Negative Islet Cell Antibodies...Type 1 or Type 2?

[dee12]

I am 22 years old and was diagnosed a little over a year ago as a type 1 based on my age, weight, symptoms, etc.  My blood sugar was about 600 that morning, my a1c was 9.6% and I lost about 8-10 pounds 2-3 weeks before my diagnosis.  
I rececently had my blood screened to determine whether I have islet cell anti-bodies which would confirm that I am indeed a type 1 (I don't need all that much insulin and occasionally can go a few hours with my pump suspended without my blood sugars skyrocketing) and it came back negative. Is it possible that I am a type 2 and perhaps will no longer be dependent on insulin once my pancreas recovers from this "phase"?

[JDRF-Team-wak]

I am not a physician, but a volunteer and the mom of a type 1 and the daughter of a type 2 diabetic.
Not needing a lot of insulin and even being suspended for a while, could be for several reasons. One of which is you could still be in the “honeymoon" phase. This is when your pancreas is still producing some insulin.  Also if you are active your body can require less insulin for up to 24 hours. Remember everybody is different.  

For example my daughter has a friend who is also diabetic both girls are on the same pumps, about the same height and weight. Yet their rates and ratios are so different, that the total daily intake for one of the girls is almost double the other.

I wish I could tell you that insulin dependence for you is just a phase, but unless you were extremely overweight and sedentary, I highly doubt it, unless they find a cure for type one.

If you do not feel comfortable with what your doctor tells you the only other thing that I would suggest is to get a second opinion., or third opinion.

I hope this helps.

[dee12]

Thank you for your reply.  I guess what I really would like to know is, if I am type 1, which I am aware is likely the case, how come my my islet cell antibody test came back negative? I have an apt to see my doc in the beginning of feb and will also discuss this with him, but I am just trying to make some sense of my test results.

[JDRF-Team-LRS]

I'm another non-physician volunteer here.  

Here's an interesting article about older & newer tests for antibodies:
http://www.medicalnewstoday.com/medicalnews.php?newsid=32723

Your weight loss is indicative of Type 1.  Your A1c is high and must be brought lower, and yet it's not so high to suggest you've been enduring very high blood sugars for the entire past 3 months.  A1c gives us an overall average of our BG over 90 days, with more heavy weighting toward the recent weeks.

Many type 1 start out in a honeymoon phase while their bodies are still making insulin.  It's great you are able to tweak your dosing so well.  If you are Type 1, the honeymoon WILL end and you will be dependent on insulin.  Honeymoons can last a year or more, especailly when we ease the stress on our pancreas by taking insulin.

Good luck ...

[who_is_this]

"You are at an advantage because unlike Type II you can eat what ever you want as long as you compensate with the proper dose of insulin."

I hope the original poster gets the advice of his/her OWN physician rather than relying on someone on the internet whose credentials are not known.  While this advice may be correct, it is not the purpose of the website, nor is the advice giver associated with Medhelp.

[JDRF Team SGG]

I think it odd that nobody has asked you whether you are overweight. If so, you may be able to help your diabetes greatly by losing weight. Fat cells are insulin-resistant cells, and this is a simple explanation of why type 2 diabetes tends to strike people who have excess body fat. Anyway, even though you have been diagnosed as type 1, if you need to lose a few pounds, I would urge you to do so. Weight loss can be all that is needed to help some of these diabetics control their diabetes. Many doctors classify their type 2 diabetics as type 1 if they need insulin instead of an oral medication to stimulate the pancreas or to help the body use its insulin better. So sometimes the label can be somewhat misleading.

I believe that the person who wrote to suggest a C-peptide level test to see exactly what your pancreas is producing has a good suggestion, if you truly feel you want to know whether your pancreas is working or not.

The other writers who mention the "honeymoon phase" are absolutely correct. In the cases of most diabetics, the pancreas eventually completely gives up the ghost if they are type 1 diabetics. However, there are a few of us that I know about (myself being one) who seem to still secret some insulin of our own many years after diagnosis (35 years after diagnosis, in my case). So you have good news if there is indeed no immune system revolt destroying your beta cells right now. You may be one of the fortunate ones who will have a slightly easier time maintaining good control if some of your beta cells continue to thrive and help you out.

One last thought that you might find helpful.. there seem to be 3 different ages when many people seem to be diagnosed. Those three ages are: 1) infancy or early childhood,
2) at about the age of the onset of puberty,
3) and early 20's such as yourself.

Obviously, if you truly are wondering if you should be on insulin or on an oral medication (assuming that you were not given oral medications to start off with), for this would be the real difference in treatment between a type 1 or type 2 diagnosis, then DO seek a second opinion.

[dee12]

Thanks for the info, I will definitely request a c-peptide test at my next apt.  As far as eating whatever I like…I try to keep it low carb anyway, makes calculating insulin doses easier and I think it helps with the swings in my blood sugar post meals.  I did mention that I can suspend my pump occasionally without my blood sugars skyrocketing, but this occurs randomly.  Sometimes I forget to un-suspend my pump and when I realize and check my bloodsugar, it'll be surprisingly normal.  While at other times i’ll have it off for just a short amount of time and its gone up quite a bit. (I am thin and athletic, which I believe was one of the reasons why I was instantly diagnosed as a type 1)