Allies Voice: Climbing out from the glycosylation gap
In the last 25 years, in spite of the average blood glucose level (HbA1c) improving in people with diabetes - the level of diabetes complications is on the rise. People with diabetes are taught to rely on a good A1c (i.e, good numbers) to prevent complications. It's disheartening if your A1c is getting better but the complications of diabetes are arriving on schedule (unlike your latest travel arrangements). The discrepancy between the HbA1c and the measure of glycated albumin (fructosamine) is known as the glycation gap and you may want to know a little more about it to prevent diabetes complications.
Here's a thought - wouldn't you want to know about a test that measures the level of complications? This imaginary test is actually faster than the A1c and it's more efficient in measuring how effective your diabetes treatment protocol is in preventing complications. Call it a defensive diabetes treatment. Call it a test by another name. Call it whatever you want - but definitely think about giving this test piece of mind in your diabetes control.
Complications in diabetes come from a memorizing buffet of imbalances. However, the repercussions of advanced glycated end products (AGEs) are spoken about rarely but account for a considerable portion of the blame.
AGEs form when proteins bind with sugars in the absence of water. In the absence of C-peptide, this concoction is guilty of the damage diabetes inflicts upon tissues. Glucose metabolism, without C-peptide, leaves a person with diabetes unable to protect their precious soft tissues from the aftermath of AGEs. Yet we all rely on our HbA1c to tell us if our "numbers" are sufficiently protecting us. Protecting us from what? Glucose metabolism regardless of the number - 80 or 380 - results in AGEs. It makes sense to measure the glycated proteins of our body rather than repeat a glucose check.
Measuring the albumin allows a more accurate measure of the existing glycation in our blood protein. Albumin has a turnover rate of 21 days. Hemoglobin regenerates every 120 days (17 weeks) so measuring the HbA1c is an accurate test every 3 months for blood glucose. That's a long time to wait to see if your latest treatment adjustment is effective. It is also very important to know if your AGEs are rising or falling. The name of the game in diabetes control is numbers - but what numbers should we be counting?
Hemoglobin is the protein in red blood cells that carries oxygen. Serum albumins are a group of several proteins that occur naturally in the blood. Both hemoglobin and albumins can bind to glucose. When this binding occurs, the protein is said to be glycosylated.
HbA1c and fructosamine tests measure how many proteins have been glycosylated. In other words, how many proteins have glucose connected to them. HbA1c is one of 3 hemoglobin molecules that makes up red blood cells. Glucose attaches slowly to this molecule of hemoglobin over 120 days. Glucose will attach to hemoglobin based on the amount of glucose available. Thus, a glycosolated hemoglobin lab value provides average blood glucose levels during a 1-4 month period.
Fructosamine (glycated albumin) measures short term control of blood sugar for the past 1-3 weeks. Each 75 µmol change equals a change of approximately 60 mg/dl blood sugar or 2% HbA1c.
Although fructosamine is available in the US - we tend to curry favor for the HbA1c. Why? Your guess is as good as mine. However times are a'changing and there is another test that is being developed to take fructosamine a step beyond the glycosylation gap. The test is called the G1a and the company developing it is Expinex Diagnostics.
The Epinex G1A™ Rapid Diabetes Monitoring Index Test will be a monthly test for the control of glycation, the underlying cause of the complication of diabetes. The test will consist of a disposable test cassette and a handheld reader device. A drop of blood is placed on the sample well of the cassette and the cassette is inserted into the reader device. Results will be displayed within 5 minutes. Sure beats waiting for the lab results, doesn't it? Better yet - this test can be performed with accuracy every 21 days, rather than waiting for insurance to cover a test every 3 months. You can't be that - in house testing, a simple drop of blood and a results-driven meeting with your doc. Finally!
Tomorrow is Earth Day - and the beautiful irony in the occasion is that it is my first appointment with Dr. Faustman since the start of human trials to cure Type 1 diabetes. I have no clue what'ss in store for me - it anything at all. But I will relay any and all details of my meeting with the MGH research team. In the meantime, please stay tuned for the next episode of "Allies Voice"!
