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Type 1 or Type 2…Confused!

Categories: Diabetes Type

Question:

=I have been diagnosed with diabetes about 1 1/2 months ago.  Let me give you =some background before I ask the question: = =* My grandmother is a Type 2.  She uses diet and exercise only to control her =levels. = =* I am a male, age 29 and my weight is currently 140 lbs. (was 150 before the =continuous urination). = =* Treatment thus far has been the following: = =Period         Medication              Fasting Level           Notes = =1st week       Glipizide (20mg)        350-400                 Dr.1 recommends =                                                               insuline, but =                                                               I want a 2nd =                                                               opinion. = =2nd week       Glipizide (20mg)        290-350                 Dr.2 tries =                       +                                       Glucophage, but =               Glucophage (1000mg)                             is skeptical. = =3rd week       Glipizide (20mg)        250-300                 Dr.2 is shocked =                       +                                       by progress. =               Glucophage (1000mg)                             Doubles dose =                                                               for Glucophage. = =4th week       Glipizide (20mg)        200-270                 Dr.2 wants to =                       +                                       give it 1 more =               Glucophage (2000mg)                             month. = =Now            Glipizide (20mg)        110-135                 He’ll be happy =                       +                                       when I see him =               Glucophage (2000mg)                             this time! = =As you can see, by watching my diet, taking my medication and exercising I was =able to bring my blood levels from +300 down to approx. 110.  Both doctors =believe me to be a Type 1 because of my blood levels and the fact that I am =as thin as a toothpick. = = =QUESTION:  Am I now considered to be a Type 2 for the simple fact that my =          levels are being controlled without the aid of insuline? It’s hard to say.  You could be a Type I whose onset hasn’t progressed to the point where you absolutely require exogenous insulin; you could be a Type I in the honeymoon phase (a phase experienced by many Type I diabetics in which the diabetes, once brought under control, can be controlled for a time without insulin injections).  Or you could be a Type II who took over a month to get his blood sugar levels under control with oral hypoglycemics, diet, and exercise. =          Had Glucophage not been invented, would I be a possible Type 2 on =          insuline? That’s a possibility.  Were you injecting insulin and comfortable with that, I’d say there isn’t much reason to worry about whether you’re Type I or Type II.  However, since you’re taking oral hypoglycemics, the question of whether you’re Type I or Type II may be of considerable importance:  There’s some evidence that injecting insulin slows the onset of Type I diabetes.  I.e., you’re a diabetic with at least some beta cells still functioning; if you’re a Type I, then injecting insulin now may delay the time at which you’ll find yourself with no (or virtually no) beta cells left.  Why can this be important? Well, the purpose of injecting insulin is to get your circulating insulin level to within a range where your body’s own feedback mechanisms can control your blood sugar well enough to keep it within more or less reasonable limits.  The more limited your body’s feedback mechanisms, the narrower the range of exogenous insulin dosage required to allow good control.  If you can keep SOME beta cell function, it’s easier to achieve tight control than if you’ve got NO beta cell function, and the DCCT indicates that tight control tends, on average, to reduce or delay diabetic complications.  So if you’re actually a Type I diabetic, you MAY be trading the convenience of using oral hypoglycemics instead of injecting insulin now for possibly years of more rigid insulin requirements sometime in the future. As with so much about diabetes, whether or not insulin is more appropriate than oral hypoglycemics is something that needs to be dealt with  on a case-by-case basis, of course, but I thought the above information might be of interest to you. I  try  very  hard  to say exactly what I mean.  I’d appreciate it if you’d bear that in mind and not try to "interpret"  my  posts  to  fit  your  own preconceived notions if I’m posting in a serious thread.  Remember:  If you throw a strawman into a heated debate, flames are likely to be the result.

Response:

I am a nurse who has diabetes and works on a diabetes unit in a hospital. The Diabetes Educator on our unit describes type 2 as those who make insulin but there is a  decreased  response of the receptor sites on cells to insulin.  This makes it harder for glucose to get into the cells, thus increasing blood glucose levels.  Type 2’s can live without taking insulin (i.e. they take oral antidiabetic medications or control with diet and exercise).  Some type 2’s end up having to supplement with insulin.  Type 1 diabetics must take insulin to live.  Their pancreas does not produce any ( or in the beginning it may produce a little and then eventually stop).  If they don’t take insulin the body "starves" and the person ends up in diabetic ketoacidosis or a coma or die if it gets that far. Hope that helps, Good Luck.

