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I am 40 years old and I was diagnosed with diabetes three months ago. My question is am I really a Type 1 diabetic?

During my initial incident, I was admitted to ICU. My blood sugar was 946 and my blood pH was 6.9. When I went in, I could barely walk (it took a great deal of will power to make my legs work), very tired, could hold only water on my stomach and had symptoms like severe heartburn.

My doctor ordered a C-Peptide test that I did not have time to receive the results from before I went in to see my new doctor. He said that the C-Peptide test confirms what he already knew. That I am a type I.

What is a C-peptide test and am I for sure a Type 1?


You were admitted with super-high blood sugar levels, and super-high blood acid levels (a low blood pH result means a high blood acid level), which fits well with the complication called diabetic ketoacidosis. Although "DKA" can rarely occur in people with Type 2 diabetes, it's much more frequently associated with Type 1 diabetes. (You didn't mention if you had a high blood ketone level; if you did, you had DKA for sure.) I'd hazard a guess, therefore, that you probably have Type 1 diabetes.

Type 1 Diabetes Mellitus is an autoimmune disease that destroys the pancreatic islet cells that make insulin. If there's no insulin being made, there's also no C-Peptide being made. Hence, people with Type 1 Diabetes have low or no C-peptide in their bloodstream.

Type 2 Diabetes Mellitus, on the other hand, is a disorder in which there's a double defect: partially in poor pancreatic function, and partially in the tissues that are supposed to be sensitive to insulin that's circulating in the blood stream. Since insulin production is not destroyed, there's still both insulin and C-peptide production occurring in people with Type 2 diabetes.

The usefulness of measuring C-peptide levels is arguable: I personally rarely arrange to get the measurement of my patients' C-peptide level, since the overall picture of the case usually allows a fairly accurate representation of whether there is (or is not) any substantial amount of insulin being produced.

And, if I'm really interested in whether my patient is Type 1 or II, I'd suggest getting antibody levels to help decide, not C-peptide levels.


P.S.: If you haven't yet gotten the results of the C-peptide testing that was done on your case, arrange to sign a records release to get the results. After all, it's your body, and you have a right to the information!

Original posting 8 Jul 96


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Last Updated: Tuesday April 06, 2010 15:08:52
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