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I really enjoy your blog. You provide so much interesting information. I'm anxious for hear about your visits with Dr. Faustman!
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Thanks Type1
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Allie....If elevated levels of Glycation are shown(based on this home test), then what?
There is no availability in the Market that has any products for the prevention and treatment of Diabetes related Complications other than C-peptide, which is no longer available since the introduction of rDNA Insulin.
The only protective agents that are available are ACE Inhibitors and Statins(not complaining), but more in the way of preventatives are really needed for us(T1DM) so that we can *Reclaim Our Bodies Back*
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Good point -- but ACE Inhibitors and are not preferrable means of mitigating or dissolving the harmful effects of AGEs. I say we (T1DMs) press in the direction of a company that WILL bring us the C-peptide we are righteously entitled to receive along with our C-peptide deficient insulin.
Lilly, Novo and Aventis are NOT the heroes on the horizon. The heroine will expose the nefarious business models that have kept the "Top 3" bottom-lines beefy while people with insulin-dependent diabetes pay hand-over-fist for inadequate and dangerous drugs. It is for this reason I run this blog -- to make the world safer for people with diabetes. The answer to our woes is on the horizon.
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"The answer to our woes is on the horizon."
Does that then mean Allie that it is no longer, "just around the corner?"
I hope the distance is then closer.............
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Congratulations. I like your hypothesis regarding the fact that C-peptide may be a significant component of diabetes complications. Properly stated, this may mean inclusion of C-peptide in treatment is a factor in controlling complications.
The testing has always been a BS excuse to cover the doctor’s butt, whenever something goes wrong. Even with more accurate methodology, the result is doctors can always claim they are working with an imperfect patient. For example, it is now known that A1c can vary from individual-to-individual, even though bG control is similar for the individuals. In other words, one is a high glycator, and another may be a low glycator. I suspect individuals would react similarly to the new test procedures. The point is that individuals in the past, who were considered ‘damn poor patients’ survived IN SPITE OF their control and their doctor’s admonitions. Maybe C-peptide (or some other protective mechanism) helped these diabetic individuals escape complications. The truth of the matter becomes one of how many testing procedures can we sell you, regardless of the fact we don’t know how to interpret/utilize/compensate for the results being measured.
Ed Silverman today included a post on his Pharmalot.com site illustrative of the entire BIOGENERIC industry: “FDA Says Genzyme Can’t Copy Its Own Biologic at http://www.pharmalot.com/2008/04/fda-says-genzyme-cant-copy-its-own-biologic/#more-13226
My takeaway was this: WE DON’T KNOW WHAT WE DON’T KNOW (but nevertheless, maintain our status as consumer-units for the insulin cartel and diabusiness.)
I hope Earth Day turns out to be a new beginning for you and the diabetic population through Dr. Faustmann’s research into a cure.
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Hey Brent, A1c is among the leading losers of imperfect tools measuring diabetes control. It is so easily manipulated and time-contingent. Knowing that your meter is 20% (up or down) from the true number (also dependent upon the lab you use) - where is the solace of safety in control? Hands-down, bB is just another money-cranking operation to leave people with diabetes chasing their tails. When all else fails and complications come creeping – good heavens don’t blame the treatment protocol. Blame the patient for his/her inadequacies.
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Eating a diet rich in meats (particularly charred red meats like BBQ'd meat) is known to increase AGE formation. As is high glycemic foods (obviously). Basically, if it tastes good to you, don't eat it.
I think the best diet for T1's to follow is anti-inflammatory, consisting mostly of olive oil, fish, nuts, vegetables, etc.
