Unfortunately, the whole business of diabetes, it's diagnosis and it's management is a complete shambles. That wouldn't be so bad if it was an uncommon disease.
In the old days, type 1 & 2 were essentially known as 'juvenile onset' and 'age onset' respectively and you were chucked in to one or the other category.
The great & the good decided that those 2 categories didn't quite correlate with the true picture and in their wisdom they decided "Type 1 & 2" was so much better. Of course, it wasn't; it's still just 2 categories and it doesn't represent the true picture much better at all. It's just misleading instead of entirely misleading.
If I had it in my power, I would go completely mad and categorize diabetes into a WHOLE 3 CATEGORIES! 'Dog', 'Cat' and 'Cow'.
By doing that, I would have immediately improved the categorization (and hence treatment) significantly and surely I will be remembered in history and get my well-deserved Nobel as a matter of course.
This sort of idiocy is an ongoing problem and nor is it the only one.
For instance, diabetics who required insulin used to be given animal insulins, namely cow or pig, extracted from the animals' pancreases after slaughter.
The problem with those insulins is that they are not quite as efficacious as human insulin. Why? Other mammalian insulins are not quite the same as human. So IIRC human insulin is a protein consisting of some 40+ amino acids strung together - some of those amino acids being the same. Pig insulin is the same but with 1 or 2 of the amino acids being different, in either position on the protein or chemically. Cow insulin, it's 3 or 4 that are changed because in evolutionary terms, our common ancestor with a cow is further away from us than that of a pig.
Remember your high school biology? What happens if you introduce foreign proteins into a human body? You get an immune response from the body and it attacks the foreign protein. That's why organ transplant patients are given immunosuppresants: so the transplanted organ doesn't get destroyed by the response from the host.
The same thing happens with the animal insulins; being foreign proteins means that they're attacked and the longer you take animal insulin, the more you have to take in order to get your blood glucose down to the same levels that you got when you first started taking it. After decades on it, patients ended up having to take huge doses which comes with it's own associated problems.
In the '80s with the advance of genetics and being able to engineer and grow yeasts that produced human insulin, everybody became significantly happier.....except the drug companies. "How can we make any money on this human insulin shit? We can't patent it!" they howled....quietly to themselves.
Enter 'insulin analogs'. These are insulins in which the amino acids of human insulin have been fucked around with. Whoopee! Patentable! Let the big bucks roll in!
These 'analog insulins' should remind you of something: animal insulins.
Drug trials don't last decades though, so the problems as evidenced with animal insulins to treat diabetes in humans haven't shown up yet and certainly didn't during the trials.
The drug companies of course have convinced the medical profession on the basis of entirely bogus data, that these analogs are so much better then that God-given human insulin shit. They modeled them to be quicker acting, they say, hence less long-term damage from hyperglycaemia, they say. Horseshit, I say. You've got fuck all worthwhile evidence and what's more, you never will have.
Am I right in thinking that some 25 year ago, before 'folding@home' and such like existed, modeling how a protein, say like a fucked around piece of insulin folded wasn't doable? So if you don't know how it's going to fold, how the hell are you going to have any idea how effective it is going to be at it's job ie. metabolising glucose?
For 20 years I've managed to avoid the analogs but eventually when I was in hospital and I was too ill to object, they put me on it.
Just ask to be put back on human insulin, you say? The problem is, if you go on to a different insulin, you then have to spend months testing several times a day and finding your right insulin regime. I just haven't got the energy for that - especially since I've also got hypothyroidism ATM (that's another total fuck-up by the medics too but a story for another time).