I was diagnosed with Diabetes Mellitus in mid-November 1976. I wasn’t diagnosed with Type 1 diabetes. I wasn’t diagnosed with Type 2 diabetes. Those terms were not in use in the 1970’s. I went to the eye doctor because I was having blurry vision and thought I needed new glasses. I suspect I smelled like fruity nail polish remover, and he told me that it was likely I had diabetes and should see a doctor immediately.
I was 24 years old, recently married, and although I had heard of diabetes, I was totally ignorant about the specifics of the disease. I dutifully went to see the recommended internist the next day.
Now you’re expecting to get to the part of the story that says he took my blood and tested my c-peptide and GAD antibodies. Those tests were not part of the laboratory diagnostic arsenal then. I was given a urine test and told to go downstairs to the medical office restaurant. I was instructed to have a pancake breakfast with lots of syrup and come back in two hours. Once again I was given a urine test and was immediately told that I had diabetes. I didn’t know enough about diabetes to be worried, scared, or surprised. This was a Friday and I was told to go home for the weekend and be admitted to the hospital on Monday morning. That seems odd to me in retrospect, but Monday morning came and I started my life as a PWD with a 4-day hospitalization. Like many Type 1’s, I learned to give shots on an orange. I was discharged with a 2,200 calorie exchange diet and prescribed Ketodiastix for testing my urine for glucose and ketones. I was instructed to take 35 units of Lente insulin daily in one injection. No mealtime insulin in those days.
Not once in the 36 years since my diagnosis has any doctor suggested that I wasn’t in the category of what we now call Type 1 diabetes. I have still never had a c-peptide or an antibody test. My understanding is that I will be required to have a c-peptide test when I reach Medicare age in order to keep my pump.
With today’s sophisticated lab tests and the increased knowledge about diabetes, I don’t understand why so many young adults are being misdiagnosed as Type 2. They are given pills instead of insulin and often must struggle for months or years to get a correct diagnosis. Many doctors are blinded by the Type 2 epidemic and are not considering that the incidence of Type 1 in all ages is also increasing.
It makes me think that maybe a pancake diagnosis wasn’t so bad after all.
I’ve written about this, and worry about it. I don’t know what the solution is. I don’t know if the appropriate tests are too expensive to be given to all suspected T2 cases. I don’t like the idea of testing differentially based on age/appearance: one of the misdiagnosed people I know was, I believe, in her 50’s at the time of (mis)diagnosis. The best I’ve been able to think of is a protocol for monitoring newly diagnosed “T2s” to make sure that the numbers are responding quickly. If they’re not, test – don’t assume that it’s the fault of lack of dietary change..
You’re right, Bob, that it’s a very complicated issue.
Not fair, I missed out on the pancakes! The rest sounds familiar though, except I was put on the pills first. Wonder if you were put on insulin because you were in your early 20’s, whereas I was at the ripe old age of 38. I had my first ever C-peptide a few months ago to get the replacement pump.
Sue-My doctor’s admitting notes also show 4+ ketones which is a good indication of Type 1. Large ketones are an unusual presentation for someone with newly diagnosed Type 2 because the body is usually still producing large amounts of insulin. Since a 50-count vial of ketone strips only costs about $15, it seems that it might be a good idea for people newly diagnosed with diabetes to test for ketones when they have several 250+ readings in a row. But since they are newly diagnosed, they wouldn’t know this unless instructed by their doctor. But that’s a subject for another post and another day.
Laddie, You have your doctor’s admitting notes? Do you know your date of diagnosis? I don’t know the date for either my son or myself. He was April 75, I was sometime in 88, that’s all I know. And I don’t think I’ve ever spilled ketones. If I have, I’m not aware of it.
A few years ago I decided that I wanted to get my 25-year certificate from Joslin and get in line for the 50-year medal. I went online and contacted the medical records department at the hospital where I was admitted. The old records were on microfiche and I was able to get copies at no charge. I hadn’t known my exact diagnosis date, but everything in the medical records matched the memories that I had. It was interesting to see the exact BG numbers and the doctor’s comments.
I would have never thought to contact my hospital, but someone somewhere on the diabetes online community suggested that it was possible. Thanks DOC!
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