I think too many diabetics get caught up in the "I'm T1 so I can match my insulin to my food and eat whatever I want like a normal person" mindset. While that may be true if they somehow are able to have perfect BG's and regulate treats in moderation, most T1's are eating just as much processed junk food and crap as the general public who is without the added danger of diabetes. I believe THAT is a *major* cause for the increase in T1 complications. Prior to the past 10 years, an overweight T1 was rare. Now, we see T1's who go on to develop insulin resistance, metabolic syndrome, obesity, and who are overweight. And they are eating all the same dangerous "foods" that are making the public at large sick. It's a double whammy.
The food out there is dangerous, and even more so to a T1 diabetic. Having "double diabetes" (i.e. Type 1 and insulin resistance) greatly increases your risk for complications and early death.
My advice is to stick to the "old" strict regulated diets of the past. I have begun to think about this recently, and have to agree that perhaps we as T1's *should* return to the regulated diets of the past (with exceptions in moderation of course). Apparently it works well for Dr. Bernstein. I have not yet read his book, but I think it might be a good read.
Obviously C-peptide and other factors play a role. Diabetics are living longer too (less DKA etc.), which increases the chance of long-term complications. I don't know if complications in T1's *are* actually increasing or decreasing. I have heard they are decreasing in some cases, with the exception of heart disease.
I think we have to look at this from all angles. Regardless, one factor we *can* control is our diet in the meantime.
In the future, it may also be recommended that all T1's avoid gluten and dairy (casein) as well. Both of these food proteins are thought to have inflammatory and (auto)immune stimulating properties.
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Sarah, you have hit the nail on the head; music to my ears. The only thing Dr. B. adds to what you say is that the type of restricted diet must be low carb -- implicit in what you say, but not explicit -- and that he thinks Dr. Atkins was far too liberal. (Imagine!) He allows his patients only 30g of carb per *day* with a target A1c of 4.5. Think about that. Then think how healthy he is after so many years of diabetes, having reversed some of his complications, and having lived with insulin analogues just as long as everyone else, and it is hard to deny there is something to his methodology. (None of this is to undermine the fine work Allie is doing railing against a pharma industry with the hubris to dare -- well, like most 'scientists' -- to claim to know better than the Creator how to make suitable insulin for humans, removing unnecessary parts, reminding one of the list of so-called vestigial organs, which list has quietly dwindled and disappeared in the last 50 years.) As Dr. B. said when I asked him about the missing C-peptide, we have to work today with what we have available now.
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I have a problem with your final statement. Dr. B states we “have to work today with what we have available now.” He and his medical brethren could have given voice to our concerns; he and his brethren could has LISTENED to patients. Unfortunately, they did not. They bought the pharma propaganda—latest and greatest—just like the human body makes—21st century technology—hook, line and sinker. THEY could have demanded PROOF, not propaganda. THEY did not. WE could not make our voices heard—but a powerful medical corsortium could have, and chose not to. Consequently, I feel they should be LEADING THE CHARGE now to give diabetics a voice for choice. What I hear is silence . . . or tired, squeaky excuses Instead, they tweak, and test, and theorize; they ‘make the best of a bad situation’; they make lemonade out of the lemons handed them by pharma and key opinion leaders within their community. Sadly, few of them do anything to make a real difference. They tout their expertise, and educational/training superiority . . . and if challenged, or asked to partner with their patients, most take the easy road, and dismiss the patient. They rely on ‘plausible deniability’ (blame-the-disease, blame-the-patient) to maintain the status quo, to continue profiting from a ‘captive’ patient population.
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Melody, while I agree in principle with all you wrote, I'm not sure Dr. B. is a suitable target for your righteous ire. Not sure if you know his history, but he got diabetes quite young, became an engineer, married a physician, who procured one of the first bulky BG meters for him in the 60's, and in his 40's went to medical school to become a doctor so he could publish his years of experimentation with foods and their affects on his control. (No one would publish the findings of an engineer.) He is extremely pragmatic and dedicated solely to helping his patients, and preaching the gospel of the law to small numbers to as wide an audience as possible, going toe-to-toe in public forums with 'diabetes establishment' types. (Search for his name on YouTube.) It is wonderful and necessary to have advocates working for a better future, as Allie and others do; it is *just* as important to have practitioners help their patients achieve the best they can with what is currently available, until that better future arrives. (I don't think we disagree on this.)
