Misdiagnosis of Adult-Onset Type 1 Diabetes Is Common. October 23, 2018

Misdiagnosis of Adult-Onset Type 1 Diabetes Is Common.
 by Miriam E. Tucker
https://www.medscape.com/viewarticle/903605?nlid=125692_1521&src=WNL_mdplsfeat_181023_mscpedit_wir&uac=164666HZ&spon=17&impID=1778358&faf=1#vp_2 

 Both Thomas (Nicholas J. Thomas, MD of the University of Exeter, United Kingdom.) and Dayan (Colin Dayan, MBBS, professor of clinical diabetes and metabolism, Cardiff University School of Medicine)  noted that there is no perfect laboratory test to distinguish between the two types of diabetes, as C-peptide can initially be positive in type 1 diabetes — although it's more definitive after about 3 years — and autoantibodies can be present in some people with type 2 diabetes and absent in some people with type 1 diabetes.

      So, there are mo tests to define what type of diabetes MD diagnose patient.  How MD possible able to treat patient without correct diagnose? The results are in Mortality tables by CDC. Diabetes type 2 is number 7 cause of Death in America. Why?
     Beside the correct diagnose there is correct or wrong treatment. If treatment correct then diabetic does not progress to insulin deficiency. If treatment wrong then, .... then less then 10 years after being diagnosed with diabetes type 2 diabetic gone if one did not start Insulin injections. If one is fortunate and was able to get MD who is willing to heal rather then keep diabetic in own stable, then diabetic type 2 will live. Then early insulin therapy started then more healthy diabetic will be and develop less complications when Diabetes type 2 progresses. Now, what Med. Pro think about it?

But session moderator Colin Dayan, MBBS, professor of clinical diabetes and metabolism, Cardiff University School of Medicine, is a bit more hesitant about putting people on insulin straightaway. "Insulin is a very difficult drug to use...I don't want to start someone on insulin if they don't need it," he told Medscape Medical News in an interview.

        I take insulin more then ten tears by now. I strted form 11 units at bed time because of I am diabetic type 2, and highest dose I injected was 720 units withing 24 hours. Why insulin is difficult drug to use? Because of insulin started so late that many complications already developed. Also there are swings high/low, high sugar level and then after insulin injections sugar in blood dropping too low. Why this happened? Because of human body is very sophisticated and very complex. What our Med. Pro educate us is wrong. They pretend that if sugar is low then a few spoons of sugar taken right away prevent sugar from dropping lower and lower. 100 years after insulin discovery Med. Pro still do not know that insulin and sugar is not in direct proportion dependency. It is not true that if today  right now my sugar in blood is 44 mg/dl then I have to take two or more spoons of sugar. If everything was so simple then just develop table how many spoons of sugar diabetic need to take according to blood sugar level. Everyone do know, there is no table like this, why? Because it does not work in this way.
      Now, I used to have 1,000 mg/dl in blood. This level was not one day, but day after day, a little bit less, but steady up and up. With every dose of insulin sugar dropped. Lowest I detected on my meter was 38 mg/dl. Of cause, because of I am diabetic type 2 I never was educated how to check up ketoacidosis. So, it never was detected, even I was in hospital. Really, I scared to go to hospital.

 The issue, Dayan said, "is whether any damage is done by waiting, using tablets...There are certainly patients where we suspect that they may have type 1 diabetes but they didn't present with ketoacidosis, so we might start them on [an oral diabetes medication] with close observation, unlike somebody where we're confident they've got type 2 diabetes...You need to keep your eyes open the first 3 years."

       At first I wish to ask, with oral medication how diabetes progressed or reversed? It is easy to see that if medicine work then A1c will go down. The numbers on glucose meter will go down. The number of medication in diabetic's medical box will decrease. BP, cholesterol, TG, and all other medical complications will not be developed with right medicine.  If medicine is wrong then with every day diabetes will progress.
     Now there is another question. Why MD pretend that it is right to let diabetes to progress during next 3 years after diagnose with diabetes type 2? Maybe it is not diabetic type 2 but LADA or MODY, or Type 1 diabetic? Most important that regardless of diagnose level of sugar in blood is great predictor if diabetic progress into complications development, or slow getting away from them.

But one key sign identified from this study is rapid deterioration in glycemic control despite use of oral glucose-lowering medications. "Rapid insulin requirement should alert the clinician to the possibility of type 1 diabetes," Thomas said.

      Say me, when it is happened and how insulin requirement  was identified? I follow all ADA recommendations for many years, and there are no insulin requirements when MD must start diabetic type 2 on Insulin. As long as I follow ADA publications there are all the time 'first line medication', and what does it mean? If diabetic come to clinic with 700 mg/dl or 599 mg/dl, would this diabetic type 2 started on Insulin Therapy? Not at all. even A1c=12.2% diabetic type 2 still take oral medicine, rapidly progressing to the Mortality Table by CDC.
    Still, I do not get the point, why do not start insulin injections as soon as sugar started to go out of normal range? What wrong with this policy? Profit.
     Diabetics are very profitable for Medical Industry. If there are no diabetics where high income will come from? Healthy patient no longer paying patient. It is difficult to get client into clinic if one is healthy. Diabetics type 2 are not healthy. We have wide range of complications. Then more we progress into insulin deficiency then more medicine we need. Then deeper we are in diabetes development then longer it takes to get out of this hole.

The correct diagnosis is important, he (Thomas)said, because patients need insulin early in order to avoid diabetic ketoacidosis. Also, even once they do receive insulin treatment, it's important to correctly distinguish the diabetes types as the respective insulin regimens and the type of education the patient receives differ considerably.

      Sorry Mr.  Thomas. DKA can be reversed very fast, but damage which done by wrong treatment and wrong diagnose not only will last too long and is too difficult to fix, but it can be fatal, or not reversible. This is another pro to start insulin as soon as diabetes was diagnosed. There is no wrong treatment if insulin taken as first line of therapy, regardless of any type of diabetes. So, it is win-win situation. The problem is only one, if there is no diabetics in clinics then there are no clients in it, or too little of clients in hospitals and clinics.

via Ravenvoron