Diabetes Types

Diagnosing Which Type You Are

It is possible to get type 1 when you are 60 or type 2 when you are young and fit. Don't just assume that you are one or another. Get tested and know for sure. Get a blood test which checks for the following items: islet cell antibodies, GAD antibodies, insulin antibodies, c-peptide and insulin.

Don't assume that because you are overweight that you have type 2! It's very important to understand as soon as possible if you have an autoimmune disorder since this will affect your early treatment and potentially enable you to preserve some of your pancreas's ability to make insulin. If you don't check, you may waste months trying a treatment for type 2 and letting your body finish off your pancreas.

Type 1

Type 1 is autoimmune which means that your immune system attacked your pancreas and has killed most or all of the beta cells which make insulin. The attack is very quick and you can go from healthy to the hospital in just a few days or weeks. If you test positive for antibodies and your c-peptide levels are low (which means you are not making much or any insulin), then you most likely have type 1. This means that your pancreas can't make enough insulin for your body to function and you will need to take insulin.

When you are newly diagnosed, your pancreas may still have some insulin making capabilities left for a while (the honeymoon period). This doesn't change the diagnosis though it will affect what you are able to "get away with" for the first few months until your pancreas stops making insulin altogether.

Type 2

Type 2 is a big bucket and people can have very different looking diabetes and still be called "type 2". To be diagnosed with type 2, your blood test must have been negative for antibodies.  That's it. It doesn't say much about how you got it or how your body in particular is experiencing the effects of diabetes. At a high level there are 2 possible problems that are causing you to be diabetic:

  1. Your body is not responding correctly to insulin.
    Insulin resistance is when either your liver, fat cells, muscle cells or brain cells do not respond to insulin like they should. Some people just have a problem with muscle insulin resistance and are overweight. Others may have problems with liver insulin resistance or some combination. Which group you fall into will affect your symptoms and your success with different types of treatment.
  2. Your pancreas isn't able to make enough insulin.
    I'm not saying how much you are making, only that it's not enough. Some type 2's make a ton of insulin (hyperinsulinemia), others are making a normal amount, while others may have exhausted their pancreas and can only make a little or none at all. Where you fall on this scale will affect which medications you should take and how you control your diabetes through diet and exercise.

Type 1.5

Type 1.5 (sometimes called LADA for Latent Autoimmune Diabetes in Adults) is a relatively new distinction. To be diagnosed, you will have antibodies present but the autoimmune attack is slower and it may not have progressed to the point that you have lost all of your insulin making capabilities. Some type 1.5's are diagnosed soon enough that they are able to slow or halt the autoimmune attack and preserve their remaining pancreatic function for years or longer.

Since you fall into a "fuzzy" or gray area of having the autoimmune aspect and diminished ability to make insulin, some of the type 1 advice may apply and some of the type 2 may apply as well. You will need to evaluate the advice against how your body responds to come up with what works for you.

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