Type I or Type II Diabetes Mellitus?

Patient

Q: I am 18 years old. I was diagnosed with type 1 diabetes in February 2010. It is now nearly October. I took insulin injections for a couple months after diagnosis, and ever since then I have controlled my blood sugar levels through diet. I know about the honeymoon phase, but that seems to be over. As long as I keep a very low-carb diet I seem to be able to regulate my blood sugar level just fine. Is there any possibility that I was misdiagnosed? And are there any dangers of me not taking insulin and just controlling it through diet as long as my sugar levels are fine? I would really appreciate your input. Thank you.

Doctor

A:   Type 1 diabetes mellitus is an auto-immune chronic medical condition that occurs when the pancreas, an organ in the abdomen, produces very little or no insulin. This auto-immune disease occurs when the immune system attacks the pancreas gland as it recognizes the gland as foreign tissue and destroys the gland. Insulin is a hormone that helps the body to regulate blood sugar. Without insulin, blood glucose (sugar) levels become higher than normal. Type 1 diabetes typically occurs in a young patient (previously known as juvenile onset), but has now been recognized later in life. It is treated by insulin replacement in the form of subcutaneous injections. Type 2 diabetes mellitus occurs when the pancreas produces insufficient amounts of insulin and/or the body's tissues become resistant to normal or even high levels of insulin. This results in high blood glucose (sugar) levels. Type 2 diabetes (insulin resistance) is associated with obesity. It typically occurs later in life (previously known as adult onset), but can occur at any age, especially in childhood obesity. It can be treated by diet alone, oral hypoglycaemic drugs or insulin injections.
With the history you have provided it is possible that you have been misdiagnosed as a type I diabetic, when in fact you have type II diabetes and you can therefore control your blood sugars through diet alone without medications. I would advise attending your family physician or endocrinologist to confirm a definitive diagnosis in your case.

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