I had previously written to you about my case. I was diagnosed as a type 1 diabetic and hospitalized on June 24, 2006. At that time, my sugar reading was 30 mmol/L [540 mg/dl]. I had gone through a very stressful period in my life. I was injecting 32 units of Humulin in the morning and 24 units in the evening. Since then, I also underwent heart surgery and had two stents. Following this treatment and my improving personal life, my sugar levels started going down and I actually started having hypoglycemic reactions. I have been off insulin since December 2006. My doctors, including my uncle, cannot actually explain what has happened. They told me that to them, as professionals, it is a pleasant surprise, while to a person like me who has faith, it is a miracle. I have noticed that my levels only go up a bit when I eat or drink sugary stuff. Otherwise, I can enjoy anything. Hospital specialists have advised me that the first test taken in January 2007 shows that my pancreas is producing insulin.

I know and accept that this is a condition I have to live with. After all, everybody has a cross to bear. Do you think that this is just the so-called honeymoon period or can it be a crisis which may be controlled and overcome?

Since getting this condition, I have become more physically active and appreciate more the good things in life. I only wish that a breakthrough will take place soon and cure all people who have diabetes.

The bottom line is that diabetes is a category of a lot of heterogeneous diseases where elevated glucose levels are the common theme. Our nomenclature and categorization for the types of diabetes are imprecise, at best. We tend to “lump” the most common kinds of diabetes into either type 1 or type 2 diabetes. We are now seeing large numbers of people whose diabetes does not easily fit either definition. In the end, we will have to see how it plays out for you. The fact that you have gotten off insulin is very encouraging and truly does suggest you are making adequate amounts of insulin. Underlying stress, both physical (from a heart condition or other illness) and mental (depression, job and life stress, etc.) can antagonize blood sugars through the production of stress hormones that counteract insulin. If you can maintain your insulin-free state for a significant time (more than a year), this is best categorized as type 2 diabetes. All the changes you are making in your life are heading you in the right direction. The best way to impact your future is to work on those life choices every day. In the end, doctors make their best estimate of the type of diabetes and then they have to follow their patients. They have to be willing to evaluate all the information. Sometimes, the initial evaluation is not correct. Type 1 diabetes usually occurs in those under the age of 30, has no family history or can skips generations, is seen in thin individuals, is associated with positive antibodies against beta cells, and results in an absolute deficiency of insulin production. Type 2 diabetes is associated with an older onset, obesity, a positive family history that does not skip generations, and, initially, is not associated with absolute insulin deficiency. This means it can be treated with pills. I hope your diabetes remains easy to control and you continue to find your new happiness.

JTL