[IP] really type 1
I don't usually respond to these, but this one was so annoying!
You are type I (aka "juvenile diabetes"; aka "Insulin-dependent diabetes") no
matter WHAT age you are at diagnosis if you have immune mediated failure of the
pancreas. This means that your body has made antibodies to the pancreas and has
destroyed it. Insulin levels are LOW. There is a HLA association; and 10% of
relatives of type I's will also have diabetes. I am type I. I was diagnosed at
age 25. I test positive for the anti GADA antibody. My dad is type I, diagnosed
in his 30's. My cousin, also a type I was diagnosed at age 4 yrs. All of us are
and were skinny, and presented with fatigue, polydipsia, polyuria. (insulin
-to-carb ratios are low, like 1:13 for my dad, 1:15 for me)
Yes, I am relatively glad I was diagnosed as an adult, and I don't understand
what it's like to be a child with diabetes. That doesn't negate the fact I do
have the disease.
Type II (aka Non-insulin dependent diabetes) involves insulin resistance. Type
II's initally have a functioning pancreas. However, their tissues are relatively
insulin-resistant, meaning it takes more insulin than normally to move glucose
into the cells. Insulin levels are HIGH (initally). Insulin to carb ratio's are
high (meaning it takes more insulin to cover fewer carbs) So, sometimes, weight
loss or oral medications can adequately treat type II. But, after a while, the
pancreas often "poops out"--it's tried so hard to produce more and more insulin
that it finally quits working altogether (or as well, anyway). In this instance,
insulin levels are low, and the person now needs to give himself insulin.
Usually, the insulin requirements for type II's are much higher than type I
(because of the insulin-resistance). Just because they now take insulin, these
patients are NOT type I's. To make things even more confusing, type I's can
develop insulin resistance and deve!
lop type II like features. This is most often (but not always) with obesity.
These are the textbook answers...but as we all know (or should realize!!!)
patients "don't always read the books", meaning that diseases don't always act
exactly the way medical personal think they "should". In the real world,
patients rarely present with all the "classic" or "textbook" features; these
descriptions are the most likely characteristics (young, ketoacidosis,
polydipsia, polyuria) but not the only possible features (perhaps onset at age
25, when you least expect it, and it forever changes the course of your career
The bottom line is that we all have a disease that we don't want, type I, II,
gestational, you name it, and it requires our constant attention and saying "you
don't have my disease because you haven't had it as long as i have" doesn't
contribute to anything constructive, in my opinion. Also, just because one is a
medical professional (I'm a doc) doesn't make one an expert on diabetes. The
person who has excellent control and has had the disease for a long time does
make that person an expert. I know an engineer who's had DM for decades, and has
an A1C of 5; he knows much more practical info than any doctor I know. YMMV.
>My philosophy is, you are not really a Type 1 (former juvenile diabetic)
> unless you were diagnosed as a child. If you haven't been a child
>dealing with diabetes, I don't care what the medical community calls it,
>are not really a Type 1. Unless you have walked a mile in my shoes,
> think you know what juvenile diabetes is. I personally think that there
>a new classification. Maybe insulin requiring Type 2 would be more
> appropriate, and in fact as I am a RN and review charts for a living, I
>doctors really call it that. Perhaps the ADA should formally change the
> classifications as many doctors do it anyway. Just wanted to get this
>it had bothered me for a long time.
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