DOUBLE DIABETES

Richard157
By Richard157 Latest Reply 2012-04-08 16:58:34 -0500
Started 2012-03-29 21:16:41 -0500

DOUBLE DIABETES

There were no diabetes "types" when I was diagnosed in 1945. All people diagnosed with diabetes were treated with insulin taken from pigs and cows. That crude form of insulin gave me back my health. In the years 1936-1939 it was discovered that there were two types of diabetes, but it was not until 1959 that the labels Type 1 and Type 2 were attached. Oral drugs for Type 2 diabeti…cs were introduced in the years 1955-1956.

Now, in current times, we are seeing more and more people with characteristics of both type 1 and type 2 diabetes. These individuals have "double diabetes". This occurs when:

1. A person with type 1 diabetes becomes overweight and develops the basic feature of type 2 diabetes – insulin resistance (IR). Typically, the type 1 diabetic would then use a type 2 medication to help control the IR. Insulin would still be necessary as well.

2. A person with type 2 diabetes has one of the key features of type 1 – the presence of antibodies in the blood against the insulin producing beta cells of the pancreas causing a decrease in the body's ability to produce insulin. The decreased insulin production can then lead to the type 2 diabetic becoming insulin dependent. These individuals still use their type 2 medication for their IR.

So double diabetics may have initially been either type 1, or type 2. Once they have become double diabetics they have IR, they are using insulin, and they are using a medicine (usually metformin) for their IR. I have several type 1 friends, and type 2 friends, who are double diabetics. Some of my type 2 friends are using a pump and a CGM.

In the 1990s I stopped using animal insulins, and began using synthetic insulins. I began gaining weight, even though I was following a much healthier diet, and eating fewer carbs. The only thing that had changed was my insulin. I have read many reports that say the synthetic insulins cause our cells to store fat. Maybe that was the reason for my weight gain, but I did not know that information until much later. I had never been more than five pounds above my ideal weight (185) until the 1990s. By the year 1997 I weighed 242 pounds. That was a net gain of 57 pounds. A lower carb intake and plenty of exercise did not seem to help at that time.

Finally, in 1998, I was diagnosed with insulin resistance. I had several relatives with Type 2 diabetes, and it seems likely I had the Type 2 gene. The gene and the weight gain are likely the explanation for my insulin resistance. In the early 2000s I reduced my daily carb intake, increased my amount of exercise, and lost 34 pounds. I initially used avandia for my IR, but started using metformin starting in early 2011. Using metformin for one year has been very good for me. That medication has helped many diabetics lose weight. I have lost an additional nineteen pounds, and am presently only four pounds above my ideal weight. Despite the weight loss, I still have IR. Metformin, eating an average of 140-150 carbs per day, and getting lots of exercise is keeping me in good health. My A1c's are typically below 6.0, and except for some mild nerve damage, I do not have any diabetes complications. Double diabetes can be controlled, and my health is just as good now as it was before I became a double diabetic.


25 replies

MrsCDogg
MrsCDogg 2012-04-08 12:22:27 -0500 Report

I went on Lantus a year and a half ago and since then I've gained almost 80lbs! I've always been a plus sized person but this is just awful. I have lots of back pain because of it and because of that I have issues with doing much of anything to get exercise. If I had known that the insulin could cause this I would never have agreed to using it. I have reduced my carb intake to very low. This weekend has been a bit bad for me because my husband brought cookies home and I have been into them several times. I now have the book Diabetes Miracle and have just started reading it. I must also be insulin resistant. But things have got to change. I do not want to go on disability because of my weight. It's good to know that someone else has had a similar experience with gaining weight and having a hard time getting rid of it. Thanks for sharing.

Richard157
Richard157 2012-04-08 16:58:34 -0500 Report

If you continue reducing your carb intake, and avoid most of the fast acting carbs, you will be using less insulin. That will help you lose weight. I also have back problems and am using a strap on back brace much of the time. Exercise has been very important to me. I have a trainer at the gym who has chosen appropriate exercises for me. She has helped me a lot, and I have lost all but 4 pounds of the weight I had gained.

annesmith
annesmith 2012-04-01 01:27:29 -0500 Report

I forgot to tell you they said I tested positive for antibodies about 3 years ago. At the time, I actually thought it meant the reverse of what it means..ha, ha..I thought it meant I made too much insulin, and the doctor was in a hurry, so, ha, ha..I walked around thinking that for at least a year..I try to keep a good sense of humor. Thank you for helping me to further my education. Sincerely, ANNE

