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January 21, 2000

Diagnosis and Symptoms

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Question from Dallas, Texas, USA:

My doctor told me yesterday that I have type 2 diabetes. I am taking Humulin-N type insulin for 15 years and I was 37 years old. Since last month I am taking insulin twice daily, one in the morning at 5:50 A.M. (18 units) and one in the evening at 5:30 P.M. (10 units).

Is that true that I have type 2 diabetes when I am taking insulin? Doctor said, type 1 diabetes is for the people who were diagnosed as a diabetes under the age of 24 years.

This question arose because doctor prescribed me Avandia 0.4 mg tablet. I was reading in a recent diabetes magazine that Avandia advertised that this tablet is not for type 1 diabetes.

Would you please clarify what is the difference between the type 1 and type 2 diabetes?

Answer:

From: DTeam Staff

There is a fundamental difference between Type 1 and Type 2 diabetes. Most people with Type 1 diabetes are diagnosed with diabetes as children or teens — although some are into early adulthood. It is less likely that someone 37 years old who is diagnosed with diabetes has Type 1 diabetes. It is much more likely to be Type 2 diabetes.

However, you must talk to your physician about your own experience. Type 2 diabetes may be treated with insulin as well as with medications by mouth. Type 1 diabetes is treated with insulin in all cases. I would encourage you to talk at length with your physician regarding your very good questions! Talking with a diabetic educator would also be a great benefit for you and your physician can help you with that arrangement.

MSB
Additional comments from Dr. Bill Quick:

Also, you can look at Classification and Diagnosis of Diabetes to learn more about what type of diabetes you might have. Please note that the re is nothing in the new classification scheme about the age at the time of diagnosis. It is generally true that kids get Type 1, and adults get Type 2, but there are exceptions to this guideline, as Dr. Brown mentions.

WWQ

[Editor’s comment: While it is generally the case that young people diagnosed with diabetes tend to have Type 1 and that older people diagnosed with diabetes tend to have Type 2, it is by no means always the case. Antibody testing can help determine whether someone has Type 1 or Type 2 diabetes, and proper diagnosis is important in choosing the correct medical care. Oral medications, for example, are for people with Type 2 diabetes (under rare circumstances, people with Type 1 diabetes can use insulin and some oral medications) and people with Type 1 diabetes are always treated with insulin. An adult with Type 1 who is misdiagnosed with Type 2, for example, will continue to experience high blood sugars and risk DKA because their body is not producing enough insulin.

JSH]