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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19461
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I’ve been diagnosed as type 2 diabetic though I’m not sure

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I’ve been diagnosed as type 2 diabetic though I’m not sure if I meet any of the criteria for that. I’m starting to think I’m 1.5.
My fasting blood sugar before breakfast was 11.2 and two hours after eating a bowl of cornflakes it has gone up to 22.9.
Is my diagnosis right?

Hello from JustAnswer. This is Dr. Love.

Diabetes type 2 cannot be differentiated from diabetes type 1.5 based on the blood sugar levels before and after meals.

What is your height and weight?

Have you been started on any medicine for the diabetes?

How long have you been taking that medicine?

Customer: replied 1 month ago.
Diagnosed start of October 2017. Initially on Metformin 3 a day but stopped that early January as had very low energy and lots of symptoms of neuropathy. Moved to morning dose of 1x sitagliptin.
I’m 6’2” and weigh 75 kilos always been slim and pretty active especially hill walking.

Thank you for the additional information.

The fact that you are slim increases the likelihood that you have diabetes type 1.5. It would be more definitive evidence that someone has diabetes type 1.5 if a medicines that work by improving insulin sensitivity, such as metformin, does not work to lower blood sugar. There may be an initial partial response to metformin, but it is not sustained. Since you had to stop the metformin because of side effects, you were not on the drug long enough to differentiate the types of diabetes.

The sitagliptan works by a different mechanism than metformin, and there is evidence that it can help people with diabetes type 1.5, as well as people with diabetes type 2.

There also are some blood tests that can be done. Diabetes type 1.5 appears to have an autoimmune component, and checking antibodies against the islet cells of the pancreas (where the body makes and releases insulin), can help to identify those people with diabetes type 1.5.

So, with your height and weight, there is a good chance that you have diabetes type 1.5, but the blood sugars and the diabetes medicine treatment history do not prove it. However, you can discuss checking islet cell antibodies with your doctor to help to clarify the situation.

If I can provide any additional information, please let me know.

Customer: replied 1 month ago.
Thanks for this. I’m concerned about how high my blood sugar is and whether this is causing my depleted energy - I was climbing mountains in October but now I get dizzy going up one flight of stairs.
Would insulin get my blood sugar down more swiftly?

Yes, the fact that your blood sugar is this high can contribute to your depleted energy, for two reasons. While the blood sugar is elevated in diabetes, the cells have low amounts of sugar. The primary function of insulin is to facilitate transport of insulin into the cells of the body, so when there is an inadequate amount of insulin or function of insulin, the cells are somewhat starved of sugar. Before insulin injections were invented, type 1 diabetics looked like they were starving to death, because they essentially were starving to death, even with sky-high blood sugars.

Elevated blood sugar also causes dehydration, because the high blood sugars cause excess urine formation, and the dehydration can contribute to poor energy levels.

Yes, insulin will get your blood sugar down more swiftly, and that is true for every type of diabetes. If someone has a diabetic emergency requiring hospitalization (diabetic ketoacidosis in a type 1 diabetic or hyperosmolar coma in a type 2 diabetic), insulin treatment is standard to get the blood sugar down quickly. In addition, insulin has the greater potential for lowering HgbA1c than other treatments. Since most people would rather avoid shots, doctors will usually try other medicine first, when possible, but insulin clearly will work more quickly and have a greater effect on HgbA1c.

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