Richard157
Richard157 2012-04-01 09:37:21 -0500 Report

Anne, I wish that all diabetics would become educated about their diabetes. So many are in denial, and don't even try to learn. It is no wonder that diabetes is number 7 on the list of killer diseases in the US. Those of us who become educated and strive to have good control are the survivors.

annesmith
annesmith 2012-04-02 02:08:14 -0500 Report

Yes..this is so true..I was told by my former internist that I was one of the best patients he had in years as far as attempting to further my education on it. I feel more in control the more I know. Of course, I'm not perfect by any means..I don't follow a rigid diet—I honestly don't believe it's realistic for me. All my life, I have either been an athlete, or a walker and runner—I love it, because, no matter what disease I have, I always feel so much better after I get done walking and running..my mind is cleared up, I burn off excess fat and sugar—it's not a cure of course, but, boy it always helps. My dad ( who was also diabetic and they also drew a question mark on his type) exercised regularly all the time, too. Him and I used to run up hills even, and race each other—ha. By thinking things through more lately, a BIG piece of information came to my mind—my father's patterns of diabetes and mine were always almost carbon copy of one another—I will definitely highlight that at my next doctor's visit. My mom, who is also diabetic, hers runs quite a bit different than mine-she's not brittle at all, but, she is almost always high..she is on insulin—Lantus I think. Every female on her side of the family, except for one aunt, was/is type 2 diabetic, and my great grandma was type 1 . 3 out of 5 of her brothers were type 2 diabetic—it runs rampant on that side..my dad, myself, and my dad's mother were/are a different pattern of diabetes—hybrid diabetes, and maybe LADA…interesting—so much type 2 on one side—well, again thank you for writing me back, as you are a great inspiration for all of us!!!—sincerely, ANNE

Type1Lou
Type1Lou 2012-03-31 13:45:17 -0500 Report

This is a great explanation. I was diagnosed Type 1 36 years ago at age 27. I had stopped seeing an endo since moving to Florida. About 8 years ago, my PCP decided that because my BG readings were creeping up that I was IR and prescribed Avandia along with my NPH insulin. I am 5'3" and weighed around 125 lbs at that time. After less than 2 weeks taking Avandia and suffering a catastrophic low BG, I insisted that I go off of the Avandia. At that point, he got me started on MDI of Lantus and Novolog which worked well until mid-2010 when I once again started experiencing severe low BG's. I then sought help from an endo who actually reduced my Lantus dose and educated me on carb to insulin ratios and sliding scales. (We're never too old to learn!) In August 2011, I started using a pump. My insulin sensitivity factor programmed into my pump is 120…which I'm told means I'm highly sensitive to insulin. The proper treatment of our diabetes must be tailored for each individual, and we, as responsible individuals must educate ourselves as much as possible to determine and voice what works for us. I love my pump and now weigh 116 lbs. Lowering my carb intake (no more than 120 grams/day) is helping me gain better BG numbers although accurately counting my carbs remains a challenge. Congratulations on your lifetime with managing your diabetes. We can all take inspration from you!

Richard157
Richard157 2012-03-31 18:49:41 -0500 Report

Lou, it sure sounds like you have great control now. Congratulations!!

Type1Lou
Type1Lou 2012-04-01 09:11:49 -0500 Report

Still striving for better control, though. My last A1c was 7.0 up from 6.8 and I had REALLY expected it to be lower. I think our aging bodies also throw us some curves that are difficult to manage and require continual adaptation…it IS a constant struggle but one worth fighting!

