Hi Phil and Janine:
Thanks for your swift interventions. They have certainly provided some interesting facts. Glad I persisted with this.
I have a feeling, when I get my head around it all I'll gain more insight into the internal processes around my Type 2 on insulin.
So please don't think I'm carping when I argue that in a dialogue such as we have here to just use the terms T1 and T2 without any further qualification i.e. T2 on insulin or T2 on oral medication is just not good communication. I further believe that T2 on insulin has more in common in a day to day practical sense with a T1 than a T2 on oral medication does.
Not that the descriptor T2 on insulin gives much of a picture either. In recent years it has come to be realized (something I've known since my diagnosis in 1977) that there are subgroups of T2s with different origins/causes – all requiring different treatment strategies, I would think.
Please note, I'm non medical, so if anyone feels the need to give me a further blast of re-education, please go right ahead .... !
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Dave
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Original Message:
Sent: 08-09-2020 17:57
From: Janine
Subject: T1 and T2
Hi Dave
I think the key difference between T1 and T2 is, as Phil has pointed out, that T1 is an auto-immune disease and T2 isn't. I must admit I hadn't thought about T2s not getting DKA, but it would certainly be an issue for paramedics to be aware of in an emergency situation. Thanks for pointing that out Phil. Type twos who are on insulin usually have a different regime too. They are much more likely to be on a mixture of fast/medium/slow acting insulins and may have only one or two injections per day. They sometimes need to have massive doses of insulin because of insulin resistance. My mother, who is an insulin dependent type 2, used to have over 100 units per injection so she had to 'dial up' twice, because most pens have a maximum dose of 70 units. They also don't usually have to do as many BGLs. All this is because they still have some insulin working, whereas T1s have none, as Phil mentioned.
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Janine
Original Message:
Sent: 08-09-2020 09:17
From: David
Subject: T1 and T2
Dave/DaveL back again....
Hello Shauna.
Haven't heard from you since my last response. This is disappointing, as having shown some interest in this topic I had hoped I would find an answer in you after some discussion. As I've already made clear, the confusion does bother me.
If however you haven't the time perhaps someone else could take up the cause? Why not a medically qualified authority if out there?
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Dave
Original Message:
Sent: 31-08-2020 10:34
From: David
Subject: T1 and T2
Yes – DaveL in response:
Thanks for that, Shauna: I thought my small contribution had been buried and forgotten. I'm very happy to return to this debate as it troubles me greatly.
Could you explain how 'As a Type 1 my medical treatment does differ to that of a Type 2 (on insulin)'? I really don't understand this. How does the 'more absolute description of one's individual medical condition as Type 1 or Type 2 serves to ensure medical treatment from all health professionals and workers, especially in an emergency, is far more relevant to the your type of diabetes'?.
I need to know how my treatment in an emergency, being diabetic on insulin would differ from that of a T1 in an emergency.
Further, evidence both from you and another's contribution is evidence that confusion does exist generally.
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Dave
Original Message:
Sent: 29-08-2020 09:27
From: Shauna
Subject: T1 and T2
To use your description of ID/NID or ID/OM DaveL would continue to muddle the (your term) 'distinction' between Type 1 and Type 2 diabetes.
Many Type 2s progress from oral meds to insulin - does this make them 'insulin dependent'? I have a Type 2 family member now on insulin who describes themselves as insulin dependent. Technically, I guess it does but a more absolute description of ones individual medical condition is Type 1 or Type 2 which serves to ensure medical treatment from all health professionals and workers, especially in an emergency, is far more relevant to the your type of diabetes.
Once in a first aid course the teacher (also a paramedic) stated that Type 2s that progress to insulin become Type 1s. I also heard this same statement from a mother of a Type 1 child. This is totally incorrect.
As a Type 1 my medical treatment does differ to that of a Type 2 (or a gestational patient - I had gestational diabetes with my second child then 7 years later became a Type 1 after contracting pneumonia and pleurisy). Your suggested terms above I feel would not adequately cover those important distinctions between Type 1 and Type 2.
Regards, S
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Shauna
Original Message:
Sent: 08-06-2020 11:32
From: David
Subject: T1 and T2
Call me Dave or DaveL if a Dave is already corresponding. Age: late 70's , diagnosed in 1977 as diabetic, placed on oral medication. Worked for a while and then placed on insulin.
For the life of me I've never understood the classifications Type 1 and Type 2. At time of diagnosis the understanding was that T1 described a total failure of pancreatic function and treatment was insulin. T2 acquired much later in life and only required oral medication. Now while those definitions have modified and adjusted over time, I have no quarrel with that.
However could those who use that terminology so freely on this forum inform as to their understanding of these terms? For me a much more useful distinction could be made: ID and NID (Insulin Dependent and Non Insulin dependent) Or perhaps ID and OM (Insulin Dependent and Oral Medication). Comments, Debate?
Regards Dave