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Question:

From Kingman, Arizona, USA:

How does one determine insulin dependence? I'm 34 years old, diabetic for 1 1/2 years. My doctor says I'm type 1 1/2 and I'm on Ultralente and Humalog. The C-peptide and proinsulin tests show that I am still producing some insulin.

Answer:

You already did it! The insulin dependency mainly depends on a correct classification of your diabetes, both from the clinical as well as aetiological point of view:

  1. it is probably a slowly-evolving form of type 1, given your age and your laboratory results; I'd also suggest checking for autoantibodies (from immune-mediated Type 1 diabetes) if easily available;

  2. the endogenous insulin secretory reserve, based on what you say, is actually still present even though reduced (as it is commonly observed during the first period of the natural history of slowly-evolving diabetes, where, differently from childhood onset Type 1, there is a progressive slow decrease in insulin production and secretion over the years); the autoantibodies, if present, could help in establishing the lifespan of your pancreatic reserve;

  3. that said, to keep assuring your body the right dose of insulin that is able to obtain the best metabolic control as judged by the HBA1c; from the clinical point of view, what matters mostly is metabolic control.

MS

Original posting 16 Oct 1998
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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