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Hey Melody, I try not to get angry at doctors for failing patients. In fact, my poor dad (as a doctor) takes a lot of abuse from my tirades about how the medical system has failed those of us with diabetes. But the truth that invigorates me is knowing that Big Pharma prospers on the business of diabetes. They remain heartless and faceless only to beef their bottom-line. The only way to defeat a competitor in business is to do ONE better. How about a company that does 4 better: better quality control, better treatment results, better pricing for customers, better profits for investors. Hit Big Pharma where it hurts – it’s more than a business to some of us. It our lives!
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Hey TechRightGuy – Dr. Bernstein has been promoting the best means possible for people with diabetes to protect themselves. He’s seen the doldrums diabetes can cause – the blurred vision, the loss of sensation, the impaired quality of life. He’s also crusaded to help people with diabetes protect themselves from the inadequacies of the available treatments. I refer to his book, Dr. Bernsteins Diabetes Solution, as my gospel for diabetes treatment. Like I mentioned in my last comment – it’s hard to motivate a 7 year old to eat greens and give-up the comfort foods. However, sometimes the enjoyment of a healthy lifetime is more than 10 minutes eating a peace cookie will ever satisfy. Easier said than done, right? I dream of baked goods!
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Hey Allie...I hear you. No one is saying you can NEVER have a cookie EVER. It's all about common sense. People should not be eating for any reason other than true hunger. It's cheesy, but the statement "Eat to Live, not Live to Eat" is true. 95% of obese people are "emotional eaters", whereas most thin/fit people are not. It's choice and control over your actions.
Eat your cookie, but just don't eat 50 of them.
I'm not trying to preach, don't get me wrong! I know I have it "easy" now, due to my Celiac dx and food allergies that appeared only fairly recently. I now have "built in" protection in some areas as I have to avoid most processed foods 100%. But not all. I can't eat cake (or anything for that matter) at your typical party, true, but I *can* go to a specialty store and buy gluten/milk free tarts, pies, and cookies to gorge on. Or I can make my own. My temptations are fewer, but they are there.
You should see my sad little face when I walk through the bakery aisle at the grocery store. The SMELL of fresh bread and all the goodies I can never have again (!) drives me nuts.
But I deal!
Even though Alba is working on a drug to help prevent cross-contamination for those on a gluten free diet, I doubt there will be a full out "cure" for Celiac (or food allergies, which is different) anytime soon...
I have heard rumors that processed foods are textured/flavored a certain way and have ingredients added to cause people to "crave" and become addicted to them. So *if* this is true and not Urban Legend, who do you want controlling your body? "Food" manufacturers, or YOU? In my mind, it's no different from us T1's not wanting to be controlled by Big Pharma!
If you *must* have junk foods, at least make your own at home.
It's everything in moderation.
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We’re all familiar with one definition of insanity as continuing to do the same thing over and over, but with expectations of different outcomes. I can give you another definition which says that whether you talk about insulin protocols, the various dietary programs, the increased testing (metrics) or many of the other therapeutic protocols related to diabetes—none has proven to be a cure for ALL individuals with diabetes. I suggest insanity today is attributable to anyone who believes any SINGLE one of these protocols is the be-all, end-all.
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Hate to inform you, but there is no way to not have complications. No matter how good you take care of yourself, this is a DISEASE. they will catch up to you. Control only puts off the complications, it does not prevent them.
A new test just means more money in a differnt area. or the possibility would exist that it is really a cheaper test that costs less money.
I used to think that a global catastraphy like a third world war is what it would take to bring true research to the table, but in my recent thoughts, just maby the bottoming out of the US ecconomy is what it is going to take for a country to take over reaserch of a CURE and not more treatments that bring in dollars.
Guess it takes more time to figure all this out.
