Replies to This Discussion

Permalink Reply by Khürt Williams on August 8, 2009 at 6:20am

Thanks for clearing that up. I was certainly sure that the medical community would ever use something like Type 1.5. The disease is not like a version of some piece of software.

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Permalink Reply by Zoe on August 8, 2009 at 7:33am

Funny, Khurt. Nor is it "halfway between Type 1 and 2.". I've had people ask me if I'm leaning more to Type 1 or Type 2. And that was one of the more knowledgeable/interested people! Sometimes when I tell people what I have I just say Type 1 and only go into more detail if they ask.

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Permalink Reply by Linda Fox on August 8, 2009 at 7:38am

Zoe, in my case, I suspect I DO have a hybrid-type or multifactorial Diabetes -- I DID gain weight, before I began losing it. BUT, I was DKA. I have GAD antibodies, and hypothyroidism, too.

I know in your case you were slender and had Graves' and probably IR did not contribute to your diagnosis.

Type 1.5 is probably not a good term for either of us, let alone both! You more distinctly have slow-onset Type 1. I clearly have hyperglycemia due to insulin resistance and underlying loss of beta cell mass due to autoimmune disease.

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Permalink Reply by Susi (Ladalife) on August 10, 2009 at 9:51am

Zoe,
This is exactly the distinction the UK makes... LADA is slow onset, thin Type 1, and T1.5 is LADA (slow onset) with insulin resistance.

Then there's a plain vanilla T1 that can come on in adulthood - no slow onset. Nothing to DKA, quickly, and totally looks like the onset of T1 in kids.

Oddly enough my endo last week was using the term T1.5, when talking about me, but when he spoke of generalities, he used LADA. Interesting!

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Permalink Reply by Linda Fox on August 10, 2009 at 10:06am

Well, as long as my endo understands what is going on, the terminology won't bug me ... I think my internist thought I just was avoiding the stigma of T2, and in a way I was, but then ... I just hada gut feeling those antibodies were there, too!

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Permalink Reply by Zoe on August 10, 2009 at 10:44am

Interesting. It sounds like the UK is ahead of the U.S. Here, I feel like we are lucky to get them to consider the idea of 1.5/LADA period (rather than just misdiagnose anyone over 35 with Type 2), let alone subtleties within the diagnosis. But the distinction works for me because I prefer the LADA term anyway; I think 1.5 is misleading.

Actually my thought process that led to me diagnosing myself LADA started with a 12 year old diabetes book I had and I was reading the chart that gave the criteria for Type 1 and Type 2 and wondering if maybe the reason I couldn't get stable was because I was, in fact Type 1. It wasn't till I came on here and another board that I started hearing about LADA/1.5.

Actually, Linda, I was overweight when diagnosed. I lost 40 pounds before and after diagnosis.

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Permalink Reply by Linda Fox on August 10, 2009 at 10:57am

Ah, I remember that, Zoe. So maybe you DID have some insulin resistance, but with the weight loss, you have lost it?

See, in considering my fasting C-peptide ... that is the scenario that makes sense for ME. But it was that weight gain that made me think I do have some -- that and the mild (now absent) AN in one armpit.

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Permalink Reply by Susi (Ladalife) on August 11, 2009 at 12:12am

Zoe, why do you think 1.5 is misleading? For many it describes exactly what's going on -- slow onset Type 1 with features of Type 2 - eg insulin resistance. That's why it was so named - even the genes, as Jenny pointed out - some genes from T1 and some from T2.

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Permalink Reply by Linda Fox on August 11, 2009 at 6:26am

Because many adult-onset T1's do not have IR ... (I am answering FOR Zoe, forgive me).

I am currently surveying the literature on this topic, and have seen arguments both ways -- that LADA does or does not invariably involve insulin resistance. And since it is not directly measurable, it is pretty debatable!

Last night I read an article on beta cell profile and preservation in T1D that had a VERY interesting reference (which I need to trace) ... it stated that even in kids 7-14 who were being followed for genetic succeptibility to T1D, the year prior to diagnosis was characterized by increased energy intake and increased weight-to-height ratio. The question goes unanswered, whether they were eating in response to "sugar spikes" or environmental factors. Interesting, no?

Permalink Reply by Zoe on August 11, 2009 at 9:17am

Thanks, Linda, LOL. Yes, that is exactly why I think it's misleading, Susi. I have not read all the diverse reports Linda has, but the general consensus I read is that LADA is a lot more closely related to type 1 than type 2 (autoimmune, much faster beta cell death, weight loss and/or thin to begin with, having other autoimmune disorders, insulin sensitive (usually not resistant) and also I'm perhaps reacting to the fact that certainly in my case I had SO many factors that appeared type 1 that the only reason I can think of to diagnose me type 2 would be age which is sheer ignorance. It's not "halfway between" Type 1 and Type 2 like the name implies. It also sounds like a software type like someone else said.

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