Lantus only for type 1 diabetes

[carole1943]

My son has just been diagnosed as diabetic.His blood sugar was 500 to 600 at admittance to hospital. I myself have been type 1 diabetic for 48 years. He appears to be having one injection of Lantus per day and only injecting Humolog when his blood sugar is above normal at mealtimes which seems to me to be very strange (i.e. no Humolog to compenate for what he eats). I gather that there is a "honeymoon period" at the start of type 1. Could this be the reason? I am getting little or no information from the general hospital he has been at (they are too busy to talk to me) but the nursing staff there told me that he is also type 1. He has just been transferred from the general hospital to a psychiatric clinic as he also suffers from schizophrenia. This means that he is and has been taking a neuroleptic which can also cause diabetes (but generally type 2). I am completely at sea here, Can someone help me? Is there a sure way of differentiating between type 1 and type 2?

[Zoelula]

Yes, you are correct. I'm LADA/1.5 myself (originally misdiagnosed as type 2). LADA is actually much more related to Type 1, just has a more gradual onset and is diagnosed later in life. That is really unfortunate that his anti-psychotic precipitated the diabetes. Does it resolve if the drug is discontinued? Maybe he can in time work with a psychiatrist who can find another drug or combination of drugs that will work. Yes, I understand that the psychosis needs to be stabilized before anything else. I'm retired from the mental health field. I'm glad to hear that it's type 2 because as you know oral meds are a lot less demanding a treatment than insulin injections so he's a lot more likely to keep it up with less consequences if he isn't compliant when he's in crisis.

[carole1943]

Thanks for your very helpful comment which I agree with entirely. In the meantime I have discovered that he has no antibodies. I'm still trying to find out whether they have tested for c-peptide. It looks as though he is not type 1 like me and it's possible that the medication he is taking for his schizophrenia has precipitated the whole thing. Unfortunately, this particular drug is the only one that satisfactorily controls his psychoses so we are stuck between a rock and a hard place. To do the hospital credit they are referring him to a diabetic clinic and he has seen a dietician but at present he is highly psychotic (really away with the fairies) and in a psychiatric clinic (I suspect that the general hospital he was at didn't make sure he took his neuroleptics or maybe the stress was just too much). I suppose that they will have to sort that out first before they can concentrate on his diabetes. I wondered if he had the type between type 1 and 2 (LADA?) but am I correct in thinking that he would have antibodies if that was the case?

[Zoelula]

It sounds to me as if your son is getting sub-standard care. If he was given his treatment instructions by the hospital where he was admitted for an emergency, he needs to be seen for follow up by his regular doctor or preferably an endocrinologist to get him on the right path. No, only taking the Humolog when he is high is not the current standard of care.He needs to work with his endo or a diabetic educator to figure out an insulin:carb ratio and begin counting carbs to determine his pre-meal bolus doses. Yes, there is a way of differentiating between type 1 and type 2 which is testing for antibodies; type 2 don't have them and type 1 does. Another useful test is the c-peptide which shows how much insulin he is actually making. The bottom line is if his numbers are coming down into range with the treatment he is using, and the correct regimen is the one that lowers blood sugar to where it needs to be the majority of the time.