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Question:

From Norcross, Georgia, USA:

I was diagnosed at the age of 44 as type 1. At the time of diagnosis, I had a blood sugar over 956 mg/dl [53.1 mmol/L]; extreme thirst; what felt like heart burn; extreme, whole body muscle cramps; breath that smelled like "Juicy Fruit" gum; inability to walk; rapid, shallow breathing; ICA and C-peptide tests indicating diabetes; and blurry eyesight. Do I really have type 1? How often are people diagnosed with type 1 at the age of 44?

Answer:

The distinction between type 1 and type 2 diabetes is sometimes blurry. You have to use clinical judgment to determine the best course of action. Some helpful indications are as follows:

  • Type 1 patients are usually thin, without a history of obesity

  • A family history is often lacking

  • It is associated with positive anti-islet cell antibodies

  • C-peptide values are low, compared to high values at the time of diagnosis with type 2

  • The fruity odor you exhibited could have been impending ketoacidosis with the smell of ketones being excreted through the lungs the cause of the odor.

  • Patients with type 1 diabetes require insulin and are not well controlled on oral agents.

These are just some tips. Individuals greater than 30 may have type 1 diabetes. This is referred to LADA for late-onset autoimmune diabetes of adulthood. You can review a variety of articles about this in diabetes literature. The major point is that these individuals eventually become insulin deficient like their younger counterparts. However, they may take a more protracted period of time to get there. Why the immune destruction of the beta cells that make insulin is more protracted is not clear. The rest of the symptoms you experienced are common to both type 1 and type 2 diabetes when blood sugars are high.

JTL

DTQ-20041213184926
Original posting 28 Dec 2004
Posted to Diagnosis and Symptoms and LADA and MODY

  
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Last Updated: Tuesday April 06, 2010 15:10:00
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