
August 23, 2006
Diagnosis and Symptoms, Insulin
Question from Marsascala, Malta:
I was diagnosed with diabetes and entered the hospital on the June 24, 2006. At that time, my sugar level was 30 mmol/L [540 mg/dl]. I was put on an insulin mix of 32 units in the morning and 24 units in the evening. I was discharged from hospital after a week and am maintaining a sensible diet. I still eat normal portions, but avoid fats, sweets, etc. Since then, my levels are an average of 5.4 mmol/L [97 mg/dl] and I am injecting a dose of six units of Humulin 70/30 before breakfast and before dinner time.
During my stay in the hospital, I was referred for angioplasty treatment. The first angioplasty was done successfully last week and I pray for a successful result for my next and final angioplasty within the coming weeks. My doctors, including my uncle, are very impressed by the results.
They have told me that my condition might not be type 1 as originally diagnosed, but type 2. I was at the diabetic clinic this week and the specialist told me I had very good results and that I should eat more to continue putting on more weight. I would like to point out that the condition emerged following a very stressful period in my life, which I overcame thanks to a new woman in my life who helped me believe in love and trust again. Is it possible that such a condition be reversible or not so serious as originally thought? I have learned to accept and live with my condition and would like to ask whether this is just a honeymoon period or a condition which might be improved with a good meal regimen and exercise.
Answer:
This is a very common series of questions. First, diabetes is never undiagnosed. That is, you have diabetes and will continue to have diabetes. Any therapy that brings the blood sugar down may have a beneficial effect on the remaining beta cells that make insulin in your pancreas. I anticipate that you have been making insulin since you brought your sugars down with the higher insulin dose. What is not known is whether you have any positive results for any autoimmune markers in your blood. These favor the diagnosis of type 1 diabetes. A family history of type 2 diabetes favors type 2 diabetes. If you are thin, you may not have type 2 diabetes, but you may have a more protracted form of type 1 diabetes where autoimmune destruction of the insulin-producing cells still is the result. Your specialist will have to help you make the distinction. For now, you are doing great and I am happy for you. Good blood sugar control is the most important thing.
JTL