I've been using the jet injector for two weeks now.
Pro: No needles to keep track of or accidentally poke myself with or pay for or pack.
Pro: Faster onset and action time.
Pro: No soreness after injection.
Pro: Can do shots totally in the dark without using my sight.
Con: More things to keep track of while injecting- especially the caps to both the insulin vial and the injector itself.
Con: Faster onset and action time (I keep going hypo while I'm still eating the meal I injected for- and I'm using Regular for pete's sake!)
Con: More frequent visible bruising, even when shots are not more painful.
Con: All the twisting to load the jet injector is hard on my hands, which have not entirely recovered from this summer's neuritis.
My G4 has arrived but because of how long it took I got more sensors to keep me going. I just put in the last of my 7+ sensors, so I guess I'll be starting on the G4 in the week of New Year's.
I'm having difficulty with my overnight blood sugars- have been for over a month (so not caused by jet injector). I'm having hard to predict and rapid onset extreme night time hyperglycemia. For a couple of weeks I had numbers above 300 roughly every other night, and was hesitant to raise doses much because some nights I'd go low. Then I raised the Lantus dose, and things got a lot better. But the night before last, I once again went to bed with a nice stable 120 (at 9 PM- I was really tired), and woke up at 3 AM with a blood sugar of 330, feeling pretty awful. During the daytime I'm tending to run low. I'm not sure if my issue is delayed absorption or not, because not all of the night time highs happened with a meal within hours of bedtime; OTOH it's a really large rise for just a basal drift. And I have been having issues in that I'm going low after some meals as if I haven't eaten.
I'm also noticing a very predictable pattern where my blood sugar shoots up after exercise. This is especially noticeable after swimming, juggling, or biking, where about ten to twenty minutes after I stop exercising, my blood sugar starts going up- on the Dexcom there's usually a straight up arrow, not even a mere angled one. My blood sugar has been dropping or stable during exercise, but afterwards... ugh.
Two interesting studies I came across:
One on risk of stroke, heart attack, and death from cardiovascular disease that looked especially at diabetes and weight. I thought it was interesting that the average diabetic (they don't differentiate between types but the average age is 58) was not underweight in this large study. It is also sobering that the increase in death was entirely in people whose weight was low or low normal.
Another is just a case series. I am always paying attention to what's happening with the whole vitamin D thing, because my own experience was so contrary to what's reported. In this study, the authors merely report on the most recent fifteen patients they'd seen with vitamin D mediated hypercalcemia. In all cases, the people had severe cognitive symptoms, did not have a disorder affecting vitamin D metabolism (unlike me), and had been given injections of very high dose vitamin D by a licensed physician. These are interesting to me because these are people whose bad effects are due only to how much they took and not because of taking them without a doctor's approval or despite a disease that makes it a bad idea. These people did not have mild side effects; they were hospitalized for an average of over two weeks.
Their vitamin D levels overlap with how high mine have been, they all had higher calcium levels than I've had, their PTH levels overlap with mine (my PTH was measured at the bottom of normal), and they're all older than me and took more than ten times the dose that I took.
Sunday, December 16, 2012
Friday, November 30, 2012
Cyclosporine
Cyclosporine given to early onset type 1 diabetics (who'd never been in DKA) was shown, before I was even born, to give almost even odds that a person would be not be needing insulin to get normal fasting blood sugars one year after diagnosis.
Thursday, November 29, 2012
Stuff Changes In The Diabetes World
I was diagnosed with diabetes 6 years and 3 months ago, which means I've been diagnosed 5 years fewer than the average American diabetic (including T2s). Even though that seems like a short time to me, a lot of things have changed.
This post, more than most of mine, is very much US centered. There are insulin pumps, CGMs, and insulins for sale in other parts of the world that I am not discussing and the products available here aren't available everywhere else.
