Point in differentiating between T1 & T1.5/LADA?

So, this is a little freaky to me...

About two years ago, I had a glucometer because my cat was once misdiagnosed as diabetic... that's a long story. But anyway, I found this meter with its year-old open (but recapped) bottle of test strips, and I played with it, testing my own BG. 200s. Between the fact that these strips had been open for at least a year, the fact that I had no classic symptoms at that time, and the fact that I had no insurance and was unemployed, I ignored it as a "glitch" from using ancient strips.

Well, here I am in the T1 club, diagnosed barely more than 4 months ago.

I was just now reminded of all this because I apparently posted on Tudiabetes way back then, asking about whether expired strips are reliable. I totally forgot about all that, until someone just now responded. I was shocked to see it was two whole years ago, and shocked to be reminded that the numbers had been 234 and 249, fasting.

This makes me wonder if I actually have LADA/1.5. From what I understand, most T1s don't walk around with undiagnosed diabetes for at least two years, like I apparently have... their symptoms land them in the emergency room within 6 months to a year, if they don't think to visit the doctor first.  (I'll point out that I didn't land in the emergency room, but was diagnosed when a GP decided to test my blood sugar because I had a yeast infection in the corners of my mouth.  That fasting number was 342, and she went on to retest and run some other tests, including an A1c that came up 13.2 and some other test that showed I was making barely any insulin at all.)

I'll mention this to my endocrinologist when I visit next month, but I'm wondering if there's much point in pursuing a diagnosis of LADA if she doesn't jump right on investigating it? I mean, is the treatment any different than T1? I've been responding very well to insulin therapy, though it seems like I don't need very much of it. (My basal rate on my pump adds up to only 5.55 units per day! Though my I:C ratios are 1:10, on average, which seems more typical.)

Freaky stuff, that I probably walked around with such high blood sugars for over two years. This also makes me so thankful that no complications have been detected so far... but much more eager to get my eyes checked out, because that's one thing I haven't done yet. (Oh yeah, and I'm so thankful I have insurance and a job this time around!)

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Have you ever talked with Cherise?  Her blog is http://www.diabetesdaily.com/shockley/ and she's been living with LADA for 6 years or so.  She might be a good resource to talk to. 

Good luck!  :)

Kim

I dropped her a comment and she's already replied.  I love how responsive and supportive the online D community is!  <3

Agreed...  the DOC has saved me more than once.  :)  I'm so glad she got back to you!

Hi Elizabeth!

I am also a newly and oddly diagnosed T1. To make a long story somewhat shorter here it is: I went to the dermatologist for a mark on my leg that was diagnosed as granuloma annulare. It is sometimes linked with diabetes, so I got blood work done to make sure I was ok. Turns out that 2 out of my 3 fasting blood sugars were in the "above normal range." I pursued it myself and went to an endocrinologist who ran more tests. Within 4 months of seeing the dermatologist I was diagnosed in the honeymoon period of T1 at age 21. I went from January (diagnosis) until early May just controling my diabetes with diet and exericise (like type 2s) until I went out of the honeymoon in May. I ever got sick like how most diabetics do when they find out they have diabetes. 

I hope that you can get an answer and an accurate diagnosis! Good luck to you in your search!

I'm interested on what you get figured out on this.  I'm still confused about the difference between LADA and type 1 and if it evens matters to differentiate the two other than calling it Type 2 that turns into Type 1.

I would imagine that the treatment wouldn't be any different if you're already on insulin.  The only step that might have been included would be starting you on an oral med as some LADA's do.  Did your GP ever start you on oral meds? If pills weren't working for you then you're going on insulin...don't see how a LADA diagnosis would alter that course of treatment.

E, thought of you when I saw this post, too:  http://www.diabetesmine.com/2010/09/my-own-definition-of-lada.html

Hi Elizabeth!

I was initally diagnosed as a type 1 but my diagnosis has been switched to LADA (my story is on my profile). I was diagnosed at the end of july 2009 and i am not on any insulin therapy as of yet, (still in my honeymoon). I have been taking type 2 oral medications for the past year which have been effective thus far. My doctors dont really know when i will start insulin therapy, it could be weeks or months. A different diagnosis doesnt really mean much in the long run,  the treatment is the same as type 1 just happens a little bit slower.

[quote user="Ideen"]I'm interested on what you get figured out on this.  I'm still confused about the difference between LADA and type 1 and if it evens matters to differentiate the two other than calling it Type 2 that turns into Type 1.[/quote]

There seems to be a lot of contradiction out there!  Sometimes I find that general idea of "type 2 that turns into type 1," but then I also run across info that insulin resistance (which is pretty much what defines type 2) is not a defining factor of 1.5.

*pulls hair out*

I'll be curious to see what I find out, too!  So far, I think you're right about the treatment.  It looks like once a 1.5 loses enough pancreatic function, they're treated just like a 1.

[quote user="Kim"]

E, thought of you when I saw this post, too:  http://www.diabetesmine.com/2010/09/my-own-definition-of-lada.html

[/quote]

What wild timing!  Thanks for the link.

Meredith:

How interesting.  Reading your story, I can't shake the feeling that I might have had a similar experience if I had gone to the doctor after those high meter results two years ago.  I've also felt, for 2 or 3 years, that something was wrong but I wasn't entirely sure what (I suspected that I was simply unhealthy from a few extra pounds and lack of exercise, and occasionally suspected I might be pre-diabetic as a result).

Now that I have much healthier blood sugar levels and feel much better, I'm pretty amazed that I didn't pursue it much sooner than I did.

I've had T1 since 2006 when I was diagnosed at the age of 39.  There is no difference in treatment.  LADA is just what they call T1 in adults.

