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RE: [IP] Autoimmune Diseases Diabetes Type 1



Hi Joy,

 > how do you know which you are, between 1,
 > 1.5 and 2?

In principle, you can check whether there are islet-cell
antibodies, and which types. If memory serves, a "pure" type one
will have Gad65 and Gad67; a l.5 will only shoe Gad65 (this is
from fallible memory -- my reference texts are all boxed up right
now). A type 2 will not have islet-cell antibodies.

A different question is whether one is insulin-dependent. When the
body produces insulin, it first creates proinsulin, which has
three linked chains of amino-acids; these get split, and the A-
and B-chains go forth as insulin, while the C-chain floats around
as "C-peptide". Ergo, for every molecule of insulin that the body
makes, there will be one of C-peptide.

In theory, it is possible to measure insulin levels in the blood
directly. In practice, that is not so useful, because insulin gets
used up (and has a half-life of five or six seconds only).
C-peptide, on the other hand, gets excreted via the kidneys, with
nearly no losses. Thus, a simple check of the morning urine (as an
average of overnight C-peptide production) will reveal a good
indication of endogenous insulin production.

Others (R. Leppanen, for instance) already noted that beta-cell
exhaustion in type 2 diabetics makes them insulin-dependent but
not type 1. To that I just want to add that while conversion from
type 2 to type 1 is rare (it takes something like acute
pancreatitis as trigger, followed by an over-the-top reaction of
the immune system), there are plenty of "type 3s" -- a shorthand
for type 1s with added insulin resistance (type 1+2, ergo 3).

Cheers,
Felix.
.
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