New and confused as to which type

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ianmacleod

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Type 2
Hello everyone,
I joined last week, but went straight into asking a question about anti-GAD. Realise now that I should have introduced myself here first.

I was diagnosed on 24th April 2012, have had numerous appointments but not sure yet whether I'm type 2, type 1.5 or type 1. Being treated as type 2 (metformin and gliclazide), but saw diabetologist on 3rd May who said I am in between - "what we call type 1.5". But on letter received summarising that appointment, it states that I am type 1!

I am 46, my weight was spot on, but suffered weight loss of half a stone in March, 1 stone since October 2011. BMI 20.8, BP 114/73, Cholesterol 6.2, HDL 1.1, Hb1Ac 12%, creatinine 68, triglycerides 2.9. I am currently on Champix to stop smoking - I've set a quit date for tomorrow 10th June.

I had a blood test for anti-GAD and anti islet cell antibodies on 11th May, but I am still awaiting results.

Finding it difficult to control my BG, and difficult understanding why at times it goes high.

Have to have an ultrasound on my pancreas on Wednesday 13th June.

I keep coming across writings that worry me regarding diabetes complications caused by BGs over 7. I can't control it.

I currently have 5 more appointments lined up. Is the future of life now just going from one appointment to another?
 
ianmacleod said:
Hello everyone,
I joined last week, but went straight into asking a question about anti-GAD. Realise now that I should have introduced myself here first.

I was diagnosed on 24th April 2012, have had numerous appointments but not sure yet whether I'm type 2, type 1.5 or type 1. Being treated as type 2 (metformin and gliclazide), but saw diabetologist on 3rd May who said I am in between - "what we call type 1.5". But on letter received summarising that appointment, it states that I am type 1!
?
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Type 1.5 doesn't exist as an official diagnosis of diabetes in the WHO classification. And it can be very misleading when that term is used. Its slow-onset Type 1 Diabetes.
Unfortunately there is no recognised treatment path for so called "Type 1.5s" to follow. The object is to try preserve as much Beta Cell function ( producing insulin ) for as long as possible. But there are disagreements about how to do that and many slow-onset T1s are given false hopes that their condition can be managed without insulin injections for years to come.
So typically, slow-onset Type 1s paddle through Type 2 palliatives on an experimental basis until things get so bad they need insulin.
IMHO insulin is needed sooner rather than later since that is the only thing that is ultimately going to work.
Ask your Consultant not to use the term Type 1.5 in your presence if he is actually classifying you as Type 1 in your records. Then there can be no confusion,denial or false hope about what type you are.
 
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Welcome Ian. Especially, hope your smoking quit day goes well tomorrow.

Diagnosis as type 1 or type 2 has big influence on some things, particularly prescription of blood glucose test strips (generally more generous for type 1s / insulin users) and treatment in hospital / GP clinics (hospital more common for type 1s).

Regarding numbers of appointments - generally more initially, but once you're sorted on the right treatment, perhaps just once a year, although it depends on how eg retinal scanning is arranged in your area, whether you need to have blood taken before a clinic visit etc.
 
Welcome Ian 🙂

Has your GP or consultant given you a blood glucose meter, because if there is any risk of you being a Type 1 you really ought to have one (and possibly something that can detect ketones as well).

Even if you are a Type 2, the gliclazide you are on can send you low enough to have hypos and therefore you would need to test before driving!

Fortunately the appointments do slow down after a while, but it is a flurry of appointment after appointment when you have just been diagnosed.
 
LOL - in my day you were immediately a hospital in-patient for 3 weeks so you didn't have any appointment till after that !

Timing of appointments can be a pain sometimes but actually, I've usually had cracking realtionships with my 'team' so I kinda look at them as a pleasant afternoon out, chatting to nice intelligent people who seem to be on the same wavelength as me who I can have a laugh with and who I sometimes ask questions of. And they usually have the answers. Never dull.

I go six monthly currently and can contact my DSN at any time (phone. text or email) in the interim. If necessary she always squeezes you in somehwre 'soon' for a face to face - esp if you don't constantly request them and she knows you only do it when you really seem to have a bit of a prob. On MDI it was 12 monthly and ditto. My clinic always like you to have one formal appt with the DSN in between consultant visits. It's no bad thing and makes me feel the NHS really are interested in taking care of me, which is very refreshing.

