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[IanKennedy]

Fortunately, type-II diabetes generally doesn't have as much of an effect on longevity; in my case, the revised estimates might be off because type-I diabetes is generally thought of as being a lifelong condition, not contracted in adulthood.

I'm afraid that's a common misconception. I work for a the Diabetes Trials Unit of Oxford University. Type II diabetes is quite a nasty disease. However, one of our studies proved that if you keep your diabetes under control (ie try to keep your blood sugar "normal") then the chance of complications is greatly reduced. Talk to a doctor about what "normal" means and what you should be aiming at.

[Captain Picard's Hair]

I've only recently contracted the disease; for the past two weeks my glucose has generally been between 90-130 mg/dl (2 week average 108). I see my doctor tomorrow.

[IanKennedy]

I've only recently contracted the disease; for the past two weeks my glucose has generally been between 90-130 mg/dl (2 week average 108). I see my doctor tomorrow.

I'm not familiar with US units so I don't now how that fits. The best thing is to talk to the doc and best of all do what they say. If it's tablets, remember to take them etc. You'd be surprised how many people forget.

[Mikey]

Fortunately, type-II diabetes generally doesn't have as much of an effect on longevity; in my case, the revised estimates might be off because type-I diabetes is generally thought of as being a lifelong condition, not contracted in adulthood.

I'm afraid that's a common misconception. I work for a the Diabetes Trials Unit of Oxford University. Type II diabetes is quite a nasty disease. However, one of our studies proved that if you keep your diabetes under control (ie try to keep your blood sugar "normal") then the chance of complications is greatly reduced. Talk to a doctor about what "normal" means and what you should be aiming at.

Which part are you referring to as a "common misconception?" The fact that "juvenile" diabetes is more commonly a lifelong condition? That's the truth, because I am the exception rather than the rule as someone who has ocntracted type-I diabetes mellitus in adulthood. And the units CPH referred to are mg of seral glucose per deciliter of blood.

If you're referring to me saying that type-II doesn't have as much of an effect on longevity, that's in relation to type-I diabetes, not that it doesn't have an effect at all.

[IanKennedy]

Fortunately, type-II diabetes generally doesn't have as much of an effect on longevity; in my case, the revised estimates might be off because type-I diabetes is generally thought of as being a lifelong condition, not contracted in adulthood.

I'm afraid that's a common misconception. I work for a the Diabetes Trials Unit of Oxford University. Type II diabetes is quite a nasty disease. However, one of our studies proved that if you keep your diabetes under control (ie try to keep your blood sugar "normal") then the chance of complications is greatly reduced. Talk to a doctor about what "normal" means and what you should be aiming at.

Which part are you referring to as a "common misconception?" The fact that "juvenile" diabetes is more commonly a lifelong condition? That's the truth, because I am the exception rather than the rule as someone who has ocntracted type-I diabetes mellitus in adulthood. And the units CPH referred to are mg of seral glucose per deciliter of blood.

If you're referring to me saying that type-II doesn't have as much of an effect on longevity, that's in relation to type-I diabetes, not that it doesn't have an effect at all.

That it doesn't have as much as an effect on longevity. Type II diabetes is often referred to as mild, which it isn't. It's just as nasty, year on year, as Type I. The only difference is the duration over which the exposure takes place. The complications of type I as slightly different than type II as they tend to be macro vascular in type I rather than micro vascular in type II. (big blood vessels rather than small ones). But they're just as nasty. Loss of limbs, blindness, kidney failure, male impotence, strokes, heart attacks to name but a few. Some people in our longest running trial (30 years) have had 10 different things happen to them one after another. You can loose up to 10 years off your life expectancy due to type II diabetes.

The good news is that with both types of diabetes are treatable. Also, both our study of Type II (UKPDS) and the US study of Type I (DCCT) show that keeping the glucose as close to normal as possible gives a significant reduction in the rate of these problems occuring.

As for the units I know what they are I just am not used to the conversion factors between mg/dl and mmol/l for glucose.

[Mikey]

*laughs ruefully* believe me, I know all too well the nasty things I possibly have in store for me. And you kindly omitted from your list some of the more gruesome possible complications as well. I wasn't considering type-II diabetes in a void - current treatment options (although insulin is coming more into vogue for type-II) are not as reactive as for type-I, which treatment is by its nature is "shoot enough insulin into your belly enough to account for what you're about to eat and for any over-normal current sugar readings." Whereas, metformin/glucophage descendants actually treat the underlying issue of type-II, which is inability uptake/utilize one's own insulin.

However, having wither type of diabetes comes with a great deal of depression, anger, frustration, strict self-denial, and facing oneself with a lifetime of rather unpleasant daily treatment as well as the distinct possibility of very nasty things happening to you. I don't recommend it to anyone.

[Teaos]

Is it possible to have type I and type II.

[Mikey]

I guess technically you could have the predisposition, but the effects wouldn't work together. Insulin is the hormone which allows the body to metabolize sugar. Type-I (sometimes known as "juvenile diabnetes") is an inability to produce insulin, either enough or at all; type-II is in an inability to utlilize the insulin that you do make.

[IanKennedy]

I guess technically you could have the predisposition, but the effects wouldn't work together. Insulin is the hormone which allows the body to metabolize sugar. Type-I (sometimes known as "juvenile diabnetes") is an inability to produce insulin, either enough or at all; type-II is in an inability to utlilize the insulin that you do make.

Not quite right. Although type II people do produce insulin we have demonstrated that they do not produce enough for the prevailing glucose levels. It's not that they just don't react to the insulin the do produce. This is an idea that is not very common in the states where 'insulin resistance' is the common belief. The true difference between type I and type II is it's origins.