-The only insulin pump that was for sale in the US when I was diagnosed, that is still for sale in the US now, is the Accu Chek Spirit. When I was diagnosed, the insulin pumps for sale were Cozmo, Minimed 522 and 722, Animas 1250, and Accu Chek Spirit.
Cozmo has gone out of the insulin pump business. Now for sale are Omnipod, Minimed Paradigm Revel, Animas One Touch Ping, Accu Chek Spirit and Spirit Combo, and the new TSlim. Omnipod is the only insulin pump without a cord (unless we count the V-Go, which I don't), the TSlim is the first with a touchscreen and also the first one that needs to be recharged, the Revel is the only American pump that can double as the receiver of a CGM, the Spirit is cheapest, the Ping inaugerated the whole remote to the pump thing (although the combo works as a remote and I believe the Revel has a remote too).
-The year I was diagnosed, animal insulins went off the market in the United States. Exubera, the first inhalable insulin to go on the market, came out a few months after I was diagnosed, and is no longer for sale. Apidra was introduced after my diagnosis. And the new newest insulin is degludec, which is being sold as Tresiba. Neither Apidra nor Tresiba has been shown to make a real difference in diabetes control compared to other insulins. Novolog, Humalog, NPH, Regular, Lantus and Levemir were on the market then and still are now.
-The year I was diagnosed, the glucowatch biographer was still for sale. Dexcom and Medtronic were both earlier versions of their CGMs- Dexcom had just gotten approval for the Dexcom STS, which could only be calibrated by using the One Touch Ultra meter, which plugged into it (that was part of why I went with Medtronic for my first CGM), has sensors approved for only 72 hours of wear, and had transmitters that would last only six months (oh, that sounds familiar, you say?). Medtronic already had the Guardian RT out when I was diagnosed, although that is a slightly different version than the Guardian Real Time. The pump-acting-as-cgm-receiver didn't get released until the year I was diagnosed, 2006. Abbott's Freestyle Navigator was not yet on the market when I was diagnosed; its brief foray on the US market started and ended during the period since my diagnosis. Two versions later, the Navigator is still selling in much of Europe and Asia, but not here in the US.
Insurance companies rarely covered CGMs then.
Here is a Dexcom STS user guide: http://www.accessdata.fda.gov/cdrh_docs/pdf5/P050012c.pdf
-The year I was diagnosed, the ADA still had the reasonable position statement that diabetes could not be diagnosed by A1c alone, and that normal range for A1c went up to 5.9%. TnZ8 antibody tests weren't being done in a clinical setting. Bone marrow transplants for new onset diabetes weren't being done in the US (anywhere), and islet cell transplants were brand new. Nobody'd heard of Faustman, much less been disappointed in her data.
- The year I was diagnosed, the smallest insulin pen needles were still 5mm (now they're 4mm), and they still made reusable insulin pens for Lantus, and they sold Regular in cartridges (they still do that outside the US). There were four companies selling jet injectors to private individuals (there's one left).
When I was diagnosed, I figured that one of the perks of diabetes was going to be that I was going to try all sorts of products I never would have thought of. I've tried to change something every year, and mostly I have. I have tried a lot of things. I have used one NovoFlexPen (one was enough), Novopen Jr, Novopen 3, Novopenmate, an Inject-Ease, seven I-Ports, vials of Novolog and vials of Lantus, Solostar pens, Opticlik cartridges (since discontinued), a few versions of Bayer's syringes with 8mm needles, five sizes of pen needle, a bunch of meters (but only the Aviva as my primary- although its on its second type of test strip), the Guardian with Sof Sensors, Dexcom 7+, NPH, Novolog, Novolin R, and Lantus (in the morning, in the evening, and twice daily).
For me, changing stuff around makes everything more interesting.
In the immediate future, I expect to see some changes in the diabetes products available. In particular, I expect the Enlite sensors for Minimed to become available; hopefully the Veo too. I'm somewhat hopeful that the Animas Vibe will reach these shores in the near future. There are at least three insulins in clinical trials and I bet we'll have another one on the market sooner or later. I am interested to see if C8Medisensors turn out to work, and I'm hoping that bone marrow transplantation as a way of heading off type 1 diabetes will become safer and more effective with new methods.