I wish you well
Robert
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Hey Robert, of the hundreds of billions spent on the war in Iraq (http://costofwar.com/embed.html ) – not to mention the loss of life: American, Iraqi and everyone in between -- think the progress that could’ve been made in cure research to save lives...not sacrifice them. I love our friends and neighbors of the world. I’m saddened that someone unanimously decided (against the advice of his advisors) to pursue a war that may not have an end in sight. Thank you to all who have served, and continue to serve, our country. Love our servicemen, love our heros!
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I disagree, Robert. Who's to say that we're suffering from disease and not injury? And if injury, who's to say we can't heal? My point is: The frame you recite in your head dictates the course of action in your body. I've learned this just recently - when I discovered that the source of my own hyperglycemic condition is not disease but injury. With that understanding, I'm now seeking to heal, not be cured.
Everyone dies. From complications of life.
Kelly
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Robert, we share similar thoughts. I kept hoping that sheer humanitarianism would prevail, but so far greed has held the upper hand. When GOVERNMENT (taxpayers) economies dominate our priorities--superseding the industry/medical profit paradigm--perhaps we can hope for change. A sad way to survive--HOPE. But currently society seems driven by corporate/individual greed; our remaining hope is that humanitarianism will triumph, and, if/when treatment becomes too costly, we won't become victims of medical genocide.
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Hey Sarah, That scares me – A LOT! I read boards where parents exchange ideas that allow their children to eat foods that (in due time) parents will learn are ultimately toxic. “Controlling” blood glucose is far from the answer. Every missing piece from a Type 1 body has great value to add in preventing complications. I’ve found it especially safe to shop the permiter of the grocery store – as natural as possible! I tried going raw – it saves a lot of time (not cooking) and the nutrient dense foods are quite satisfying. But try feeding a big bowl of greens and colorful veggies to a 7 year old newly diagnosed… good luck with that feat. It’s a crying shame that diabetes treatment relies so heavily on beta cell destruction, replacement synthetic analogues, and mind-numbing treatments that daisy-chain one another for the bottom-line of heartless pharmaceutical companies. Sorry, I try not to let business get personal but when it comes to diabetes – I’m afraid I’m neck deep in the personal crusade.
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I'm with you on that! We all know that there is no incentive for a cure when it comes to Big Pharma. But do realize that outside of the US, first world countries have national healthcare that has to pay out for diabetics to the tune of billions. Canada actually does a LOT of T1 research towards a T1 cure (Insulin and Islet Transplants were "discovered"/"perfected" here). Sick Kids hospital in Toronto made that recent HUGE Substance P breakthrough connection in regards to T1. Sernova Corp.(in British Columbia) is working on perfecting the Valdez model of xenotransplants. There IS good work going on in Canada/Europe etc, outside of the US, where Big Pharma reigns. I am not saying BP doesn't have it's hands in all of the international pots, just that some governments DO have an incentive to prevent Type 2, and cure Type 1. Type 2 prevention (with lifestyle not drugs) is HUGE here.
As for kids, I totally agree...but there's no excuse or reason for kids to eat unhealthy foods period. There are more health problems that can occur from processed foods other than just affecting diabetes control. We (and our kids) are so brainwashed that people think that "eating healthy" means eating diet Jello, Healthy Choice frozen meals, and "1/3 Less Sugar!" Lucky Charms. It's best to not start an addiction, as opposed to have to stop one.
I personally am going to feed the kid (if I ever change my mind and decide to have one) REAL "healthy food" from day one. They will also be raised gluten and milk protein free (no one NEEDS to eat either anyway), so they'll never miss what they can't have. If it helps prevent T1/other autoimmune diseases, that is the best outcome possible. The odd safe treat I'll allow (I don't want to be a Food Nazi) but 95% of their diet will be whole unprocessed foods. As this is great for their overall health, but does nothing to prevent T1, this is why they will also be gluten and casein free.
