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[IP] Re Type 2, David's question (warning...long)
<<If a type 2 were to
have beta cell burnout to the point that they could no longer produce enough
insulin to even meet basal needs and the person would go into ketoacidosis
without injections would he still be considered type 2?>>
The underlying cause of the original diagnosis is still there, even if no
insulin is being produced. Insulin resistence may still be there, if truly
Type 2. There are many adults with slow onset type 1, who are initially
diagnosed as Type 2, and this confuses the issue even more. There is more
continuing research, but I am not sure if the researchers have come to major
conclusions. With Type 2 having more than 20 subsets, it is difficult to pin
all of this down to anyone's satisfaction. The main difference is identifying
the autoimmune process of Type 1.
So, if you can be Type 1 with the family genetics to also develop Type 2,
then whose to say that you can't be Type 2 with a resulting autoimmune
process of Type 1.
Part of the arguement in changing the names from Type I and IDDM, and Type
II NIDDM (Roman numerals), to Type 1 and Type 2 (Arabic numerals), (ADA, June
1997), was related to the confusion in treating individuals based on age at
diagnosis. You can get Type 1 at any age.
Bottom line...the recommendation is to use what works to get the BGs to
normal range. If pills don't work, insulin is needed.
DKA is not strictly confined to Type 1 only, either. Overwhelming stress or a
major illness can lead a Type 2 into a ketotic state. If any of the
physicians on the list has anything to add for clarification, please do so.
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