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Thanks for the Type 1.5 Article. I just received my February 2003 issue of Diabetes Health and was pleased and excited to read the article "What's Your Type? Diabetes Isn't Always Easy to Classify" (p. 40).
More attention and publicity need to be given to people with diabetes who don't neatly fall into the type 1 or type 2 category. Far too many doctors assume that if diabetes starts in adulthood, you're automatically a type 2 and pills are the way to go. This obviously is not true. Even my own doctor, whom I consider to be pretty much on top of things, misdiagnosed me, at least according to Dr. Hirsch's guidelines, which stated that type 1.5s look like type 2s and are insulin resistant. My own insulin needs are low-less than 30 units per day-proving that I'm definitely not insulin resistant; and I was thin and losing weight at diagnosis.
On another subject, in the article "Meters, Meters Everywhere" (p. 32), you quoted Steven Santinelli, whose doctor advised him that he didn't need to test regularly, that "the A1C was enough." Unfortunately, far too many doctors tell this to newly diagnosed patients. This is wrong, wrong, wrong. The key to good control is through frequent testing, and all doctors should tell this to their patients.
Of course, it would help if test strips were more affordable.
I was also pleased to see the article on calculating insulin-to-carb ratios (p. 42). This is a much better way to control blood-glucose levels. I've been using carb counting very successfully since I started insulin.
Tell Me Why
I have been a reader of your magazine for a few years now and usually read it from cover to cover as soon as I receive it.
I would like to comment on and/or question two articles that appeared in the February 2003 issue.
The first article, "Eating Nuts May Help Prevent Type 2 Diabetes in Women," appears on page 19. Does this mean that men would not benefit from this same diet? Why did this particular study focus only on women?
The other article is "Meters, Meters Everywhere," beginning on page 32. Since I use the Accu-Chek Advantage and have been doing so for many years, I naturally read that particular meter's line carefully. What caught my eye was that you stated there is a computer download available for this meter. I do not know about the other meters, but Roche Diagnostics in-formed me that they do not have a download for a Macintosh, which is the computer I use. If you know of any other download available for this computer and this meter, I would appreciate knowing about it. Otherwise, I think you should amend the article.
Keep up the interesting and informative articles.
Leonard J. Queen
Mount Vernon, New York
Editor's note: About your first question/comment: The study about nuts and diabetes uses data from the 83,818 women who participated in the Nurses Health Study, which was established in 1976 and ran for 16 years. Nurses are predominantly women. Does that mean that the conclusions do not apply to men? Not necessarily. It simply means that, since the subjects of the study were women, we now have results that we know apply to women. We do not yet have the corresponding data for men. Similarly, the results of the Diabetes Control and Complications Trial (DCCT) apply, in a strict sense, only to type 1s (who were the subjects of the trial), even though it is becoming increasingly clear that tight control is also good for people with type 2.
Your second question is a good one, and point noted. I use both a Mac and a PC but did not think to indicate that the software was for PCs only, given that those are the most widely used computers.
It has been stressed many times, and rightly so, that type 1 and type 2 diabetes are two different diseases. There is an epidemic in our country involving type 2 diabetes. It is even striking today's children.
I have lived with type 1 diabetes for 40 years and have seen many changes in self-management. Thankfully, I have very minimal complications, as do many long-term type 1s. It is not an easy task controlling our disease, but it can be done with constant vigilance.
Among individuals who have diabetes, 90 to 95 percent have type 2. When a person, especially an adult, says that he or she has diabetes, it is presumed that the person has type 2. Unfortunately, some in the medical profession also make this assumption. Now, with the onslaught of type 2 diabetes in children, I can only imagine what type 1 children have to put up with. Some type 2 kids, with the loss of weight, healthy eating habits, and exercise, need not go on diabetes medications. Type 1s do not have that option.
I think the time has come to give the two diseases different names.
Both types are serious, but I and many other type 1s believe we should have a name change to distinguish the very real difference. Insulin is essential to the life of type 1 individuals from the day of diagnosis. Nothing but a cure or a transplant will ever change that fact.
Who would have the authority to enact a name change for type 1, and how could it be brought into fruition?
Rapid City, South Dakota
Editor's note: We don't have the answer but agree that this is a great question. We agree that the two types should have different names.
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.