Don't get me wrong, unlike some past posters, I'm NOT saying that a simple change in diet is the be all and end all. That is ridiculous. We all know that complications can occur no matter what (autoimmune basis for complications? Lack of c-peptide? GM insulin?). But I still feel like it would be foolish for anyone to eat the crap out there, let alone a T1, who is already "compromised". A pretty simple, but important point. If we don't keep ourselves healthy until we get our cure, what good will it be? And Bernstein claims to even have *reversed* some of his complications (?) with good dietary management. I do have a hard time believing that, but who knows?
Believe me, I want a cure as much as anyone. And hopefully we will have one sooner rather than later.
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Sarah.........
have children. We (Humanity) need an increase in the population of children who are from intelligent/wise/common sense/able to take responsibility for themselves/able to see Cause-Effect Relationships/ Women(YOU).
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wow ur amazing to be honest i do NOT know how u stay so positive i have tyoe one type2 they dont even no i take pills and needles and i think its stupid that they keep pushin the drugs but dont seem to find the issue but listen im on U500 seems to me its harsh its highly concentrated it crazy scares me to be on it to be honest i dont even no somethings how did you come to be on these topics like i think its amazing how ur helpin people wow way to be anyway let me know what ur thinking take care
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Anne.........
You need someone like Dr. House, MD to give you the correct Diagnosis and
Treatment Plan.
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i ha to agree with you there my insulin is 5 times stronger then regular insulin so i take 10 units in one shot but its worth 50 so ya i take alot of isulin at one point i was taking 800 units of insulin aday intence but im just scared for the out come of my health at this rate with my sugars being so high im scared that my kidney are going to take a beaten i already have a liver problem as if i need more any thoughts
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i have to agree with you there my insulin is 5 times stronger then regular insulin so i take 10 units in one shot but its worth 50 so ya i take alot of isulin at one point i was taking 800 units of insulin aday intence but im just scared for the out come of my health at this rate with my sugars being so high im scared that my kidney are going to take a beaten i already have a liver problem as if i need more any thoughts oh and on top of that im almost 19 and ive had these problems on going for 3 years now
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How can you still be alive and take that amount of Insulin?.......Unless this is some kind of joke?
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ummm...NO not a joke they say i have partial lypo dystropy and thats a severe resistence to insulin now i dont know but i mean im alittle fustrated and i dont know what to do anymore right now my sugars is and has been running high like 15 to 30 ish and im only on 300units or so a day right now but i take metform and advandia both max amouth that can be givin i have high cholostrol fatty liver diease and im always sick i have cronic pain and my doctor says im considered cronicly ill so i donno im lost on what i should so next to be honest
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Hey Anne,
Is it possible you may have Type 2? Did your physician ever perform a stimulated C-peptide test before diagnosing you? If you have C-peptide function it is very possible your beta cells may be poised for recovery if you do not have insulin auto-antibodies.
If the antibodies present are or IA (insulin antibodies) your body is attacking the analogue that was designed *by pharmaceutical companies* to (seemingly) help glucose control. What this has done, in fact, is cause insulin resistance in your insulin receptor cells. At this point they are rejecting your own ENDOGENOUS insulin production, as well as destroying your insulin production with insulin antibodies.
If the antibodies present are ICA (Islet cell antibodies) your body is destroying the source of endogenous insulin to prevent deadly HYPOGLYCEMIA. This level of low blood glucose is caused by the “perfect storm” of oral meds, analogues, and endogenous insulin. Really – it’s not fair to you as a human being or as a trusting patient!
It’s a very confusion situation for a body. It’s an even more confusion situation for physicians to try and correct a condition “medicine” seems to exacerbate. It appears you live outside of the US because you quoted your glucose readings in mmol/L. It might be worth a shot to see if your physician will write you a script for natural insulin – from beef or pork pancreas (if you are willing to give Mother Nature a try). It’s amazing what a provervial “breather” can do for a body beaten into submission by confusion pharmaceuticals – even your liver might start to show signs of repair.
