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Re: [IP] Insurance and your rights

At 01:53 PM 6/25/02 -0700, you wrote:
 >Hi Bobbi! I have an honest question that I hope no one
 >finds offensive or dumb....you say that you are a type
 >2 diabetic and yet you seem to use way more insulin
 >than I do (a type 1), do equal or more testing and are
 >on the pump.  What is the line of distinction between
 >type 1 and type 2?  I am not trying to cause problems
 >here, just wondering.  Thanks for anyone out there
 >helping me out!  Cynthia

Type 2 diabetes is a disorder of complex and poorly understood 
origin.  It's probably no more than a catch-all for a bunch of different 
syndromes, lumped together because they all have similar symptoms but 
no-one's been able to determine how they differ in origin yet--kind of like 
diabetes mellitus.  That said, one commonality among many type 2s is a high 
degree of insulin resistance.

The theory is that in type 2 the cells in the body are unable to use the 
endogenous (produced in the body) insulin to its capacity, therefore the 
pancreas has to produce more insulin.  Because of the strain of producing 
this excess insulin, the beta cells of the pancreas eventually wear out, to 
the point that acceptable bloodsugar levels cannot be controlled without 
exogenous (injected or pumped) insulin.

Even when they're taking exogenous insulin, though, these type 2s still 
have the insulin resistance to contend with.  For this reason, a type 2 on 
insulin will often need to take more insulin than will a type 1 of similar 
age/weight/body type/activity level/etc.

The current test to determine whether a person is type 1 or type 2 is 
called a c-peptide.  C-peptide is produced with endogenous insulin and must 
be released before the insulin is made available to the cells.  C-peptide 
is released molecule for molecule with endogenous insulin, so the amount of 
c-peptide is equal to the amount of endogenous insulin.  Exogenous 
(injected or pumped) insulin does not provide a c-peptide molecule. This 
makes the c-peptide a good test even for those who are taking exogenous 

Because they don't produce their own insulin, there is little or no 
c-peptide in the blood of type 1 diabetics. There can be more in the blood 
of type 2 diabetics, but because people who have had type 2 for a long time 
often produce little or no endogenous insullin, there's really no clear cut 
line between the two.  Medicare says that if your c-peptide is at or below 
0.3 you're a type 1. I'm not sure at which point you're officially type 2. 
Anyone who knows the number can chime in here now!. BTW: According to 
Medicare you're eligible for pump therapy at 0.6

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