The cause of type I is your own body attacking your own beta cells (the cells that produce the insulin), these cells are just about wiped out by this attack. This is an immune reaction much in the way that arthritis can be caused. The root cause of what triggers your body to start attacking it's self is little understood, although there are theories about viral infections and other such issues starting the process. This typically happens when one if fairly young, often in your teens but sometimes later. A person with type I diabetes has virtually no insulin production of their own.

Type II diabetes stems from a reduction in the ability to produce insulin in the first place. However, it is a very slow decline over a number of years. It is caused by the same beta cells killing them selves off. This effect is more that the cells somehow break themselves producing a substance in the process called Amylin. This is a very very tough protien that is virtually impossible to disolve. This means that type II diabetics have a slow decline in insulin production over time. This is why they are often treated with tablets that allow them to better utilize the insulin they already have. Having said that there is a lot to be said for insulin treatment early on as it is thought to help preserve the insulin production that they still have.

There are other combinations but they are very rare. For example there is a disease called MODY (short for Maturity Onset Diabetes of the Young). As the name suggests this is a disease that looks very like Type II diabetes, however people tend to get it when they are young. It is typically caused by mutations in DNA that is present from birth but doesn't show it's self until about 14 or so. There are about 24 variations on this disease, most of which have been found by a chap that used to work in our department. This is very uncommon and only accounts for about 0.5% of the diabetic population.

[IanKennedy]

Is it possible to have type I and type II.

No you cannot have both together. Type I (young diabetes) wipes out just about all your beta cells, so there would be nothing left for the problems of Type II to work on. See my other post for an explanation.

[Mikey]

"young" or "juvenile" diabetes are common terms, but are misnomers. I developed type-I diabetes right around my 34th birthday as a result of an autoimmune reaction to a simple viral infection - in fact, antibody tests do confirm this in certain cases. The antibodies are short-lived compared to the onset of diabetic symptoms, so it's not a conclusive negative test, and is really academic anyway. However, congenital factors may also be to blame in true "juvenile" cases.

As fas insulin resistance being the effect of type-II as a "common belief," you had better add that it is a common belief among endocrinologists and other diabetes researchers, so as not to make it sound that it is just an old wives' tale among us uneducated laity. If it was completely false, how would glucophage help?

[IanKennedy]

"young" or "juvenile" diabetes are common terms, but are misnomers. I developed type-I diabetes right around my 34th birthday as a result of an autoimmune reaction to a simple viral infection - in fact, antibody tests do confirm this in certain cases. The antibodies are short-lived compared to the onset of diabetic symptoms, so it's not a conclusive negative test, and is really academic anyway. However, congenital factors may also be to blame in true "juvenile" cases.

As fas insulin resistance being the effect of type-II as a "common belief," you had better add that it is a common belief among endocrinologists and other diabetes researchers, so as not to make it sound that it is just an old wives' tale among us uneducated laity. If it was completely false, how would glucophage help?

Yes, I said it was a common belief in the states, that doesn't make it true. We have actually demonstrated damaged beta cells in-situ within subjects with type II diabetes. The stuff was actually discovered in our laboratory about 20ish years ago. It took about five years to find something that could disolve it so it's structure could be identified. Of the two people who discovered it one still works in our building but the other went to the US and founded a company. I wouldn't call endocrinologists diabetes researchers, they tend to think of diabetes as a minor thing not really worthy of study. They're more concerned with tumors and things like Cushings. We have lots of those in our building too.

As for Glucophage, which is better known as Metformin, it has a number of actions only one of which is related to decreasing "insulin resistance". http://www.netdoctor.co.uk/medicines/100001181.html as you can see described in this article it also works to reduce the amount of gluconeogenisis within the liver, ie the amount of triglyceride (a type of fat) that gets turned into glucose. However, it was, and still is to a great extent, used in the obese, who do suffer insulin resistance, due to being fat rather than diabetic. It was one of the treatments that was used in the UKPDS (United Kingdom Prospective Diabetes Study, our 30 year trial), it was found to be just as good as the other agents in controlling type II diabetes, but it also showed a significant heart protection ability. Our study was the only thing that kept it in production, as it's owners where about to dump it when our results came out. It is now the treatment of choice for new diabetics.

[Tsukiyumi]

I'm rather strongly hypoglycemic - any advice on that front?

[IanKennedy]

I'm rather strongly hypoglycemic - any advice on that front?

Not specifically, if you are on Insulin then you have to balance the dose based on activity level and size of meals, if you get this right then it can help a lot. The other thing is to look at the type of insulin you are taking. Some of them are better at warning of impending hypos than others. At least if you can feel it coming you can do something about it before it becomes a major issue. A good diabetes specialist nurse, rather than a doctor, would be a good person to discuss it with as they tend to be more on the practical side. Assuming there are such things where you are.

If you are on tablets they tend not to be as much of an issue on this front however, some are better than others.

[Tsukiyumi]

I'm rather strongly hypoglycemic - any advice on that front?

Not specifically, if you are on Insulin then you have to balance the dose based on activity level and size of meals, if you get this right then it can help a lot. The other thing is to look at the type of insulin you are taking. Some of them are better at warning of impending hypos than others. At least if you can feel it coming you can do something about it before it becomes a major issue. A good diabetes specialist nurse, rather than a doctor, would be a good person to discuss it with as they tend to be more on the practical side. Assuming there are such things where you are.

If you are on tablets they tend not to be as much of an issue on this front however, some are better than others.

I'm sorry, I meant to specify that I have hyperinsulination; i.e. I make too much of it (maybe I can toss you some, Mikey ), but still have to keep a watchful eye on what I eat or drink.