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ive actually been on every insulin there is the one im on now as i calll it super insulin is very consintrated and yes im canadian and yes my sugars would be running around 400 or so most days they havnt been able to figure out how to resolve this issue as they beleive my pancrus may work but my body is amouned to my own insulin and is unable to use normal insulin my insulin is actually imported from the US and only 5 people are on it in my provence im not sure about those test but im going to bring them up when i go thanks for that any ideas on how to get my sugars down in the mean time beucause i cant live like this on a constent high its really hard to hold a job because im so tired.. you thought
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Anne.......
I am sorry, I did not know that you were referring to the metric system before. Here in the States, we do not use it, so when I saw those numbers, I thought it was very strange that you would be on that much Insulin.
This is what you first should do:
1, You need an accurate diagnoses. Get in touch with the Canadian Diabetes Association and ask them for a Physician referral.
2. Exercise and food intake is the way to go in order to balance your blood sugars along with the Insulin you are on. Remember though, Insulin is not a cure. It is a treatment because your tissues are not getting the Insulin that your cells may or may not be producing or your cells are totally unable to produce Insulin at all(Type 1 Diabetes).
3. You need a really Intelligent Physician who understands Diabetes and is able to communicate with you effectively.
Stay in touch and keep us informed. You have my Email address if you wish to write. Go to my Site:bettercell.blogspot.com
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no need to be sorry i wasnt sure if u knew what i met sorry about that they say my diagnosis is the partial lypo dystrophy but heck i dont even no myself what to beleive anymore
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Where do you live and how can I and "My band of Brothers and Sisters help you?"
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im not sure im in canada i live in new bruswick im just so unsure how to cop with all this nothin seems to be working and i came accross this sit and there was some good advice on here don't no where to turn these days
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oh when i was diagnosed they said type1 then another doctor said type 2 and then another said type 1 so i have know clue but its hard to know these days
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Anne-
All of us complain because no one is working on or finding a cure; for you, they haven't even been able to relieve the symptoms.
Because I'm old and less 'tolerant'--having lived with diabetes for 52 years--I would suggest to you that you find an endocrinologist somewhere in the world who knows what he's doing. Obviously your doctor(s) have not found the root cause of what is going on in your system. In the battery of tests you have probably already had, either the lab made a mistake or the professionals involved missed a very important consideration along the way. As Allie said, you probably should have your C-peptide challenge test, a battery of insulin resistance antibody tests, and I suspect your liver problem demands further investigation.
You will never be able to provide the right answers when you don't know what the right questions are. Many people here have found they must proactively guide their doctors. The results you are currently experiencing DEMAND that YOU push your caregivers. I don't think you can afford to sit back and take a "let's see what happens next" attitude while they continue to PRACTICE on you. If you have the ability to travel, are allowed to see another doctor, I would suggest you travel to British Columbia and engage Dr. John Hunt (an endocrinologist).
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wow thanks for the advice and yes i agree sitting back and waiting isnt helping at all.. my endocrinologist is suppose to speclise in my condition but as far as im concerned she no nothin at the rate im goin ill be on more the 300 units of insulin day what she told me was thta i wilkl keep getting sicker and sicker fot the rest of my life and that i will be on hondrad and hundrads of units of insulin aday the only doctor i have the even seems concerned is my family doctor and he's not allowed to play with my insulin because i have a speclist that doesnt update him on whats going on they seem to think im doing everything wrong tell me its what i eat and half the time i have a had time eating at all... then they accused me of not taking my meds and then figured out that i do take them and its not that now im to the point why do i bother taking thses meds they dont work half the time anyways what they say it all comes down to is the partial lypo dystrophy but i for some reason dont feel its that at all so now im just lonst on what to so in the hole sisutation and right now traveling is hard the money isnt really there and im off work again and havnt been able to hold a stable job because i miss so much time a work that im gettin written up so i have to leave and find new work which is starting to become diffidult....your thoughts
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i just found out they ran all those test althought they didnt no say the results they seen but yes ive had those test done 3 times in the past 2 years
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