I think the sooner you get onto insulin the better really from the sound of it and that's most likely what they think too and why you actually have so many all lined up already. You could - of course! - always ask 'em !!!!
 
Hi Mark
Yes, I've got a meter and some ketostix. I've only had 1 hypo so far, but didn't realise why I was shaking - so didn't treat it for upto 1/2 an hour, it took about 45 mins after to lose the shakes.
My main problem is high readings (not majorly high, although a trace of ketones detected only twice) - I understand the target is between 4.0 & 7.0, but I am above this more than 70% of the time.
As the symptom of my hypo was the shakes, will this always be the symptom, or is it likely to vary?
 
Hypo symptoms do vary a bit person to person but not all of us get all of them, IYSWIM. Years ago I also used to feel like I had sweat on the bit between my top lip and my nose; I don't seem to get that any more so perhaps it was a feature of the insulin at the time? Dunno. But yes the shakes, and often as it drops further, seeing spots like I've been looking at the sun.

You'll settle into your own 'normal' pettern of hypo symptoms in your own time. Plus you may get symptoms even when you are above 4, this is a feature when your BG has been running higher for a while, so is known as a 'false' hypo, but actually because the effect on the body is actually the same as a 'real' under 4 hypo, you still need to treat it, but try not to be too aggressive with the carbs. Have you been told 15g of fast-acting carbs, and what do you take for it? I find Lucozade works really well for me and better than glucose tablets, jelly babies etc because I sometimes have difficulty chewing a swallowing when I'm low. However because you are not on insulin yet, you may get away with 10g at the moment.

Usually for me and a lot of people the more violent the symptoms and the more sudden their onset, the faster the BG is dropping. My meter makes me test again after 15 mins, beeps at me unremittingly until I obey LOL I can press a button to make it stop but it's not wise. If it's coming up I'll leave it another 15 and test again, but if it's the same or lower I'll take another 15g fast acting carb until it complies.

You can probably see now why DVLA say if you hypo whilst driving then you must wait until 45 mins after your BG has got above 4 again, before recommencing driving. And you shouldn't even start driving really unless you are 5+ and can be confident you'll stay there.
 
Hi Ian,

Possibly you might end up stuck in the same situation as me - my consultant is fairly sure I'm actually going to be a Type 1, yet I'm currently being treated and doing OK on Type 2 treatment. Give it a few years and I'll suspect they will decide one way or the other.

Have you seen Alan S's Test, Review, Adjust advice? The basic idea has value to both Type 1's and Type 2s'.

Are your high's just after meals or certain times of the day, or just all the time?

Metformin doesn't do anything for post-meal highs and just increases the efficiency of your insulin, meaning you come down a bit overall. Gliclazide causes your body to secrete insulin, but if your pancreas is failing then it will do pretty much nothing.
 
Thank you all for your comments. I've taken it all on board.

I only test before meals and before bed. My highs tend to be more often pre-dinner and pre-bed.
Having had a quick read of Alan S's Test, Review, Adjust advice, it looks like things are likely to get a lot more confusing and complicated if I'm to sort out my high readings.

Also, trophywench said : "Hypo symptoms do vary a bit person to person but not all of us get all of them, IYSWIM." :confused: What does IYSWIM mean?
 
ianmacleod said:
Thank you all for your comments. I've taken it all on board.

I only test before meals and before bed. My highs tend to be more often pre-dinner and pre-bed.
Having had a quick read of Alan S's Test, Review, Adjust advice, it looks like things are likely to get a lot more confusing and complicated if I'm to sort out my high readings.

Also, trophywench said : "Hypo symptoms do vary a bit person to person but not all of us get all of them, IYSWIM." :confused: What does IYSWIM mean?
Click to expand...



If you see what I mean,ian
 
Dare I say, Ooops, sorry! and ROFL ?
 
Thanks to steff and everydayupsanddowns

FWIW I'm LMAO now.

But, I'm not sure how LMAO works per the list of abbreviations, but, what the hell, I'm using it anyway
 
ianmacleod said:
Thanks to steff and everydayupsanddowns

FWIW I'm LMAO now.

But, I'm not sure how LMAO works per the list of abbreviations, but, what the hell, I'm using it anyway
Click to expand...

PMPL............
 
Now you're cheating! PMPL isn't in the list.
Is there another list that can help me, or am I beyond that?🙂
 
😛 a quick search on the web and now I'm enlightened, and I'm still LMAO especially as steff has PMPL! 🙂 not mine, hers
 
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