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Question:

P> Seven weeks ago, I was diagnosed with type 1 diabetes after serious DKA and coma. Prior to the onset, I had lost 50 pounds over a four month period. The only dieting I had done was to cut out excess sugars (sodas and desserts) and to increase my daily water consumption. My friends and family in medicine were curious about the type 1 diagnosis since I'm 22 years old and had been overweight. In addition, the weekend prior to being in the ER, I had developed serious throat and gastrointestinal infections. My C-peptide result was a 2.6, which did not come in until after I was discharged.

I was taking premixed insulin twice daily, and two weeks ago, I began using NPH alone (80% of the previous dose). Despite that, my pre-lunch levels were still getting low (and I was feeling pretty lousy) so the next morning, I resolved not to take a shot because of a large amount a physical activity in store at work. Since then, I have still tested four times per day, and fasting/pre-meal levels have not been higher than 110 mg/dl [6.1mmol/L] and two-hour post-meal readings have not been higher than 160 mg/dl [8.9 mmol/L].

Is it possible that I have type 2 diabetes? Is there a remote chance, that this episode was virus-induced but didn't cause enough damage to put my pancreas out for good?

Answer:

It sounds as though you are in the honeymoon phase of type 1 diabetes. If you truly were in DKA [diabetic ketoacidosis], the C-peptide level still denotes a level of insulin secretion that was unable to prevent the DKA. The weight loss was the result of previous hyperglycemia that caused glucose in your urine and subsequent loss of calories. You are the correct age for type 1 diabetes.

The honeymoon phase of type 1 diabetes is best described as the recovery of the surviving insulin secreting cells. The removal of the high sugar environment helps with this restoration (the glucose toxicity effect). I would probably recommend you get a GAD antibody level which level should be high with type 1 diabetes.

It is thought that the better the control that is achieved, the longer the honeymoon period.

JTL

DTQ-20030325174539
Original posting 3 Apr 2003
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:44
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