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Q:

Can one have both type 1 and type 2 diabetes? I've had type one for 62 years and as doing fine, but My A1C is 9.1 and has always been high, even tho my blood sugars seem stable. I need to take Lantus in the morning and Novolog before meals usually. I miss taking my NPH with one shot a day, but my new doctor thinks it's not good. What's your opinion? Would type 2 pills help me lower my A1C? Thanks.

Dr. David Erani

A:

Insulin resistance is the major factor in the development of type 2 diabetes. Being overweight or obese causes insulin resistance. Most people with type 2 diabetes are overweight or obese. Type 1 diabetes is caused by autoimmune destruction of the insulin-producing pancreatic beta cells. Many people with type 1 diabetes are thin. What if someone with type 1 diabetes is obese? There is no reason to think that their obesity would not cause insulin resistance. This would increase the amount of insulin they need to control their blood glucose. If you are insulin resistant, does that mean that you have type 2 diabetes in addition to type 1 diabetes? It’s impossible to tell. The only way would be to take away your type 1 diabetes and see if your blood glucose was still high enough to meet the criteria for the diagnosis of diabetes. There are things other than obesity which can cause insulin resistance. If your insulin requirement has increased, your doctor should consider other causes of insulin resistance, including thyroid and adrenal disease as well as certain medications. As far as the type of insulin you take, Lantus (glargine) has the advantage of lasting longer than NPH. For that reason, you can take Lantus once daily, whereas most people with type 1 diabetes need to take NPH twice daily. If you have not already done so, you should contact Joslin to get your 50-year medal to celebrate the fact that you have lived with diabetes for over 50 years. You can find further information on the medalist program by following this link: http://www.joslin.org/joslin_medalist_program.html

June 12, 2013 at 4:41 pm

1 reply

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best cook ever 2013-07-30 05:01:08 -0500 Report

I have type 2 diabetes and nuropithy and my wife's first husband had the same thing with no pain ,I have serve pain in both legs and it is getting worse and i have numbness in my left hand in my little finger my big toes are getting numb how can i explain to her my nuropithy to her so she can understand my pain!!!