I use very little insulin.  My ration is the same as yours 1:10.

The most common test for LADA is one that looks for GAD (glutamic acid decarboxylase) antibodies.http://www.phlaunt.com/diabetes/18382053.php

[quote user="Khürt Williams"]

LADA is just what they call T1 in adults.

[/quote]

 Hi Khurt,

It sounds as though you are a bit misinformed.  As you speak to more and more people in the diabetes online community, you will find many who were diagnosed with T1, not LADA, as adults - and experienced that sudden need for insulin (and resulting DKA episode) that is a hallmark of T1. 

Please read http://forecast.diabetes.org/magazine/features/other-diabetes-lada-or-type-15:

While not everyone has settled on calling the condition LADA (some prefer “type 1.5”), or even whether it’s distinct from type 1, researchers are working on a set of criteria for its diagnosis: 1) the presence of auto­antibodies in the blood, 2) adult age at onset, and 3) no need for insulin treatment in the first six months after diagnosis. This definition would distinguish LADA from type 1—because people diagnosed with type 1 typically need to start insulin immediately—and from type 2, because of the presence of autoantibodies in the blood. 

Scientists have discovered several different types of auto­antibodies related to diabetes. People with type 1 have higher levels and more types of these proteins than do those with LADA, which may be the reason beta cells are destroyed faster in type 1 than in LADA.

 

I realize these posts are rather old, but as I am newly diagnosed LADA I am doing lots of reading and hope that you are still monitoring your posts.
I feel like I’m reading my same story over and over again. Diagnosed at 51 (11 months ago), I’ve had granuloma spots for most of my adult life. I am in the honeymoon stage for sure; still producing insulin (at the bottom of the normal range). I’ve been on Metformin since diagnosis and recently added Januvia. My A1C was holding at 6.6 (down from >9) but recently jumped to >7.
I have attended seminars where they claim they can reverse autoimmune diabetes, though my endo says these are hocus pocus.
Also looked into the paleo approach, but the restrictions on that diet are crazy.
I really want to believe there’s another way besides insulin…
I feel so terribly alone and frustrated with this disease :frowning:

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I’m right there with you, I was initially diagnosed as type 2 for the last 6 years. It was easy to believe even though I stay in good shape and was eating clean and exercising regularly when I was diagnosed. I have a family history of diabetes and have lost 10 family members to it in my lifetime. After losing a very close cousin to it in January I decided to do something about it and make some serious changes. I started a program to reverse type 2 diabetes and changed my diet to a low fat, plant based non processed way of eating. I dropped my A1c from 8.5 to 7 but I was not getting the same results that others in the program were seeing. A lot of people were actually reversing their diabetes completely. My nutritionist suggested I have a C-Peptide test done to see if my body was actually producing enough insulin and it turned out that it wasn’t. So as of mid July I have been trying to find out as much information as possible and a lot of times I have been feeling kind of lost. I’m not on insulin but I did get a CGM and even though I am in range around 74% I still have so many questions. It feels like I’m on an island between type 1 and type 2 and it’s an island no one wants to visit. My doctor said we’ll leave things the way they have been as far as treatment until I eventually need insulin. But I have not had an antibodies test and since my doctor never even thought of the C peptide test, I wonder how on top of it he really is. It feels like all the books are either about type one or type 2 and there is so little information about someone in my position. Using a cgm I’m seeing all the spikes I never knew I was experiencing and I wonder how normal they might have been or are they a sign I need insulin. It’s on my mind at all times.
Good luck to you, to both of us and to all of us.

hi @DlGregory Welcome to Type One Nation, hey you are replying to a 12 year old post I doubt very much the OP and the rest of the folks on the thread are still active here. LADA and Type 1 are autoimmune disease and changing your diet, or exercise will not change the outcome. By “outcome” I mean it will not hasten or delay your need for insulin. If you have high sugar and low c-peptide, something is causing you to make less insulin than you need. It’s a great idea to get a Endocrinologist willing to work with you and explain the strategies. All I can think of is that insulin needs to be taken carefully - as it can cause you to get low enough to hurt yourself. A doctor’s main job is do no harm. this one you have thinks the dangers of insulin outweigh the highs you are getting. it’s totally OK to get the opinion of a more aggressive doctor. 75% in range and an a1c (if you’ve never had on it is called “glycated hemoglobin”, (its a blood test) and is called out as an HbA1c, we nickname it an A1c) that is elevated and you may want to consider insulin. If you are already testing, then that’s all that you would need to do once you start insulin. Save the CGM data to show to your doctors. Get the book “Think Like a Pancreas”. it is a book explaining most of whatever your questions are. … and you can always just ask, 'cause that’s what we’re here for. good luck!

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Thanks, Joe

My A1C is at 7 right now, down from 8.4 before I changed up my diet when I was still considered a Type 2 which I was for 6 years. I am saving my CGM data and I do have the “Think Like a Pancreas” book.
the main thing that I worry about are the times when my blood sugar goes over 250 -300.

Thanks for your reply!

oh, ok, sorry for being so obvious.- yes, that’s a good worry. I try to stay under 175 max peak after meals (for me - i don’t make any insulin) , also since my bs is much more variable, I don’t like to be above 70 (mg/dl) higher than my starting (meal) blood sugar. If you are frequently over 250 after meals, my best advice is for you to find a more aggressive doctor. Well controlled T1’s can have “Time in range” 75-90% and a1c below 7. Hope you can find medical support!

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@DlGregory - my after dinner (ate at 5) spike was 135 (max) but I have a good set up I was way morea active this afternoon than typical.