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Re: [IP] Tye I or Type 2

A. Bender, M. D. wrote:
> In my experience Many type 2 diabetics develop islet cell failure and
> become type 1. In order to determine if it is auto immune you need to do
> anti GAD-65 antibodies.

That's the whole point. If they have antibodies, whether GAD, or ICA or
whatever, they're Type 1, and they were ALWAYS Type 1. They were NEVER
Type 2, even though they were misdiagnosed as such. Their diabetes may
have developed more slowly than in children, but that doesn't mean they
were ever Type 2. 

According to the diagnostic criteria of the ADA, Type 1 is auto-immune
destruction of the beta cells. Type 2 is pancreatic insufficiency
combined with insulin resistance. 

There are also OTHER Types, such as secondary diabetes as a result of
pancreatectomy or cystic fibrosis -- these people have to be treated
with insulin, but they aren't truly Type 1, because their diabetes is
not the result of autoimmunity. 

It's very frustrating to those of us who are neither one nor the other
for others to try to force us into one category or the other, because it
may lead to poor treatment decisions, and unnecessary bureaucracy. I'm
becoming increasingly attracted to the idea that diabetes is diabetes,
and you treat according to how the patient responds -- yes, there are
diagnostic clues in many cases, but every once in a while, someone will
confound you! 
 ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- ._c- 
 Natalie A. Sera, with all her ducks in a row!
 Type Weird, pumping!
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