they now seem to be giving him. This will help him absorb the carbohydrate from the food he’s eating, and should help him gain weight, and also the suggestions about extra fat with things should help as well.
The Libre sensor will tell you what his blood glucose is doing the whole time, not just when his finger is pricked, and is a really useful tool in the management of his blood glucose levels. You scan it every so often, and it not only tells you what his blood glucose is doing at that moment, but also what it’s been doing since you last scanned it. I use one, it’s a little white disc that sits on your arm (it has a filament that sits just under the skin, but you can’t feel it at all).
 
First off don’t panic ok . With T1 insulin is necessary. Though I must admit that I am a little confused that they want to keep your husband on a mixed insulin as well as a rapid one, so it might be worth a good idea to check up on that.
Now your husband has the correct diagnosis he has a better opportunity of better equipment , such as the freestyle Libre , a sensor on his arm.

Quite a few folks on here were originally diagnosed as T2 me included, basically due to age , lifestyle or a GPs misguided belief that T1 only started in childhood.
Their is also a slow onset type of T1 that occurs in adults , LADA or 1.5
Latent auto immune diabetes in adults, it starts off responding well to T2 management and meds , then these stop working over time, it really is a case of how long is a piece of string , mine took many years .

Ask all the questions you need to ok.

With T1 it is initially a steep learning curve and hubby will need to keep in close contact with
His DSN diabetes specialist nurse at the hospital or his Consultant .
But it will get easier , honest !



But
 
Peanut butter is really nice and should help his weight @Ibby I remember your husband’s blood sugars were high. Hopefully adding the rapid insulin will allow him to get more normal blood sugars and that should help his weight too.

No, you can’t change from Type 1 to Type 2. They’re different conditions. @Bruce Stephens has posted the links I posted before on another recent thread here. They have good basic information. Type 1 is an auto-immune condition. If your husband is Type 1, it might be that he’d be better off moving from the mixed insulin to a separate basal insulin and the rapid insulin at every meal. That would be normal for a Type 1 and would give him better flexibility and control. The rapid insulin can also be used without food to correct high blood sugars. Again, that would be great and should help a lot.
 
Hope your husband’s treatment improves now that he has an accurate classification @Ibby
 
Inka said:
Peanut butter is really nice and should help his weight @Ibby I remember your husband’s blood sugars were high. Hopefully adding the rapid insulin will allow him to get more normal blood sugars and that should help his weight too.

No, you can’t change from Type 1 to Type 2. They’re different conditions. @Bruce Stephens has posted the links I posted before on another recent thread here. They have good basic information. Type 1 is an auto-immune condition. If your husband is Type 1, it might be that he’d be better off moving from the mixed insulin to a separate basal insulin and the rapid insulin at every meal. That would be normal for a Type 1 and would give him better flexibility and control. The rapid insulin can also be used without food to correct high blood sugars. Again, that would be great and should help a lot.
Click to expand...
The diabetic dr at the hospital didn’t say use with out food he just said use at lunch time .I’ve bought peanut butter with now added salt of sugar and no palm oil
 
Inka said:
Peanut butter is really nice and should help his weight @Ibby I remember your husband’s blood sugars were high. Hopefully adding the rapid insulin will allow him to get more normal blood sugars and that should help his weight too.

No, you can’t change from Type 1 to Type 2. They’re different conditions. @Bruce Stephens has posted the links I posted before on another recent thread here. They have good basic information. Type 1 is an auto-immune condition. If your husband is Type 1, it might be that he’d be better off moving from the mixed insulin to a separate basal insulin and the rapid insulin at every meal. That would be normal for a Type 1 and would give him better flexibility and control. The rapid insulin can also be used without food to correct high blood sugars. Again, that would be great and should help a lot.
Click to expand...
The hospital dr didn’t say use it with out food just said use at lunch time he hasn’t said what dose to use he’s rining next week . The diabetic unit are keeping a close eye on him what’s basal insulin do you have to carb count as I don’t think I would be able to for him .
the peanut butter is no added salt or sugar
 
Bruce Stephens said:
Not really, and going the other direction is possible (just because you have type 2 that doesn't mean you can't also have the autoimmune condition leading to type 1) but probably not especially common.

But much more commonly it seems to be misdiagnosis: they think you're type 2 because you're older and maybe a bit overweight, but gradually they decide that actually you're type 1. In older people type 1 can develop slowly enough that it's not obvious (it's more common in younger people, and then it usually happens quickly so isn't so easy to miss).

Someone recently posted a couple of links, Differences between type 1 and type 2 diabetes and Type 1 diabetes.

On the positive side, having the right diagnosis should improve the care available.
Click to expand...
My husband has never been over weight he was diagnosed in 2013 and was on tablets for a while but then went on novo mix cos it was the only thing for his kidney transplant
 
Ibby said:
The hospital dr didn’t say use it with out food just said use at lunch time he hasn’t said what dose to use he’s rining next week . The diabetic unit are keeping a close eye on him what’s basal insulin do you have to carb count as I don’t think I would be able to for him .
the peanut butter is no added salt or sugar
Click to expand...

Using the rapid insulin to correct high blood sugar would be something possible for the future. Basal insulin is a slow background insulin that keeps the blood sugar in range in the absence of food. You then use the rapid insulin (which is called bolus insulin) to deal with meals. In people without diabetes, the body trickles out tiny amounts of insulin day and night - we use the basal/slow insulin to try to mimic that. The body then releases bigger lots of insulin to deal with meals - we use the rapid/bolus insulin to mimic that.

