May 10, 2001
Daily Care
Question from Chennai Tamil Nadu, India:
I am 30 years old, have no family history of diabetes, my fasting c-peptide is 0.2 pmol/ml, and my stimulated c-peptide is 0.4 pmol/ml. My blood sugar was 257 mg/dl [14.3 mmol/L] before food and 424 mg/dl [23.6 mmol/L] after food. Since taking 15 units of insulin in the morning and 10 units of insulin in the evening along with a sulfonylurea, my blood sugar level was 174 mg/dl [9.7 mmol/L] before food and 218 mg/dl [12.1 mmol/L] after food. Will I continue insulin injections for life, or in due course, will they stop it?
Answer:
Your clinical data are highly indicative of a form of type 1 diabetes (relative young age and negative family history for diabetes, high blood sugar readings at first diagnosis and low C-peptide levels either fasting or after a stimulus). I don’t think antibody studies are easily available in your city, and anyway, their eventual presence doesn’t change the current clinical approach. On this basis, I think insulin (perhaps at low dosage and added to oral hypoglycemic agents), will be your therapy for life.
MS
