Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
September 30, 2002
Diagnosis and Symptoms, Pills for Diabetes
Question from Raynham, Massachusetts, USA:
I am a 26 year old Native American who was recently diagnosed with type 1 diabetes (less than four months ago), and it is believed that I have delayed type 1 diabetes. My doctor was the general practitioner, at the local Indian health center, who put me on insulin, but after a few weeks I was having severe hypoglycemia episodes, so I went to an endocrinologist. The endocrinologist suggested I try no insulin for a few days and closely monitor my blood sugar, and for about three weeks, my sugar was normal! He told me he believed that my sugar was close to normal because I was in the 'honeymoon period', and my body still had some insulin. Then, I got sick with a sinus infection and bronchitis. Of course my sugar was uncontrollable, and I had to go back to insulin for a short time. However, again I experienced low blood sugars, sometimes threateningly low. So, my doctor started me on Prandin (repaglinide), after my infection went away. From what I have read and researched, Prandin is not for people with type 1 diabetes, but it is working fine and keeping me normal. My doctor said that eventually my pancreas will stop working altogether, and I will inevitably have to take the injections of insulin, probably for life. If I am in fact in the honeymoon period, is it safe for me to be on Prandin? I am concerned about side-effects, low blood sugar, etc.
The safety issue is in the monitoring. If your sugars go below 60 mg/dl [3.3 mmol/L], there is concern the medication may be too much for you. As long as you are taking a medication that lowers your sugar, there is always the possibility that you could go low.
The question of whether you have type 1 or type 2 diabetes is an interesting one because there is no set test for the condition. Individuals with Late-onset Autoimmune Diabetes of Adulthood (LADA) tend to be thin, do not necessarily have a family history, and have positive antibody titers for anti-GAD antibodies that serve as a marker for immune system destruction of the insulin-producing cells in the pancreas. Type 2 diabetes is more common in Native American populations, tends to occur individuals who are overweight, and are anti-GAD antibody negative. Markers of insulin secretion are usually positive with type 2 diabetes.
You will need help from your physician to make this important designation. A tip off that you have type 1 diabetes would be a rapid return to high blood sugars after a period of months when the honeymoon phase should end. The longer you go without high blood sugars after this time, the more likely it is that you have type 2 diabetes.