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Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
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Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Living with diabetes blog
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Nov. 3, 2009
Diabetes diagnosis — Type is not always clear
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
I've noticed in writing this blog and reading the comments a surprising bit of animosity between individuals with type 1 diabetes and type 2 diabetes. In my practice, I've heard statements such as:
- "Type 1 diabetes, that's the bad one?"
- "People with type 2, it's their own fault they have diabetes. If they would've taken better care of themselves they wouldn't have diabetes."
Diabetes is bad, no matter what type you have. And the end result can be the same if blood glucose isn't well controlled.
Interestingly, the lines between the types of diabetes are getting a little blurry as we learn more about diabetes. When I first started as a diabetes educator, diagnosing type 1 versus type 2 was pretty clear cut. You were type 2 if you were over 40, were overweight and had a family history of type 2 diabetes. You were type 1 if you were thin, had small insulin requirements, were under 30 years of age and had ketoacidosis.
Today endocrinologists say there are multiple classifications of diabetes. According to the American Diabetes Association's 2009 Standards of Medical Care in Diabetes, there are four clinical classes of diabetes:
- Type 1: Results from beta cell destruction, leading to zero insulin production (autoimmune disorder)
- Type 2: Results from progressive insulin cell release defect in addition to insulin resistance
- Other types due to specific causes: May result from genetic defects in the cells that release insulin, diseases of the pancreas (such as cystic fibrosis), or drugs or chemicals (such as treatments for AIDS or after organ transplant)
- Gestational diabetes
Some patients can't be clearly classified as having type 1 or type 2 diabetes. Occasionally, patients who are diagnosed with type 2 will actually turn out to have type 1, and vice versa. True diagnosis becomes more obvious over time. One form of type 1 diabetes I'm beginning to see is latent autoimmune diabetes in adults (LADA), sometimes called type 1.5 diabetes. These are older adults with slow onset of progression to type 1 diabetes. Sometimes granny is started on an intensive insulin program at age 82.
OK people, enough with the animosity.
Regards,
Nancy
11 comments posted
August 20, 2010 5:39 p.m.
I was dx as type 2 15 years ago...and was treated with oral meds only for aboutn 5 years, then I saw a specialist who based on my history (I had a simple paper cut that required major surgery because it would not heal, evidence of minor sores that should have healed and faded with age) discovered that i was really type 1. i also had a strong family hx of type 1 diabetics (father and all his siblings, his mother and all her siblings were all type 1). I was underweight with a very small frame. be sure to really question your m.d. about dx and treatment options. if in doubt seek advice and eval by endo m.d.
- Sandi
April 6, 2010 3:38 p.m.
Donna: Yes, your 16 year old daughter should see her provider. Normal fasting glucose range for people without diabetes is 70-100. Pre-diabetes: 100-125. 126 and higher: diabetes.
- Nancy and Peggy
April 4, 2010 9:43 a.m.
my dad just tested my 16 yr old after a 12 hr fast her level read 184 should i be concerned and get her tested????????????/
- donna
February 17, 2010 8:11 p.m.
Hello, Can you help me? What is considered a normal blood level? What would your blood sugar level be if you are dialbetic, & what would the level be to be consider pre-diabetic. Thank you
- Shannon
January 29, 2010 3:05 p.m.
Do you know the percentage of individuals with type 2 diabetes that are insulin dependent?
- Mike
November 29, 2009 9:59 p.m.
I went for a check up due to recent heart attack. The doctor specializes in heart and Diabetes. He ordered a fasting test and then i drank the sugar water and had a 2 hour test. The fasting was 90 and the 2hr test was 182. They said I was positivaly diabetic. He has me checking my blood once a day. The highest it has been is 105. I now walk 40 min a day. How can he say I am diabetic when the normal numbers are higher than mine?
- Deb
November 4, 2009 12:59 p.m.
I like your blog very much. Each time I see the Mayo newsletter in my inbox, I'm eager to read your blog. Not all of your postings apply to me, but I know they apply to others. I was diagnosed with type 1 more than 24 years ago, so I know quite a bit on this topic. But living with diabetes is a daily challenge, and your blog usually provides me with very helpful information and insight. Thank you.
- Nina
November 4, 2009 9:35 a.m.
How unkind, Anita. What makes you an expert that you should call out another blogger? Everyone is entitled to what they feel. I haven't always agreed with every article or every blogger but that doesn't give me the right to call them out on it. By the way maybe you should re-read your own blog. The word is anti-depressant - not anit.
- Ferne
November 4, 2009 9:18 a.m.
I like your blog - I was a mis-diagnosed type 1 - and I found this posting to be very helpful. Britt, darling, you've got some issues, if you are receiving "advice" on which blogs to read and which not to read. You need to re-read your own missive again - talk about animosity! And maybe considering upping your dosage of whatever anit-depressant you're on.
- Anita
November 3, 2009 11:17 p.m.
Animosity...I feel like you are a teacher calling students down. I do not like your blog. I often wonder if you reread what you write and become upset with some of YOUR opinions. I have been advised not to read your blog and now I choose not to read your blog. I have never learned anything...but I am a former nurse and yes a type 2 with two parents and many family members maternal and paternal. You have a great place for true learning----use it.
- Britt
November 3, 2009 4:14 p.m.
Well, I had a scare I thought has neuropathy gone far enough to take my foot, it was hurting inside and I had a ulser on the side of my big toe, my foot seemed swollen, It was red. I went to the Dr. he said to wash it good and put neosporen on the ulser, ans set up appt. with podietrist (sp). What is the progression to foot loss? Is this a given eventually, I've known several older people that have lost legs and poof they were dead, oh I'm 56 they were in their 70's well I haven't seen anything on this, it may be to gross to publish
- Fred
11 comments posted