I am a 270 pound, 27 year old male with a hereditary vulnerability to diabetes and a sedentary activity level. About a month ago I developed DKA with a blood sugar level of 600 mg/dl [33 mmol/L]. I was originally treated with a 50/50 insulin mixture three times a day with meals and Actos [pioglitazone], but after returning home, I started walking regularly and following a diet so that now I am off medication and my blood glucose readings are usually 80-125 mg/dl [4.4-6.9 mmol/L] at all times of day and night.

I am not sure whether this is type 2 diabetes or type 1 diabetes in a honeymoon phase. The doctor says that it was a case of insulin resistance, and that my pancreas is functioning normally now. What exactly do you think it is? Will I need insulin in the future? Will I get complications from diabetes?

Congratulations on your recovery! You likely have type 2 diabetes. It is uncommon to have DKA [diabetic ketoacidosis] with type 2 diabetes, but it can happen. Now that you are off all medications, it is important to continue your exercise and diet.

Your doctor can order several tests which measure antibodies in your blood. They are markers for type 1 diabetes. If present in high amounts, they would suggest type 1 diabetes. However, the setting of increased weight, family history, and no insulin after such a short time are still most consistent with type 2 diabetes.

You can never say you won’t need insulin because 50% of all patients with type 2 diabetes eventually need insulin to control their blood sugars. It is also important to point out that type 1 and type 2 diabetes both are associated with complications. The best way to prevent the complications is to stay after your blood sugars.

JTL