This post, more than most of mine, is very much US centered. There are insulin pumps, CGMs, and insulins for sale in other parts of the world that I am not discussing and the products available here aren't available everywhere else.
-The only insulin pump that was for sale in the US when I was diagnosed, that is still for sale in the US now, is the Accu Chek Spirit. When I was diagnosed, the insulin pumps for sale were Cozmo, Minimed 522 and 722, Animas 1250, and Accu Chek Spirit.
Cozmo has gone out of the insulin pump business. Now for sale are Omnipod, Minimed Paradigm Revel, Animas One Touch Ping, Accu Chek Spirit and Spirit Combo, and the new TSlim. Omnipod is the only insulin pump without a cord (unless we count the V-Go, which I don't), the TSlim is the first with a touchscreen and also the first one that needs to be recharged, the Revel is the only American pump that can double as the receiver of a CGM, the Spirit is cheapest, the Ping inaugerated the whole remote to the pump thing (although the combo works as a remote and I believe the Revel has a remote too).
-The year I was diagnosed, animal insulins went off the market in the United States. Exubera, the first inhalable insulin to go on the market, came out a few months after I was diagnosed, and is no longer for sale. Apidra was introduced after my diagnosis. And the new newest insulin is degludec, which is being sold as Tresiba. Neither Apidra nor Tresiba has been shown to make a real difference in diabetes control compared to other insulins. Novolog, Humalog, NPH, Regular, Lantus and Levemir were on the market then and still are now.
-The year I was diagnosed, the glucowatch biographer was still for sale. Dexcom and Medtronic were both earlier versions of their CGMs- Dexcom had just gotten approval for the Dexcom STS, which could only be calibrated by using the One Touch Ultra meter, which plugged into it (that was part of why I went with Medtronic for my first CGM), has sensors approved for only 72 hours of wear, and had transmitters that would last only six months (oh, that sounds familiar, you say?). Medtronic already had the Guardian RT out when I was diagnosed, although that is a slightly different version than the Guardian Real Time. The pump-acting-as-cgm-receiver didn't get released until the year I was diagnosed, 2006. Abbott's Freestyle Navigator was not yet on the market when I was diagnosed; its brief foray on the US market started and ended during the period since my diagnosis. Two versions later, the Navigator is still selling in much of Europe and Asia, but not here in the US.
Insurance companies rarely covered CGMs then.
Here is a Dexcom STS user guide: http://www.accessdata.fda.gov/cdrh_docs/pdf5/P050012c.pdf
-The year I was diagnosed, the ADA still had the reasonable position statement that diabetes could not be diagnosed by A1c alone, and that normal range for A1c went up to 5.9%. TnZ8 antibody tests weren't being done in a clinical setting. Bone marrow transplants for new onset diabetes weren't being done in the US (anywhere), and islet cell transplants were brand new. Nobody'd heard of Faustman, much less been disappointed in her data.
- The year I was diagnosed, the smallest insulin pen needles were still 5mm (now they're 4mm), and they still made reusable insulin pens for Lantus, and they sold Regular in cartridges (they still do that outside the US). There were four companies selling jet injectors to private individuals (there's one left).
When I was diagnosed, I figured that one of the perks of diabetes was going to be that I was going to try all sorts of products I never would have thought of. I've tried to change something every year, and mostly I have. I have tried a lot of things. I have used one NovoFlexPen (one was enough), Novopen Jr, Novopen 3, Novopenmate, an Inject-Ease, seven I-Ports, vials of Novolog and vials of Lantus, Solostar pens, Opticlik cartridges (since discontinued), a few versions of Bayer's syringes with 8mm needles, five sizes of pen needle, a bunch of meters (but only the Aviva as my primary- although its on its second type of test strip), the Guardian with Sof Sensors, Dexcom 7+, NPH, Novolog, Novolin R, and Lantus (in the morning, in the evening, and twice daily).
