AskNadia: Can Type 2 Diabetes Turn into Type 1?
Dear Nadia:
I have type 2 diabetes and am on 500 mg of Metformin. My A1c inched up a bit, and my doctor doubled my daily metformin medication. I also wear an Abbott CGM, which I love. Some nights I wake up with a 40-blood sugar reading. Other times I will eat a burger at night, and my blood sugar is excellent throughout the night. I drink red wine with dinner every night. I stopped taking my medication for one day.
Can my Type 2 diabetes turn into type 1?
AE
Dear EA,
You are doing the right thing by working with your healthcare professional. The prescribed Metformin is based on your unique medical profile. Typically an increase in dosing is an effort to lower your blood sugars to achieve your A1c goal.
How Does Metformin Work
Metformin prevents the liver from releasing glucose, allowing the insulin your body still produces to be more effective.
Drinking wine every night is generally not recommended by healthcare professionals. One of the dangers of drinking with medications is possibly confusing a low blood sugar by feeling “buzzed.”
If you started experiencing low blood sugars right after you increased your medication, remember, your doctor is trying to figure out what the best dose for you is. 500 mg may be too low if your blood sugars are running high, while 1000 mg per day may be too high if your blood sugars are running low. Not taking your medication is never a good idea. Metformin is either time-released or immediately released. Read your prescription bottle to see if you have a generic or branded metformin.
Your healthcare professional team depends on you to give them feedback on how the medicine is working in attaining your mutually agreed blood sugar goal. I would call your doctor to share the frequency of low blood sugars. Let them know when it is most likely to dip down. To dial in the perfect dose, make sure to continue the follow up with your healthcare professional on your blood sugar readings until you achieve the blood sugar targets you have both set for yourself.
The long answer is, unless you are a person living with type 1.5 diabetes, then the answer is no. Type 2 does not turn into type 1 diabetes.
Type 1.5 Diabetes
Type 1.5 diabetes, also known as Latent Autoimmune Diabetes in Adults (LADA), is an autoimmune disease that falls between type 1 and type 2 diabetes because it has characteristics of both.
According to an article in The Beacon News, approximately 10 percent of patients with type 1.5 are misdiagnosed with type 2. If you’re over 35 when you develop diabetes, and especially if you have excess weight or classified as obese, your healthcare provider may assume that you have type 2 diabetes.
Therefore, if you don’t quite fit the profile of someone with type 2 diabetes, if diabetes pills don’t seem to be working well, or if you show some of the characteristics of type 1, maybe you have LADA. People with LADA have islet antibodies in their blood and, as in type 1 diabetes, their immune system is attacking beta cells. However, this is happening at a much slower rate and initially they don’t need insulin. One may consider that LADA is type 1 diabetes that progresses slowly.
One study in Diabetes Care states you probably have LADA (rather than type 2 diabetes) if two or more of the following fit:
• You were under age 50 when you were diagnosed with diabetes.
• You had “acute” symptoms at diagnosis, that is, symptoms typical of type 1 diabetes.
• Your BMI is less than 25.
• You have a personal history of autoimmune disease (such as thyroid disease, celiac sprue, Addison’s disease, or others).
• You have a family history of autoimmune disease.
The symptoms of type 1.5 are the same as the more well-known types of diabetes. They include increased thirst, increased urination, weight loss, and blurred vision.
I wish you the best in health!
Nadia
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Disclaimer:
Nadia’s feedback on your question is in no way intended to initiate or replace your healthcare professional’s therapy or advice. Please check in with your medical team to discuss your diabetes management concerns.
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AskNadia (ranked #1 by Google), named “Best Diabetes Blog for 2019 & 2017 by Healthline and with 24 nominations, Nadia Al-Samarrie’s efforts have made her stand out as a pioneer and leading patient advocate in the diabetes community.
Nadia was not only born into a family with diabetes but also married into one. Propelled at a young age into “caretaker mode,” and with her knowledge of the scarcity of resources, support, and understanding for people with diabetes, co-founded Diabetes Interview, now Diabetes Health magazine.
Under her reign- Diabetes Health magazine was named one of the top 10 magazines to follow in the world for 2018 by Feedspot Blog Reader
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