Yes, ideally you should carb count in some way. The body automatically releases enough rapid insulin to deal with food, but when you have Type 1 you have to work out what would be the right amount. You do that by seeing how many carbs in the meal. Although it sounds hard, it’s not. It’s just because you probably haven’t ever bothered with looking at carb info before. You can look at a box of cereal if you have one. You can see the carbs listed there. A carton of milk will have carbs on too, as will pretty much all packaged food. It sounds daunting but it’s honestly not. Because of your circumstances, you might just be given some general pointers to start with.

I know this must all be added stress but think of it as a positive thing. You have the support of the diabetes unit.

The peanut butter sounds fine. I often eat a teaspoon or two out of the jar. I love it.
 
Inka said:
Using the rapid insulin to correct high blood sugar would be something possible for the future. Basal insulin is a slow background insulin that keeps the blood sugar in range in the absence of food. You then use the rapid insulin (which is called bolus insulin) to deal with meals. In people without diabetes, the body trickles out tiny amounts of insulin day and night - we use the basal/slow insulin to try to mimic that. The body then releases bigger lots of insulin to deal with meals - we use the rapid/bolus insulin to mimic that.

Yes, ideally you should carb count in some way. The body automatically releases enough rapid insulin to deal with food, but when you have Type 1 you have to work out what would be the right amount. You do that by seeing how many carbs in the meal. Although it sounds hard, it’s not. It’s just because you probably haven’t ever bothered with looking at carb info before. You can look at a box of cereal if you have one. You can see the carbs listed there. A carton of milk will have carbs on too, as will pretty much all packaged food. It sounds daunting but it’s honestly not. Because of your circumstances, you might just be given some general pointers to start with.

I know this must all be added stress but think of it as a positive thing. You have the support of the diabetes unit.

The peanut butter sounds fine. I often eat a teaspoon or two out of the jar. I love it.
Click to expand...
I’m confused the dr at the hospital unit didnt say any thing about carb counting and in now confused what he wants me to do for hubby with the rapid insulin he just said they would start him on it at lunch time to bring Down his levels down out the late teens and early twenties.I hope I dont have to carb count for my hubby as that would mean me watching every thing he eats and im not with him every day as he goes to day care at our local hospice. He’s ringing on Thursday to see what his 4 times a day bloods are so will as a bit more if he dosent tell me . This sounds more complicated then his twice day norvo mix 30
 
Don’t worry @Ibby It might just be as simple as being aware of the carbs not actively counting them eg serving up a similar amount of potato when/if he has it.
 
type 1 has the antibodies in high titre most commonly GAD65 sometimes islet cell antibodies can occur at any age but classically younger, although half occur in adults, usually rapid onset, strong genetic component as much more common than expected in (particularly identical) twins. needs basal bolus insulin ideally.
type 1.5 has the antibodies in variable usually lower titre than classical rapid onset type 1 typically adults over 30, very often misdiagnosed as type 2 as has a slow onset, can be many years depending on the antibody titre, will need insulin eventually. our previous PM, Theresa May is an example of someone initially thought to be type2 but who turned out to be LADA, type 1.5.
Both types are associated with other organ-specific autoimmune disease eg Thyroid disease, both Graves hyperthyroidism and Hashimoto's hypothyroidism, pernicious anaemia, coeliac, Sjogren's, Addison's either in the patient or in close family members,

type 2 no antibodies, often lifestyle factors such as central abdominal adiposity, but not always, tend to be older adults, some genetic component as more common with a family history, more common in males, associated with insulin resistance, body produces insulin at the outset but doesn't react to it initial treatment diet if obese. Diet, exercise, weight management, oral antidiabetic agents metformin, SU, GLP1, SLGT, insulin eventually and often requires high doses.
 
Please don’t worry about the carb counting and adjusting the insulin accordingly. That may come later , first off they will be trying to gradually reduce his BG levels , so he will be on fixed doses of insulin for awhile , which they will gradually keep adjusting .
You may well find that the mixed insulin will be changed to a Basal (background insulin)

You and your husband will not be expected to learn and be experts in five minutes flat , that’s why initially they do all the tweaking of doses . If your husband goes onto MDI , that’s the Basal and a separate mealtime insulin, he will be eventually offered a course called DAFNE , dose adjustment for normal eating, where they teach you how.

I know this all sounds very complicated right now but you will get there honest!
 
Ljc said:
Please don’t worry about the carb counting and adjusting the insulin accordingly. That may come later , first off they will be trying to gradually reduce his BG levels , so he will be on fixed doses of insulin for awhile , which they will gradually keep adjusting .
You may well find that the mixed insulin will be changed to a Basal (background insulin)

You and your husband will not be expected to learn and be experts in five minutes flat , that’s why initially they do all the tweaking of doses . If your husband goes onto MDI , that’s the Basal and a separate mealtime insulin, he will be eventually offered a course called DAFNE , dose adjustment for normal eating, where they teach you how.

I know this all sounds very complicated right now but you will get there honest!
Click to expand...
his bloods this morning were 6.8 that's withthe higher insulin dose the nurse gave him
 
That’s fine.
 
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