For me, changing stuff around makes everything more interesting.
In the immediate future, I expect to see some changes in the diabetes products available. In particular, I expect the Enlite sensors for Minimed to become available; hopefully the Veo too. I'm somewhat hopeful that the Animas Vibe will reach these shores in the near future. There are at least three insulins in clinical trials and I bet we'll have another one on the market sooner or later. I am interested to see if C8Medisensors turn out to work, and I'm hoping that bone marrow transplantation as a way of heading off type 1 diabetes will become safer and more effective with new methods.
Wednesday, November 28, 2012
The Glimmer of a Honeymoon Still Matters
Among type 1 diabetics, the ability to make even a tiny amount of insulin is strongly associated with the ability to get lower A1cs without more severe hypoglycemia.
A majority of Joslin medalists- people who have been on insulin for more than 50 years- are still making a detectable amount of insulin.
Among adolescents who still have measurable levels of c-peptide (and thus, insulin production) one month after diagnosis, more than 90% still have measurable levels of cpeptide two years later.
C-peptide levels at diagnosis of type 1 diabetes are usually younger in younger people.
Decline in c-peptide levels is those type 1 diabetics who are positive for c-peptide is usually most rapid in the first year after diagnosis.
Even among type 2 diabetics, lower c-peptide levels are associated with higher rates of some complications, such as kidney disease.
Some medications used to treat type 2 diabetes (especially the sulfanureas) lower cpeptide.
http://diabetes.diabetesjournals.org/content/61/8/2066.long
A majority of Joslin medalists- people who have been on insulin for more than 50 years- are still making a detectable amount of insulin.
Among adolescents who still have measurable levels of c-peptide (and thus, insulin production) one month after diagnosis, more than 90% still have measurable levels of cpeptide two years later.
C-peptide levels at diagnosis of type 1 diabetes are usually younger in younger people.
Decline in c-peptide levels is those type 1 diabetics who are positive for c-peptide is usually most rapid in the first year after diagnosis.
Even among type 2 diabetics, lower c-peptide levels are associated with higher rates of some complications, such as kidney disease.
Some medications used to treat type 2 diabetes (especially the sulfanureas) lower cpeptide.
http://diabetes.diabetesjournals.org/content/61/8/2066.long
Tuesday, November 27, 2012
Vitamin T
1 in 4 men with type 2 diabetes has low testosterone levels, and insulin sensitivity usually increases in med with low testosterone levels. However, high testosterone levels in women (especially from PCOS) usually causes insulin resistance, and very high testosterone levels (about male normal range) also causes insulin resistance.
Testosterone significantly affects insulin sensitivity, but not linearly.
Today marks five years since my first injection of testosterone. The five year mark is significant in an artificial sort of way because it's recommended that transmen get bottom surgery by then because of concerns about endometrial and ovarian cancers (more endometrial). In one of life's little ironies, transgender people are at increased risk of reproductive organ cancers (so, for that matter, are some types of intersexed people).
Monday, November 26, 2012
A Senator With Diabetes
Norman Atkins (appropriate name), cofounder of Diabetes Canada, was also a member of the Canadian Senate. He was a type 2 diabetic, and that's what he died of; his son was (at least according to Canadian Senate speeches) the first Canadian type 1 diabetic fire fighter.
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While looking for a fact for today, I found out that the US Senate has a candy desk - one senator keeps a desk full of candy to be eaten by all senators. Somebody claimed that this tradition was started by a diabetic, which is how my google search turned it up. But I don't think it was- it was started by George Murphy and I can find no link from George Murphy to diabetes, and I doubt Murphy was diabetic during his run as senator.
