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Re: [IP] now t1 vs t2..........LONG



<< I know I can go for about 4 hours before I start to make ketones
and I feel pretty awful.>>

In 4 hours without basel insulin, I would be producing LARGE ketone bodies,
and would be very sick.. nausea, vomiting, smelling like nail polish (ketone
bodies for you, and I do NOT paint my nails), and very very tired.. where I
want to go lay down and sleep.

<<The question that should be asked is, "For how long, and accepting what
amount of damage?">>

I might last 2 days, before loosing all brain function (death). And that is
a might, due to the fact that I have other major medical issues, that can be
complicated by uncontrolled diabetes.

<<I really almost feel that some T1 people are saying gee you T2s
have it made, you don't really need insulin, all you need to do is get your
life straightened out and you'll be fine without mdi>>

I honestly take offense in that. I am 1 of over 100 KNOWN type 1's in my
family (mum's side has the type 1's.. brother's oldest son has type 1, and
sisters son has type 1 too), and then my fathers side, has almost 200 type
2's (Mum was dx'd with type 2 6 years ago, her father's brother [my maternal
great-uncle] was type 2, my father was just diagnosed TODAY [8, May 08] with
type 2, so now my father and all his siblings have type 2 diabetes).
I DO know that type 2 diabetes CAN and DOES run in families, even if you
were this skinny mini (mum was 138 pounds, 5' 6" when diagnosed).

<<I have a REAL disease. Even my sister doesn't understand that I have a
legitimate medical issue here that requires treatment>>

ANY form of diabetes, either it be type 1 or type 2, IS a real disease. Both
can and do kill (by either total lack of insulin or complications).
Diabetes, either it be type 1 or type 2 are legitimate medical diseases and
both need the respected treatments available.. insulin and/or orals (pill),
diet control (portion/carb counting, ect.. but then EVERYONE needs to learn
to do that, no matter if you have diabetes or not), exercize (as stated in
the previous.. all need exercize to be able to 1. stay the same weight, 2
increase muscle mass, 3 loose weight [if you need to] 4. exercize is very
good for your physical health in general.. even if it is just walking or
swimming.. even the low impact exercizes help with physical health, and in
some it helps with mental health too).

<<Did I hear right a few mins ago that someone's T2 husband "isn't allowed"
to go to the endo? They can't do that!>>

Actually THEY CAN, therefore THEY DO. Some insurance plans state in plain
english in their membership handbook, that a type 1 can get a referal to a
endocrinologist, but on the other hand a type 2 needs to be seen by a
general medicine doctor (internal medicine or family medicine). It is NOT
illegal to not allow payment to a specialist, if it is NOT in their policy.
Just like NOT all states have it in their regulations have it so diabetes
supplies/education is covered. ONLY 48 states mandate that 50 percent of
diabetes supplies and education be covered. That means that there is
3 states that do not have it on their books, so that means that there is 3
states that if you live there, and you have diabetes, the insurance
programmes do NOT have to cover diabetes care.. that means you pay 100% of
diabetes supplies (strips, syringes, lancets, pump supplies, ect).
------As of January 2008, *forty-six states* and DC have some type of laws
requiring health insurance coverage to include treatment for diabetes. Most
states require coverage of both direct treatment and the costs of diabetes
treatment equipment and supplies often used by the patient at home.  The
states *not* included are Alabama, Idaho, North Dakota and Ohio.   The laws
in three other states are limited to requiring that insurers *offer *coverage,
but not necessarily include the coverage in all active policies-
Mississippi, Missouri and Washington. ------ http://tinyurl.com/64g9mf

<<That  person deserves just as good a treatment as the T1 partner, and I'd
be darned if I'd stand for someone telling me I didn't.>>

I agree, that no matter if type 1 or type 2, they both deserve the same
quality of medical treatment/care. But then again, insurance do not care.
There is alot of insurance that discriminate between type 1 and type 2. If
you are a type 1, then sure, you can see a endo, sure you can have a pump,
and so on, but if you are a type 2, and want to see a endo, it is, "I am
sorry but you need to be seen by your reg. doctor" (thank g-d this is NOT my
insurance telling me that, I am a type 1 who preferes to NOT to see a
endocrinologist.. been burned by a couple of them.. so as long as my reg.
doc is willing to prescribe my supplies, then I am fine, I am capable of
managing this disease (last HbA1c was 5.4.. higher than my last one at 5.2
and the previous 3 at 5.1, but I did have a major surgery and was under alot
of stress before and after, and i do not think a 5.4 is that bad [And yes,
Michael, I did update my profile]).

<<It's hard for me to see how a type 1 could be overweight at diagnosis.>>

I have seen many type 1's diagnosed as a overweight person.
One particular person was almost 200# when diagnosed. She went from the
almost 200# down to about 150 in a month. She was very sick, her mum and dad
took her to hospital. Her sugars were almost 700. Antibody tests came back
Possitive. GAD65 was Possitive.
This was a 14year old female (she is now 22y/o). She was always
overweight..at birth she was close to 10 pounds (big baby). Her mum and dad
were both heavy.
So it does not matter if a type 1 is extreamly skinny, normal size or obese,
just like it does not matter  with a type 2, as type 2's are also skinny,
regular/normal size, and obese. You can not/should not judge a book by their
cover.

<<I'm curious about "what happens" to Type 2s before diagnosis? I know there
is no typical, I am just wondering>>

Type 2's usually present to their doctors with issues that they can not
explain. They are usually complications of diabetes, yet the person does not
know that they have it. Aproxamately 70% of all type 2's are diagnosed when
they present to their doctors with a maladie that they can not explain and
the doctors look into it.. Which means 70% of type 2's have had it for
years, but never knew that they had it and only found out when complications
have already set in. Then there are those type 2's that KNOW that they have
a family history of type 2's and tell their doctors, and if the doctor has
his/her head on straight will test them for type 2 diabetes every 5 years
like they should (actually I think that everyone that does not have
diabetes, should be tested.. yearly if they have a familiar issue with it
[they have a immediate or close relative with] or 5 years if they do not [no
close or immediate family members]).

<<I now begin to spill moderate ketones when my bg is over 200 (even
slightly over) for more than 2 hours. That's what I get for tight control.>>

I start to spill the following ketone bodies:
Small - Bg about 180
Medium - Bg about 230-240
Large - 280+

I am in extream tight control, because I do not want the complications that
diabetes can cause. I saw my great uncle (maternal great uncle.. mum's
fathers brother) die due to complications of T2IDDM. Kidney failur, cardiac
failure, (had a leg amputated in 81.. about 18mo after being diagnosed),
ect.
My doctors (all of them) want me to allow my sugars to run higher than I
actually like them (I try to keep betwen 90-120 and the docs want 150-200)
to see if I can regain my hypoglycemia awareness (I normally do not feel my
lows until I am low to mid 30's). I have been in extream tight control for
over 10 years now (since early 20's).

<<had no symptoms until I was put on a prednisone dose pack and my vision
got very blurry>>

Prednisone, like almost ALL steroids will skyrocket the blood sugars. You
could have been slowly going up in your blood sugars (becoming resistant to
insulin, and/or your liver not being able to accurately guage your exact
bg's so it was constantly dumping glucose, and causing your sugars to go
higher and higher), and the prednisone, most likely tipped you over the
edge.
Prednisone, like all oral steroids can (and in some that are predisposed to
type 2 will) cause a form of type 2 diabetes (it causes sugars to raise
extreamly high and the beta cells peter out quickly trying to control the
sugars, which after several years of consistant use, can/will happen).
.
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