November 14, 2001
Daily Care
Question from Charlotte, North Carolina, USA:
I am a 29 year old who has had type 1 diabetes treated will insulin since the age of 18 months, and now my current specialist feels that I may actually have type�2 diabetes. This doctor feels that he may be able to take me off of insulin and use insulin sensitizing drugs. He bases his opinion on two lab tests. One is a C-peptide level of 1.4 (or normal as the doctor has said), and the other is negative antibody result (as would be associated with type 1). I also have a very large family history of type 2 diabetes.
I have been told however by another physician that over time (roughly 28 years now) that the antibodies would lessen or even disappear. Is it truly possible for this to happen? Is it possible that I could come off of insulin and use only oral hypoglycemic agents?
Answer:
It may be possible to have measurable C-peptide over time, and it may be possible to have negative antibodies yet still have type�1 diabetes. I strongly suggest you not withdraw from insulin before getting a second opinion from another physician. There may be measurable insulin present, but this does not mean it will be adequate to maintain normal blood sugars.
JTL
[Editor’s comment: If you do plan to discontinue insulin, please be sure to check zillions of blood sugars (at least four daily) and keep ketone test strips and your insulin supplies handy — if you have type 1, and start to go into DKA [diabetic ketoacidosis], you could die without prompt recognition and therapy.
WWQ]