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While looking for a fact for today, I found out that the US Senate has a candy desk - one senator keeps a desk full of candy to be eaten by all senators. Somebody claimed that this tradition was started by a diabetic, which is how my google search turned it up. But I don't think it was- it was started by George Murphy and I can find no link from George Murphy to diabetes, and I doubt Murphy was diabetic during his run as senator.
Sunday, November 25, 2012
NPH reduces A1c more compared to Lantus or Levemir in Type 2 Diabetics
When a person is started on only one type of insulin (not on a pump), making that insulin NPH or a mix of NPH and a short acting insulin, will reduce A1c more than taking Lantus or Levemir or a short acting insulin.
Probably this is for the very simple reason that if you are taking an insulin that acts as both basal and bolus, you can raise the dose to an extent that you can't do if you are taking an insulin that is only basal or bolus, and with more of your insulin needs covered.... ta da! Your A1c drops more.
Studies to this effect are included in the Lantus patient information, but a number of newer studies have shown the same thing, such as this one. I find this especially remarkable given that NPH or a 70/30 mix can be bought at Walmart for $25/1000 u vial, while Lantus can't possibly be bought anywhere for less than $90/1000 u vial (including amount paid by insurance).
And I'll throw in a bonus fact: the average A1c of a type 1 diabetic adults in different areas ranges from 7% to more than 10%. In the DCCT participants, the average A1c of the control group, and of the intensive group after they stopped getting intense attention from doctors, was 8.9%. If you are looking at data about average complication rates, you should probably assume that those are average for people whose A1cs are in the neighborhood of 9%- because that is about what average people seem to acheive if they are not personally doing a lot to change their diabetes outcomes.
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Yesterday I seem to have accidentally deleted the last six months' worth of comments on this blog. I hope none of you are as bugged by that as I am. Feel welcome to go back and make up for it by leaving lots of comments.
I am kind of annoyed at Dexcom because my case manager is not doing much. Not getting back to me, not getting a prescription. And everybody at Dexcom keeps telling me she will. Ha!
My Gentle Jet is being built now. Yay!
My blood sugar's been a mess for a couple of weeks (random highs in the 300s) and I kept thinking the issue was delayed absorption of meals but yesterday I didn't eat after 5:30 PM, didn't go to bed until midnight and still went into the 300s overnight. So I'm thinking the issue is really mostly a too low Lantus dose even though it doesn't totally look like it (I keep going low too, for one thing). Tonight I'm raising the dose although I haven't decided by how much.
Probably this is for the very simple reason that if you are taking an insulin that acts as both basal and bolus, you can raise the dose to an extent that you can't do if you are taking an insulin that is only basal or bolus, and with more of your insulin needs covered.... ta da! Your A1c drops more.
Studies to this effect are included in the Lantus patient information, but a number of newer studies have shown the same thing, such as this one. I find this especially remarkable given that NPH or a 70/30 mix can be bought at Walmart for $25/1000 u vial, while Lantus can't possibly be bought anywhere for less than $90/1000 u vial (including amount paid by insurance).
And I'll throw in a bonus fact: the average A1c of a type 1 diabetic adults in different areas ranges from 7% to more than 10%. In the DCCT participants, the average A1c of the control group, and of the intensive group after they stopped getting intense attention from doctors, was 8.9%. If you are looking at data about average complication rates, you should probably assume that those are average for people whose A1cs are in the neighborhood of 9%- because that is about what average people seem to acheive if they are not personally doing a lot to change their diabetes outcomes.
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Yesterday I seem to have accidentally deleted the last six months' worth of comments on this blog. I hope none of you are as bugged by that as I am. Feel welcome to go back and make up for it by leaving lots of comments.
I am kind of annoyed at Dexcom because my case manager is not doing much. Not getting back to me, not getting a prescription. And everybody at Dexcom keeps telling me she will. Ha!
My Gentle Jet is being built now. Yay!
