If Khurt hadn't brought it up, I'd still be in the dark about it. I had no clue that there was such a thing as type 1.5 diabetes. And what's sadder is that I fit the description to the "T". I was originally diagnosed type 2, responded "well" to oral medications and eventually didn't. Tested positive for antibodies, so I got re-diagnosed as type 1.

Any more type 1.5 types around?

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Sounds like me...my doctor has never called it 1.5 but has often said that I have the qualities of both Type 1 and Type 2 diabetes. I was originally diagnosed at age 21 as Type 2 but required insulin a few months later.
Officially, there is no such thing as type 1.5, at least according to the "Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus" which was prepared by an international Expert Committee, working under the sponsorship of the American Diabetes Association, established in May 1995 to review the scientific literature since 1979 and to decide if changes to the classification and diagnosis of diabetes were warranted. The Committee met on multiple occasions and widely circulated a draft report of their findings and preliminary recommendations to the international diabetes community. In 2003, the Committee discussed and revised numerous drafts of a manuscript that culminated in this published document. (Diabetes Care 26:S5-S20, 2003). However, from a practical standpoint, it certainly makes sense to refine the classification since most people known as type 1.5's don't really fit the mold of traditional type 1s or type 2s.

There's a lot wrong with the the ADA diagnostic criteria you cite. For starters the information on the "Genetic Diabetes" category is many years out-of-date and hasn't been updated with the recent rewrite.

The ADA did put in a category for "Genetic Diabetes" which is where they put MODY, but they did not note the more recent research that found that people with these forms of genetic diabetes may NOT have a parent who was diagnosed with a severe form of diabetes because it can also manifest as impaired glucose tolerance and get missed.

They describe Genetic diabetes as extremely rare, which based on the mail I get isn't true either. The SEVERE form that looks like Type 1 is rare, but the milder form of the most common defects causing MODY are more common than people realize and is almost always diagnosed as Type 2 (in non-obese people) because fasting C-peptide tests in MODY are very often normal and there are no antibodies The problem in the more common forms of MODY is that fasting insulin secretion is ALL you have and your beta cells cannot secrete in response to rising glucose in the blood stream.

As a result of this out-of-date information, most endocrinologists who are even aware of genetic diabetes will tell you if your parent didn't have it, you can't. This isn't true. But they only learned this after they gave genetic tests to the entire family of people who had been diagnosed and turned up many people who had the autosomal dominant gene who had not been diagnosed.

The other error in their description is that MODY is not diagnosed exclusively in adolescents. The current research shows it being diagnosed up to age 55. And it very frequently shows up first in thin women (like me) who get GD almost immediately after becoming pregnant.
Is it possible that Type 1.5 diabetes is actually Type 1 but caught much earlier in the progression of the disease? It seems like it usually progresses to classic Type 1 symptoms (weight loss, thirst etc) when not treated properly right away. Or could it be that it is the same cause in adults or kids but just manifests itself differently at different ages? It seems helpful to have a distinction if it is beneficial in treating it (and it sounds like it is) but as far as categorizing in terms of finding a cure, I just wonder if it is actually the same disease. What research has been done on this, if any?
I agree.....it seems to be the same disease manifesting differently. I wonder why....
i have LADA and thats how it is for me.. they originally diagnoised me as a type 1., then realising my slow progression and that i didnt need insulin right away, switched my diagnosis to 1.5.. ive been able to last a year and 3 months so far with good blood sugar control (A1C in the 6's), but i will likely be starting insulin in the next few months. i know for me its definately just a very slow progression to type 1. i would have been at risk for DKA if i didnt catch it when i did.
I was 44 when I became diabetic, and within a month started insulin because oral meds had no effect. My endocrinologist also thought I was a type 1.5; she described this type as someone who needs insulin, even though insulin might still be naturally produced. Just recently (10 years after the initial diagnosis), my new endocrinologist had some type of test done (of course, requiring even more blood than usual!!), and determined that now at leat, I have no naturally occurring insulin.

I'm not sure what a type means practically, in terms of day-to-day living. Is there the thought that a 1.5 type could ever not require insulin?
No- LADAs have the same autoimmune process that type 1's have- it just seems to happen slower and *some* LADAs don't progress totally to full insulin dependence. Although I think the vast majority of them will succumb to the their immune system's destruction of the beta cells and become totally insulin dependent.
I have been diagnosed for almost 5 years, at age 50, and have been on 8 u's of Lantus plus Humolog. All of a sudden, I am waking up with fbs of 200+. It may be happening! I had a second phase, I believe, that caused lows a few hours after eating and dosing, but I haven't had them lately. It could be hormones, or fluctuating weight, but I've not noticed such dramatic differences before.
I was discussing this with my GP the other day. I have autoimmune hypothyroid and I asked her if most people progress to complete thryoid failure and dependence on artificial hormone such as synthroid. She said no. For most people, their bodies come to a state of equilibrium. The autoimmune attacks do not continue to an inevitable destruction of the thyroid. We were speculating that the cause of complete destruction of the pancreas and ultimate insulin dependence is NOT the autoimmune attacks but the damagingly high BG that results from the attacks. This would explain why some Type 2s progress to insulin dependence. Therefore, theoretically, if you catch the diabetes (any type) early enough, you can prevent pancreas failure and insulin dependence by keeping your BG normal. I was lucky enough to be very early and am hoping this will be true for me. That's why I am superdiligent about keeping normal BG levels. My endo says I am an extremist, but my GP totally understands.
By extreme, does your Endo mean healthy?
No, she thinks I'm wacko :-)




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