[IP] RE: Well, who knows if I'll get a pump....
>Actually, a C-peptide test will not answer whether someone has type 1 or
>type 2, it is only a measure of their level of endogenous insulin
>production. It is true that most type 1s have little if any endogenous
>insulin production by diagnosis (even during the honeymoon period, the
>C-peptide levels are below normal). However, type 2s may have elevated
>levels resulting from insulin resistance, normal C-peptide levels, or
>negligible levels, depending on their duration with the condition.
>Tests include autoantibodies to islet cells (ICA), antibodies to insulin
>(IAA) and glutamic acid decarboxylase autoantibodies (GAD Ab) are very
>typical, and they will often accompany a C-peptide test as well. ICAs
>are present in 80% of newly diagnosed type 1 patients, but are not
>present in any type 2 patients. ICA, GAD Ab and IAA do not appear all at
>once, but at random, varying rates depending on the individual patient.
>Therefore, an entire battery of tests would really need to be done to
>determine if someone has type 1, type 2, LADA, or some combination.
Which (if any) of these will give information on the type of diabetes
in a person diagnosed 35 years ago? At the time I was diagnosed I
fell in the crack between juvenile-onset and adult-onset age ranges.
I assume type 1 because I did not respond to oral medications when
they tried them, my TDD is below what Walsh's table 9.1 would suggest
for my weight, but I can hit a BG of 300 in hours off a pump (or on
one, If I've just changed sets--i.e., I am quite sensitive to both
insulin and carbohydrates which it seems to me argues against insulin
resistance.) Very few boluses above 5; the last one was for
Thanksgiving dinner (6.4 including two pieces of pumpkin pie, the
second because I started to go low.) No problem now, but my
excellent insurance will become secondary to Medicare before long,
and I want to have all my ducks in a row before then.
Sue Ann Bowling, North Pole, Alaska
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