My blood sugar's been a mess for a couple of weeks (random highs in the 300s) and I kept thinking the issue was delayed absorption of meals but yesterday I didn't eat after 5:30 PM, didn't go to bed until midnight and still went into the 300s overnight. So I'm thinking the issue is really mostly a too low Lantus dose even though it doesn't totally look like it (I keep going low too, for one thing). Tonight I'm raising the dose although I haven't decided by how much.
Saturday, November 24, 2012
Liver Diseases In Diabetics
Non-alcoholic fatty liver disease most commonly occurs in people with overweight people with insulin resistance- in type 2 diabetics, in fact. It's fairly treatable with a low fat diet.
Roughly 40% of type 2 diabetics have NAFLD.
I expected, when I looked for prevalence studies of NAFLD in type 1 diabetics, to find that we'd have lower rates- near normal rates. We don't. I found only two prevalence studies of NAFLD in type 1 diabetics (both on adults) and they gave prevalences of 44% and 53%
There are other liver diseases that are linked strongly with diabetes. One of the more unusual ones is called glycogenic hepatopathy, which is an acute liver disease caused by high blood sugars over a medium term- not a long term complication but you don't develop it in a week either (the cases I've read about have been in people with type 1 diabetes and A1cs between 10% and 14%). It goes away when you get better blood sugar control. It can be differentiated from NAFLD by liver biopsy. Glycogenic hepatopathy is one of those complications of diabetes that I figure I really do have the power to stop myself from getting- not maybe, but definitely.
Roughly 40% of type 2 diabetics have NAFLD.
I expected, when I looked for prevalence studies of NAFLD in type 1 diabetics, to find that we'd have lower rates- near normal rates. We don't. I found only two prevalence studies of NAFLD in type 1 diabetics (both on adults) and they gave prevalences of 44% and 53%
There are other liver diseases that are linked strongly with diabetes. One of the more unusual ones is called glycogenic hepatopathy, which is an acute liver disease caused by high blood sugars over a medium term- not a long term complication but you don't develop it in a week either (the cases I've read about have been in people with type 1 diabetes and A1cs between 10% and 14%). It goes away when you get better blood sugar control. It can be differentiated from NAFLD by liver biopsy. Glycogenic hepatopathy is one of those complications of diabetes that I figure I really do have the power to stop myself from getting- not maybe, but definitely.
Friday, November 23, 2012
Misdiagnoses Happen... and Sometimes They Matter
Recently I read a piece on a man who was diagnosed with type 1 diabetes at the age of 60, in France. He had gone to his doctor because he had lost 20 lb without trying, and he was thirsty. His random blood sugar was in the 300s, but his A1c was only 7.2%, indicating that he'd had a rapid onset of diabetes. So his doctor put him on insulin, and he felt better. His doctor did not test c-peptide or antibodies; he didn't see a reason.
Except that one month later this newly diagnosed diabetic went to the emergency room with extreme stomach pain, and was diagnosed autoimmune pancreatitis. Autoimmune pancreatitis is a rare condition mostly seem in middle aged men, and it usually gets a lot better when the person is put on steroids. So this guy was put on prednisolone for three months. After two months of prednisolone, he went off of insulin. Three years later, he is not on any medication at all, and his A1c is below 6%.
This particular misdiagnosis- autoimmune pancreatitis misdiagnosed as type 1 diabetes- is not common. For one thing, AIP is not common, and for another, the diabetes is usually not the first symptomatic part of it. And most doctos looking at a middle aged or elderly person with new diabetes are not going to leap to the assumption that it's type 1.
But misdiagnoses in general are common. Some of them are very serious- as when diabetes is the first thing seen in what turns out to be pancreatic cancer, and the doctor only diagnoses diabetes. Or as when somebody is diagnosed with type 2 diabetes, treated only with oral medications, and goes into ketoacidosis before getting insulin. Or when diabetes is misdiagnosed altogether as the flu. Or when a person with diabetes responsive to sulfonyureas is put on insulin only (if you were diagnosed with diabetes before the age of one year, for your own sake please get tested).
The following things make misdiagnosis more likely:
- Neither antibodies nor c-peptide were tested.
