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Frequent Responder
achill6969
Total Posts: 53
Registered on: ‎05-06-2010

First A1C since dx at 13.6% 04/28/10

I was diagnosed 04/28/10(i think everyone remembers the date huh) and spent 5 days in the hospital with a BG of 541 and an a1c of 13.6%. just did my 3 month 07/29 and i was at 4.9% with an avg of 97 for BG. I was so happy with the results. My Dr told me i was a T1 diabetic and would need insulin which i have been using the last 3 months. During my apt my Dr showed me labs and my C-peptide was 0.8-(0.8-3.1) he said that i have type 2 numbers but was on the border of T1 with 0.8.
He offered to put me on metformin to try it out but said i might have elevated BG levels. I decided to try pills with the recommendation from my diabetic educators advice. the diabetic edu. said i might have a low cpeptide due to having been taking insulin and my body not having to use its own insulin. My Dr has not done a GAD test even though it was recommended. Besides my great A1C i would like to know what pepole on the boards think of the c peptide discussion? i am now taking lantus 6units and metaformin 2times daily. i also went from 325lb at dx to 275lb currently. i would take less than 10 units daily of humalog before and 10 units lantus at night before changing. As an update for the past 5 days on metaformin and lantus i have not exceeded 103bgs(knock on wood) 2 hrs after eating reading. i eat on avg 40-50 carbs total 3 times daily. so around 100-150 daily....thanks for all the help i frequent the boards daily and read as much as possible.

Dx 04/28/10 A1c 13.6
A1C 07/29/10 A1c 4.9
Lantus 6 units
1000mgs metaformin 2 times daily
Contributor
acidrock23
Total Posts: 1,362
Registered on: ‎10-31-2009

First A1C since dx at 13.6% 04/28/10

Wow, 4.9 is smokin'!! I am clueless about C-peptide, I have no idea if they'd invented it when I was dx'ed or not. It might be that you could get a different answer entirely on the T2 board. On one hand, you are kicking some serious butt w/ the insulin, if I understood correctly you'd been taking it but, on the other hand, insulin is a pretty hard drug? Metformin is pretty serious too though. That would be a tough decision to make. I sort of wish I had to make it though?
Long Lost Member
n3qe-tim
Total Posts: 377
Registered on: ‎11-01-2009

First A1C since dx at 13.6% 04/28/10

acidrock23 (8/9/2010)
I am clueless about C-peptide, I have no idea if they'd invented it when I was dx'ed or not.


It's been around for a while but it used to be a very rarely run test. If you were a kid you had juvenile diabetes, if you were an adult you had adult diabetes. (pre T1 and T2 terminology) Of course now we know things aren't so clear cut.

I remember C-peptide testing being one of the requirements for participating in the DCCT about 27 years ago - didn't sign up for the DCCT, so I didn't get it.

I was diagnosed without a blood test and I guess that a lot of us diagnosed in the stone knives and bearskin days have a similar story. Peed on the testape and it turned jet black instantly. Heck it wasn't that long ago that the dictionary and medical definition of diabetes was "sugar in urine".

Tim.
Established Advisor
Angua
Total Posts: 787
Registered on: ‎04-02-2010

First A1C since dx at 13.6% 04/28/10

Hi Angel,



It might be, that like a few of us here, you have type 1.5 diabetes -- this means your beta cells, like in type 1 no longer produce insulin, for the most part, but sometimes they "wake up" and decide to help out. It also means that you might have some characteristics of type 2 also (hence the metformin?). (This is actually a gross simplification of the whole T1/T1.5/T2/LADA/MODY discussion).



The c-peptide is probably a good indicator of the fact that your own pancreas produces very little insulin -- I know that when my pancreas "wakes up", it doesn't seem to take into account the fact that there's insulin in my system and I end up going low. YMMV of course though!
Frequent Responder
achill6969
Total Posts: 53
Registered on: ‎05-06-2010

First A1C since dx at 13.6% 04/28/10

So would it be best to get a GAD-65 done or what would tell me wither i am T2 or T1. If metaformin takes a little while to work should i expect high readings? i havent had a high reading yet of over 110 ( knock on wood) i am proud of my 4.9% its been alot of work, this whole D thing is alot of work.



well ill continue my exercising and eating healthy and hope for the best.
Super Advisor
_julie_
Total Posts: 969
Registered on: ‎11-01-2009

First A1C since dx at 13.6% 04/28/10

Angel - great job on your 4.9%!!!!!!

