type I or Type Ii

Hello Doctor,

How do you distinguish between Type I and Type II ?

I am a 48 year old male of Asian -Indian ancestry. I was diagnosed in my early 20s but had symptoms (increased thirst & urination ) since my late teens. Before diagnosis I may have been overweight but not obese (BMI 26) . when I started taking medication for my condition, it was one month of pills followed by insulin (aged 29). I now take 135 units of insulin every day & other medications (lissinopril, metaprolol, lipitor, Syntheroid & aspirin)  for heart  & thyroid related problems. I am still not sure what type I have but since i have high cholesterol & hypertension as well so I guess I may be Type II

My question to you is if I am Type II then would adding metformin to my medications reduce the amount of insuln I have to take ?

Thanks.

[Anita Ramsetty, MD]

Hi,
Taking your question in two parts:
1)The best way to find out if you have Type 1 or 2 is to check for antibodies(anti-GAD and anti-islet cell), as well as c-peptide production. You can ask your doctor to do these tests.People with Type 1 diabetes are almost always antibody positive and have very little c-peptide present.
For Asian Indians, a BMI of over 23 is considered overweight(not 25 as in caucasian populations), so your risk is a bit different when looking at weight.

2) If you do have Type 2 diabetes, you still may not produce enough insulin of your own to benefit from oral medications. But you should speak with your doctor anyway about trying oral medications if you have Type 2, as it may lead to a decrease in your insulin dose.

Take care.