annesmith
annesmith 2012-03-31 02:07:11 -0500 Report

I'm so relieved someone brought this up, as I have both…I found an outstanding doctor about 4 months ago, but am still waiting for him to be open for new patients. He took a look at my daily brittle numbers and about dropped his clipboard. My daily numbers are between 86 and 600. I was almost admitted for ketoacidosis 5 times in the last 4 years..keytones were always found in the emergency room. Here is what has me perplexed: The last time I was in the emergency room, they took my A1c and said it was 16. I had just had my A1c done at the doctor's office a week earlier and it said my A1c was only 5.9. Now, you can understand why I'm frustrated beyond belief..ha. Just a little humor there..Every time I've been to the emergency room over the last 10 years, they said I was type 1. Slow acting insulin my body responded to beautifully. I won't go on and on, as I know I've talked to you before. This last excellent doctor said he has never ever ever ever had a type 2 with daily numbers like that, HOWEVER, he saw my different A1cs showing only 5.9..he said he also has NEVER had a type 1 patient with that. I paused, and thought to myself "Well, then, what?" It sounds to me like I am type 1.5. He had to get going, but wrote down on my paper " needs insulin before meals and after meals" , and insulin I think a small dose before I go to bed, too. He said he could not give me a prescription for it because I'm not one of his patients..he works at a clinic. Well, to me, I am right down the middle between both types then..ha, ha,ha..is it POSSIBLE? I mean, he's right on what he said..I agree with him completely. Do you think it is possible that some of us ( which seems to be me) are in a different ZONE? Ha…I mean, it is really frustrating..hospital always says type 1, clinics always say they don't know…boy, sorry to sound so frustrated, but, MAN, I'm getting tired!!—ha, ha, ha. My own opinion is I am LADA, or type 1.5. It doesn't take much for me to get KEYTONES. I have always been a very dedicated walker and runner. I found out I am burning off twice the amount of calories I need to. I have proven untreated childhood diabetes. A good friend of mine said he thinks I have a hybrid form of diabetes—I agree. I have been adding more greens to my diet , and one time for a whole year I ate nothing but nuts, berries and greens..I got weak eventually. Ha, ha…if you are laughing, I don't blame you, but, yes, this is serious. Write me back! I can't thank you enough for bringing up DOUBLE DIABETES, as nobody believes me -ANNE

Richard157
Richard157 2012-03-31 11:40:49 -0500 Report

Anne, I have read several times that there are multiple sub categories of each type that would help explain these kinds of variations. They are not clearly identified yet, and have not been given names. I think I am also in a category rather different from an ordinary type 1. Maybe we are both hybrids, and yet different from each other. I am not laughing because I can identify with being so different from the mainstream type 1 diabetics.

I would not try that greens and nuts diet, although many type 1 diabetics have been successful with it. I have to eat at least 130 carbs each day or I don't have enough energy to get exercise.

Those big swings sound like you may be injecting insulin into scar tissue. Then that happens the insulin is not absorbed properly, if at all. That would certainly cause very high blood sugar.

annesmith
annesmith 2012-04-01 01:19:45 -0500 Report

Yeah…I forgot to tell you that I don't currently take insulin..they wrote me out a prescription for it in 2005, and said to come back to the emergency room and get it if my same 700 reading happened again..they had given me insulin earlier that night to bring the 700 down. I woke up around 2:30 am, my symptoms returned, and I had no way to get to the emergency room . I should they say have called 911, because I was in bad bad shape..I didn't..went to bed and had a couple of seizures..nightmare. Ever since, I've been in this WEIRD zone..ha, ha..I honestly think I'm a hybrid type. I bet you are too. Thank you SO very much for sharing what you have read several times. It all makes sense…sub categories of each type—there'd have to be. I believe that some day they will be able to see the sub categories in a lot of detail. I would not recommend the nuts and berries diet to anyone, no matter what the type—why? I specifically remember getting very weak with it, but I kept forcing myself to abide by it no matter what. It's been about 16 years since I did that..I remember I would eat pure tomatoes, no meat, nuts , berries, salad with no dressing—after about 13 months, I stopped doing it, because I ran out of energy to walk and run then..ha. Since the last doctor said I'm type 1.5, I am going by that now..it's definitely a weird zone—you feel like you are "hanging" in a type 1 zone, but you also don't feel like an ordinary type 1. At the same time, you definitely can tell you aren't a type 2. Oh, the exasperation..ha, ha. I had a very close friend 11 years ago—she was a lot older than me..she was 65 and I was 30 years old, but we hung out together every weekend. She was diagnosed without a doubt as having double diabetes—and , she was brittle—hardly anybody, except for me, would believe her..they all said " Oh, there's no such a thing." Yes, there is such a thing. She was on insulin and pills both, and she was definitely not a regular type 2, but, she had characteristics of type 2. It turned out that she had been diabetic in her 30s, but it went undiagnosed . Then, when she turned 40, they found it, and she was very brittle. She often had what they called insulin attacks..I definitely remember that. She'd average I think in the 300s-700s without her insulin, but, yet, she had a lot of attacks where after she took her insulin, or before sometimes, she'd drop SO low—down into the 30s, and the people in the nursing home ( she was in a nursing home at age 63) would have to give her a bunch of crackers and orange juice…ANNE

dietcherry
dietcherry 2012-03-29 21:29:36 -0500 Report

Greetings Richard. You have spoekn about this subject before; I am T1 since 1981 and started on Metformin late January on my Endos suspicion that I had developed IR. I was taking alot of insulin so he cut the dose in half and I take 500mg. of Met daily.