- A diagnosis was made that doesn't fit the c-peptide or antibody results.
- The person making the diagnosis was not an endocrinologist, and the patient has never seen an endocrinologist.
- The person is a young adult when symptoms start.
- The person is a baby when symptoms start.
- The person first went to see a doctor early on.
If you were diagnosed with type 1 diabetes without ever having either a positive antibody test or a low cpeptide (and not low for blood sugar, but actually low), it might be a good idea to get your cpeptide levels tested. More than a few people have found that they've been on insulin for a long time without needing to be.
I find it comforting to know that my cpeptide is nil and my antibodies are positive. There are no doubts about my diagnosis.
Except that one month later this newly diagnosed diabetic went to the emergency room with extreme stomach pain, and was diagnosed autoimmune pancreatitis. Autoimmune pancreatitis is a rare condition mostly seem in middle aged men, and it usually gets a lot better when the person is put on steroids. So this guy was put on prednisolone for three months. After two months of prednisolone, he went off of insulin. Three years later, he is not on any medication at all, and his A1c is below 6%.
This particular misdiagnosis- autoimmune pancreatitis misdiagnosed as type 1 diabetes- is not common. For one thing, AIP is not common, and for another, the diabetes is usually not the first symptomatic part of it. And most doctos looking at a middle aged or elderly person with new diabetes are not going to leap to the assumption that it's type 1.
But misdiagnoses in general are common. Some of them are very serious- as when diabetes is the first thing seen in what turns out to be pancreatic cancer, and the doctor only diagnoses diabetes. Or as when somebody is diagnosed with type 2 diabetes, treated only with oral medications, and goes into ketoacidosis before getting insulin. Or when diabetes is misdiagnosed altogether as the flu. Or when a person with diabetes responsive to sulfonyureas is put on insulin only (if you were diagnosed with diabetes before the age of one year, for your own sake please get tested).
The following things make misdiagnosis more likely:
- Neither antibodies nor c-peptide were tested.
- A diagnosis was made that doesn't fit the c-peptide or antibody results.
- The person making the diagnosis was not an endocrinologist, and the patient has never seen an endocrinologist.
- The person is a young adult when symptoms start.
- The person is a baby when symptoms start.
- The person first went to see a doctor early on.
If you were diagnosed with type 1 diabetes without ever having either a positive antibody test or a low cpeptide (and not low for blood sugar, but actually low), it might be a good idea to get your cpeptide levels tested. More than a few people have found that they've been on insulin for a long time without needing to be.
I find it comforting to know that my cpeptide is nil and my antibodies are positive. There are no doubts about my diagnosis.
Thursday, November 22, 2012
ABO Blood Groups and Diabetes
One of the interesting things to me about pubmed is that it sorts articles by newest to oldest automatically, and makes it easy for me to compare old articles and new articles.
Almost all articles on the topic of diabetes and ABO antigen blood types published before 1985 found no relationship. All of the articles I found published after 1990 found a relationship between ABO blood group and risk of type 2 diabetes. From reading these, my conclusion is:
Blood type B is protective against obesity related type 2 diabetes, particularly as compared to type O and type A blood types.
Some people with type A blood have a particular form of the allele that, when homozygous, raises risk of type 1 diabetes.
Having a blood type that is different from your mother's blood type is a risk factor for multiple autoimmune diseases, including type 1 diabetes.
Almost all articles on the topic of diabetes and ABO antigen blood types published before 1985 found no relationship. All of the articles I found published after 1990 found a relationship between ABO blood group and risk of type 2 diabetes. From reading these, my conclusion is:
Blood type B is protective against obesity related type 2 diabetes, particularly as compared to type O and type A blood types.
Some people with type A blood have a particular form of the allele that, when homozygous, raises risk of type 1 diabetes.
Having a blood type that is different from your mother's blood type is a risk factor for multiple autoimmune diseases, including type 1 diabetes.
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