PCOS Messages for July, 2002: Re: What You Should Know about Diabetes

Re: What You Should Know about Diabetes

From: Renee (anonymous@obgyn.net)
Wed, 03 Jul 2002 11:51:39 -0700

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My observations are from the 70% of my outpatient patients being diabetic (I'm a wound care specialist, and diabetics have a lot of problems with wounds), a large portion of my inpatients being diabetic (I don't track those numbers), being a health care professional for 8 years, having 2 graduate degrees involving much work in diabetes, and working with a diabetes education program. I also asked a certified diabetes educator with many years experience (including research) for confirmation.

I completely agree that over time a type 2 diabetic can need to go on insulin. They become an insulin dependent type 2 diabetic. Type 2 forms from the receptor sites not working. They don't regenerate after the pancreas stops working correctly. In type 1, the receptor sites work. Therefore, once a type 2, always a type 2. It is just a matter of whether you need insulin or not in addition to your other control methods (diet, meds).

Kristy's friend may have been mis-diagnosed based on her age initially. Someone may have assumed that if she was in her 20's then it must be type 2, thinking it would have been diagnosed earlier if it was type 1. Then, they learned otherwise, or further testing revealed the error, and her diagnosis was change. I'm not saying this IS what happened, since I don't know the people involved, of course, but it is one possibility.

So, again, you can not go from a type 2 to a type 1, though you can become an insulin-dependent type 2 diabetic. The receptor sites don't work, so, to use your term, "by definition," you're still a type 2.

Renee

"Pat Sonnenstuhl, ARNP, CNM, MS" wrote: >
> I wonder what you base your observations upon? Just folks you have had
> contact with? Type II Diabetes very definitnly can progress to using
> part medications, part Insulin, and some eventually insulin only, as
> nothing else works, or they cannot tolerate the medicaitons. Eventually
> all of the cell quit functionoing. Type I is considerd due to a virus,
> has a different course, as folks need insulin immediatly. But, the
> pancrease can totally shut down in a Type II diabetic, and thus, by
> definition, become Type I. The mechanism is different.
> I suspect we both are saying the same thing. If uncontrolled, Type II
> Diabetes can progress to Type I where insulin only is used.
>
> <<<Your friend may have misunderstood her doctor and thought that if
> she now needed insulin that she became a type 1. You don't convert from
> a
> type 2 to a type 1. I've never met anyone who's converted from a type 1
> to a
> type 2, though I suppose it would be possible if their receptor sites
> wore out
> over time.>>
>
> Pat Sonnenstuhl, ARNP, CNM, MS
> Balanced Eating Support
> http://home.attbi.com/~cnmpat/favlowcarbsites.htm
> http://home.attbi.com/~cnmpat/siteindex.htm
> PCOS Support
> http://www.midwivesofwa.org/pcos.htm
> http://www.midwivesofwa.org//pcosarticles.htm
>

-- -------------- Renee Cordrey, MSPT, MPH, CWS

---
Dwell in Possibility.
--Emily Dickenson

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