I cant say I see a difference in my numbers. What I can say is my appetite has gone missing and hasnt returned despite him assuring me that it will. I force feed myseif and have lost 15 pounds to date.

My theory is my numbers havent changed because I am no longer eating much of anything. My next appt. is in April and we will reassess my using Met.

Gabby
GabbyPA 2012-03-31 12:02:09 -0500 Report

Please let us know how that goes. These things have to be put out there or our doctors just think we are making stuff up. I am very curious about how that is working for you.

dietcherry
dietcherry 2012-04-01 10:37:33 -0500 Report

Hey Gabby! I will definitely be sharing my experience on Met with all of you. Again I cant say that its doing anything for me in regard to decreasing insulin resistance, if in fact I have that. I think my Endo will want to increase the dosage to see if there is any effect. BUT if my appetite doesnt come back this would certainly negate proof of benefit.

I weighed about 139 in January and am now at 124. I went from a size 6 jean to a loose size 2 in 2 months. I can clearly see the benefit of Met for anyone wanting/needing to lose weight and I would go so far as to recommend Met to them for this purpose. For someone who was slim to begin with, its difficult for me to want to continue with it :(

annesmith
annesmith 2012-04-02 02:13:54 -0500 Report

I know that even though I turned out to be allergic to Metformin, when I did take it I lost 30lbs in 4 and a half months. It seriously cut off my appetite, though, to the point where I'd eat only 1 meal a day sometimes..if it works for the next person, I am happy for them…ANNE

Richard157
Richard157 2012-03-30 18:34:00 -0500 Report

Hi dietcherry, reducing your Met dosage was a good idea. Maybe you can reduce it even more, and eliminate it completely. Some people do that. If your doctor agrees then maybe your appetite will return. Losing some appetite is a known side effect of Met for many people. Even taking half dosages at the present time may help in that respect. It seems strange that I never lost any appetite since I started Met. I had to increase my carb intake to keep from losing too much weight. Not eating much of anything sounds unhealthy, and so does losing too much weight. Good luck to you in the months ahead!

dietcherry
dietcherry 2012-04-01 10:25:30 -0500 Report

Hi again! Richard Im not convinced at this point that the Met has done anything at all for me, hence Im thinking I dont have IR. However Im hanging in there until my appt. on the 24th and see what my A1c is and what my Endo recommends going forward. He may increase the Met or take me off it altogether.

By phone a couple of weeks ago, he told me the Met alone wasnt responsible for my loss of appetite. He says it is also the reduction in my insulin dosage. I agree with him on this; I hadnt thought about it until he mentioned it.

Richard157
Richard157 2012-04-01 10:55:59 -0500 Report

It took about a month of using Met before I was loosing weight, reducing my insulin, and experiencing less IR. We are all different in our reactions to Met. Some people have such terrible side effects they have to stop using it. I am using Met ER (extended release). Each dose is 1000 mg and lasts 12 hours. You may need larger doses to help your IR, but then I think you would lose too much weight and lose even more appetite. I hope you do not have IR, so you can stop the Met.

annesmith
annesmith 2012-04-02 02:20:27 -0500 Report

I was told I have serious serious serious insulin resistance in the emergency room about a year and a half ago—they found keytones again , and they ran a test for insulin resistance..the doctor came in after seeing my results and he said " You have really really serious insulin resistance." I guess whatever they find in some test shows the degree of insulin resistance one has. He said it was very extreme insulin resistance. Again, it's confusing to me..sounds like LADA to me, in reference to my first letter to you Richard—ha, ha..I seriously think you and I are a hybrid—2 different hybrids—ha, ha, ha..I say LADA in regards to me at this point, because, a standard type 1 would not have that much insulin resistance would they? Maybe I am wrong..ANNE

Richard157
Richard157 2012-04-03 21:52:36 -0500 Report

I have so much IR that I am using 2000 mg of Metformin each day. Type 1 diabetics can have a lot of IR. I am only 4 pounds above my ideal weight, but still have that much IR.

annesmith
annesmith 2012-04-06 01:22:20 -0500 Report

Oh…thank you..that's good to know. The more education , the better..hope all is going good for you…ANNE