Response:

- Hide quoted text — Show quoted text – Hi everyone, I have been diagnosed with diabetes about 1 1/2 months ago.  Let me give you some background before I ask the question: * My grandmother is a Type 2.  She uses diet and exercise only to control her levels. * I am a male, age 29 and my weight is currently 140 lbs. (was 150 before the continuous urination). * Treatment thus far has been the following: Period             Medication              Fasting Level           Notes 1st week   Glipizide (20mg)        350-400                 Dr.1 recommends                                                            insuline, but                                                            I want a 2nd                                                            opinion. 2nd week   Glipizide (20mg)        290-350                 Dr.2 tries                    +                                       Glucophage, but            Glucophage (1000mg)                             is skeptical. 3rd week   Glipizide (20mg)        250-300                 Dr.2 is shocked                    +                                       by progress.            Glucophage (1000mg)                             Doubles dose                                                            for Glucophage. 4th week   Glipizide (20mg)        200-270                 Dr.2 wants to                    +                                       give it 1 more            Glucophage (2000mg)                             month. Now                Glipizide (20mg)        110-135                 He’ll be happy                    +                                       when I see him            Glucophage (2000mg)                             this time! As you can see, by watching my diet, taking my medication and exercising I was able to bring my blood levels from +300 down to approx. 110.  Both doctors believe me to be a Type 1 because of my blood levels and the fact that I am as thin as a toothpick. QUESTION:  Am I now considered to be a Type 2 for the simple fact that my       levels are being controlled without the aid of insuline?  Had       Glucophage not been invented, would I be a possible Type 2 on       insuline? Any input would be greatly appreciated. Thanks again…adios from sunny Tucson Arizona!

At this point and time, we don’t know.  I’m suprised that your doctors, believing you are type 1 have agreed to treat you as type 2.  If you are indeed type 1, your medication will increasingly become ineffective as the remainder of your Islets are destroyed.  It may be that the Glipizide and Glucophage are helping you produce insulin with the remainder of your islets.  But, if you are type 1, I would think that your islets are under greater stress and will be destroyed more rapidly than if you were placed on insulin and your natural insulin production requirements were lessened. I am not an M.D. and defer to your physicians re your treatment.  Time will tell as to how you will be classified if classification is all that important.  The crucial issue is maintaining good control whether type 1 or type 2. Orville R. Butler

Response:

Hi everyone, I have been diagnosed with diabetes about 1 1/2 months ago.  Let me give you some background before I ask the question: * My grandmother is a Type 2.  She uses diet and exercise only to control her levels. * I am a male, age 29 and my weight is currently 140 lbs. (was 150 before the continuous urination). * Treatment thus far has been the following: Period          Medication              Fasting Level           Notes 1st week        Glipizide (20mg)        350-400                 Dr.1 recommends                                                                 insuline, but                                                                 I want a 2nd                                                                 opinion. 2nd week        Glipizide (20mg)        290-350                 Dr.2 tries                         +                                       Glucophage, but                 Glucophage (1000mg)                             is skeptical. 3rd week        Glipizide (20mg)        250-300                 Dr.2 is shocked                         +                                       by progress.                 Glucophage (1000mg)                             Doubles dose                                                                 for Glucophage. 4th week        Glipizide (20mg)        200-270                 Dr.2 wants to                         +                                       give it 1 more                 Glucophage (2000mg)                             month. Now             Glipizide (20mg)        110-135                 He’ll be happy                         +                                       when I see him                 Glucophage (2000mg)                             this time! As you can see, by watching my diet, taking my medication and exercising I was able to bring my blood levels from +300 down to approx. 110.  Both doctors believe me to be a Type 1 because of my blood levels and the fact that I am as thin as a toothpick. QUESTION:  Am I now considered to be a Type 2 for the simple fact that my            levels are being controlled without the aid of insuline?  Had            Glucophage not been invented, would I be a possible Type 2 on            insuline? Any input would be greatly appreciated. Thanks again…adios from sunny Tucson Arizona!

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