February 27, 2001
Diagnosis and Symptoms
Question from Davenport, Iowa, USA:
I am 40 years old and was diagnosed with diabetes about a year and a half ago. I was sick with a virus and for about two weeks, had no energy, and was tired and thirsty all the time. My doctor did a blood tests which showed high blood sugar. I was put on Glucophage [metformin] for about two weeks then changed to Amaryl for about a month. At the time of diagnosis, my hemoglobin A1c was 7%. I continued to lose weight, about 40 pounds in one month. I am overweight and African American. I was sick with a virus or stomach flu and produced a large amount of ketones when my blood sugars were only slightly above 200 mg/dl [11.1 mmol/L]. My doctor then started me on insulin, and I have been on the insulin pump for about 10 months. My HbA1c is 6.8%, and I have very good control. My doctor feels I am a type 1 because of the small dose of insulin I am on. I currently take anywhere between 18-20 units a day on the pump, despite being overweight. Could this be possible? I did not think overweight people could get type 1.
Answer:
The small dose of insulin does speak to type 1 diabetes over type 2 diabetes. I believe we see people who have both type 1A (autoimmune) and, in a person with a family history of type 2 diabetes, some insulin resistance.
It is reassuring you only need a small amount of insulin. Other antibody tests are available for testing for markers of type 1 diabetes. You can also test for residual insulin or C-peptide secretion as a way of diagnosing type 1 diabetes.
JTL
