Question:
From Norman, Oklahoma, USA:
I'm a 37 year old male and was diagnosed with diabetes 6 weeks ago. This occurred when I was hospitalized because of dehydration. Now, I am taking insulin and my blood glucose is generally under control. My recent c-peptide was 2.7 when the blood glucose was about 200. Should I be classified as Type 1 or Type 2? Should I not be oral medication instead of the insulin? My c-peptide in hospital was 1.9 when the blood glucose was over 400. I have tested negative for ketones (i.e. no ketones).
Answer:
If you require insulin you probably have Type 1 Diabetes although
you might have one of the much more rare types of Maturity Onset Diabetes
in the Young. The oldest cases of Type 1 Diabetes seem to be in their
middle 40's and there has been one unsubstantiated new onset case in his
early 60's. C peptide levels may persist for a number of months after the
onset of Type 1; but your hospital level was certainly low for the blood sugar.
Nowadays it may be of some importance to distinguish between Type
1 and Type 2 because new drugs like Troglitazone may offer a small (15%)
chance to come off insulin, albeit rather expensively. The quickest way to
decide is to ask your doctor to arrange an antibody test and if you call
1-800-425-8361 they can tell you how to arrange this. This is a more
certain approach than a trial of oral hypoglycemics. If you are antibody
positive you are committed to insulin permanently; but if you turn out to
be negative and your insulin requirements are minimal it would certainly
be appropriate to try oral medication with a program of diet and exercise
as well.
DO'B
Original posting 29 May 97
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