Wednesday, October 19, 2011

C-peptide and Medicare

This is for all the friends that love me.

Backstory: I have agonized for 20 years about what type of diabetes I have, and whether I'm faking it, and had bouts of denial, and binged myself into a coma last year which almost killed me. I know it's emotionally crazy, but I'm being honest about all my horrible feelings.

I will be eligible for Medicare in less than a year and a half, and I've been in excruciating emotional pain thinking that my C-peptide would be too high for them to cover my pump. So when a friend on TuDiabetes got hers done, and JUST squeaked in under the line (110% of the low end of normal), I put my heart in my mouth and decided to get mine done too. She suggested that I do it privately, because I have been just too scared to ask my doc because once a higher than cutoff C-peptide has been recorded, the shit has hit the fan.

So I went and got a blood draw yesterday, and wasn't expecting results so soon, but there they were in my email box this morning. And:

0.9 (normal range 1.1-4.4) !!!!!

This is EXCEEDINGLY good news, for 2 reasons. First, I'm solidly below the cutoff, AND I do have residual insulin production, which clearly contributes to better control. How lucky can I get?

I'm just shaking with relief, and now I have to ask my endo's office to request the results, because I CAN share them. And hopefully never have to have another test.

Still reluctant to actually call myself Type 1, (still prefer Type Weird), but at least I know I'm not a hyperinsulinemic, insulin-resistant Type 2. No insult to Type 2's -- you know that I have utmost empathy for them, but I really needed help with dealing with all the shame and blame issues that are imposed on Type 2's when I believed in my heart of hearts that that's what I really was.

Maybe this is a ramble, but I needed to do it. And if you respond to me, I'll feel even better!


  1. Natalie, I am really, really glad that you decided to do this. I understand not wanting to have it done thru your doctor, just in case, but at least now, the big worry is taken away. I like to tell people approaching Medicare age to have one done instead of waiting until the last minute. I have read too many horror stories of people having pumps for years and then can't get the supplies once they go on Medicare. Now you can retire in peace!

  2. Great news indeed, on three counts! You should not be reluctant to call yourself type 1 -- no, you should simply say flat-out that you're not type 1. I've never had a c-peptide run, but I've sure it would be indistinguishable from zero.

  3. Paleolith, I have a different reason for calling myself Type 1. It's not for general consumption, it's for MEDICAL consumption. Last year, I had a diabetic coma, and was being treated with Type 2 protocols, and they weren't working, and the CDE on the case had to fight with the hospitalist to get them to use Type 1 protocols. Then, when they finally got me stabilized, they sent me to a rehab hospital/nursing home, and the Type 1 orders didn't follow me, and I relapsed into BGs above 400, and severe symptoms and hallucinations and blackouts. After 3 days, I managed to corner the hospitalist, and get him to give me semi-appropriate treatment (fixed dose, sliding scale), but I ended up being there for 3 weeks, and only managed to get my BGs down by semi-starvation. I never want to go through that again. Medically, I need to be treated as a Type 1, even though I do produce some insulin.

    And, by the way, according to the Joslin 50-year Medalist study, a good number of Type 1's DO produce residual insulin. Perhaps YOU produce none (although you don't know that if you've never had a C-peptide done), but you aren't speaking for all or even most Type 1's.

  4. Ah yes, I wasn't thinking along that line. Very good point. Ideally you would get the doctors to think more flexibly, but HAH HAH ... I agree, for the doctors, putting type 1 is a good idea.

    I have a similar issue though it doesn't have the same potential for trouble. My doctor likes to get my blood pressure below 75 diastolic. He thinks it's better for my kidneys. I'm not convinced, but since it's probably better for my heart -- a much greater concern to me -- I go along. But one time his staff had to send a summary to another doctor, and stated that I was being treated for hypertension, which was not correct. Takes BP drug, ergo is treated for BP.

    Cheers, gal.