I don't know much about using c-peptide to definitively figure out which type of diabetes a person has. I think that he GAD-65 test is the normal one that comes back positive for a regular type 1. If the Metformin works, you must be a type 2 or perhaps a type 1.5 like Angua said.
Julie
Type 1 since January 2008
OmniPod Insulin Pump/Dexcom G4 CGM/Apidra Insulin/Dabbling with Symlin
(anon)
Total Posts: 0

First A1C since dx at 13.6% 04/28/10

I'm just curious, since this is posted on the T1 side, do any of you T1's have an endo that would say an A1c of 4.9 is good? My Endo would freak out if any Type 1 had that LOW of an A1c. Is that correct, are we T1's supposed to stay around 6%. I'm somewhat new to this too and want to get the lowest A1c possible but my Endo says never to go that low, too many hypos.

C-peptide measures how much insulin you're still making, it depends too on when the test was takin' and what your fasting BG was, it's supposed to be done fasting with a fasting BG reading. A GAD-65 or ISLET cell test (positive) would confirm you're a type 1. Even type 1's can still be producing some insulin. Usually Type 2's, when a cpeptide is done, have a high result, thus...they're producing enough - a lot of insulin but are resistant to it. C-pepetide in Type 1's none, low or end of low. At least that's what my endo told me. I tested positive for both GAD-65 and Islet antiboides (beta cells live inside the Islet Cells) but have a cpeptide of 1.0 with a fasting BG of 165, coming down from a fasting of 383. Thus type 1, Endo didn't even use the term 1.5, it's just type 1 she said.
Contributor
acidrock23
Total Posts: 1,362
Registered on: ‎10-31-2009

First A1C since dx at 13.6% 04/28/10

My endo is ok w/ 5s but I'm not sure what she would make of a 4.9, although I'd like to find out?

I recall that Ron/ Daggerfall reported 4.6 ish numbers but I don't recall him mentioning what his endo made of that?
Long Lost Member
n3qe-tim
Total Posts: 377
Registered on: ‎11-01-2009

First A1C since dx at 13.6% 04/28/10

sarahbee (8/10/2010)
I'm just curious, since this is posted on the T1 side, do any of you T1's have an endo that would say an A1c of 4.9 is good? My Endo would freak out if any Type 1 had that LOW of an A1c. Is that correct, are we T1's supposed to stay around 6%. I'm somewhat new to this too and want to get the lowest A1c possible but my Endo says never to go that low, too many hypos.


Over the years I've had several to many A1C's in the 5's, almost all the rest in the low 6's, and it used to be, whenever I had a number like that the endo always gave me the "dangers of hypos" lecture. I swear I got that kind of lecture like 100 times. OK, I'm exaggerating a little, I didn't get it every single time but multiply 30 years by 2 to 4 doctor visits a year and it's not exaggerating much.

But you know what? In the past few years I have not gotten such a lecture. I select docs that have very aggressive stances on bg control so my sample is obviously biased, but if I turn in an A1C of 6.2% my docs have been telling me "Tim, that's not bad, but I know you could do a little better than this..." instead of giving me the "dangers of hypos" lecture.

Tim.
Super Advisor
marymary
Total Posts: 1,170
Registered on: ‎10-31-2009

First A1C since dx at 13.6% 04/28/10

My daughter had a 4.9 only once and the doctor was not concerned but she had been having some lows at the time. Her insulin requirements constantly change, but she has not had an A1c that was not in the 5's since she started pumping. I am happy when we can keep her in the low 5's, and start thinking that we need to make changes when she gets into the high 5's. I think that most people can do better than 6's, but of course that is everyone's choice to make for themselves and some people are safer staying in the 6's depending on circumstances. The daily bg numbers themselves and the readings on a CGM tell you much more than an A1c anyway. My son used to have decent A1c's in the low 6's, but his control was all over the place. That was using the older insulin, and trying to manage a teenager with 4 different types of insulin at once. He is now also in the 5's, but using MDI's and a CGM.
Mary, mom to Michael and Melissa, both Type 1
Michael is an adult, living on his own and using a CGM and MDI
Melissa is also an adult, with an intellectual disability, therefore she needs lots of help managing her diabetes. She uses an Omnipod pump and Dexcom CGM