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Established Contributor
gibby767
Total Posts: 1,009
Registered on: ‎11-27-2010

Type 1.5 Diabetes or LADA Diabetes

Well, I have just read about Type 1.5 Diabetes or LADA (Latent Autoimmune Diabetes of Adults). And it may answer a lot of questions.

Some 15-20% of Adult Onset Diabetes may not be Type 2, but a sub-type called LADA or Type 1.5 -- you all may know tons about this and there may be a whole lot on this site....but so far I have missed it. I searched the site and found something helpful in the magazine, but nothing in the discussions.

As it so happens, my Endocrinologist called to today about adjusting my thyroid meds dosage (my Pre-diabetes was news to her) so we  I chatted ...after we did, she definitely wants to see me b4 Feb and definitely will test me for LADA antibodies.

So here is what I found out that is so interesting:
Backgoround Info
LADA shares elements of T1 and T2 -
With T1 it shares 1) the fact that it is auto-immune...the body develops antibodies that fight its own cells, essentially attacking the pancreas and destroying it, which is what causes the diabetes and 2) the need for insulin eventually for many, if not most, patients.

With T2 is shares 1) later onset than usual T1 diabetes and 2) some insulin resistance (less than T2's though)

LADA patients are likely to have a family history of autoimmune disease (Rheumatoid Arthritis, Thyroid disease) and it is inherited with only one gene, from either parent and it is likely that a parent had the disease.

While most T2's in the US are overweight (some significantly so) many LADA patients are of normal weight and can even be underweight and many are physically fit. Type 2's also are likely to have Metabolic Syndrome (constellation of symptoms including high cholesterol, high blood pressure and glucose intolerance).

LADA patients rarely have the other two issues associated with Metabolic Syndrome (lipids and high BP).

So - what's in it for me ---
Well, first, because my father (an M.D./Ph.D. educated at Johns Hopkins...so he knew what he was doing)  was unable to control his diabetes with diet and exercise w/in just a year of diagnosis (1972?) at about age 55. I remember his calling me at collegerather distressed, talking about "out of control blood sugars" and my not knowing what to say or do. (Nothing as it turns out).

Second, he was never-ever overweight and had normal blood pressure and cholesterol well into his upper 70's.

Also...while naturally curvy , I never had a history of being heavy (though I always complained b/c I didn't look like a twig) with the exception of the last year when I had a horrible year due to thyroid surgery, inability of docs to get meds right and inablility to exercise. I ballooned to a BMI of 28 in 6 months, but I am now okay and with proper correction of meds 8 weeks ago am back down to normal at 24 now (lost 23 lbs).

But then, thyroid disease (auto-immune...)runs in my family (both my mom and ME)....

My dad and I have no high cholesterol or BP....my latest numbers were awesome at a total of 125 and I have never even been close to  200. 

So...a number of the factors associated with LADA popped out at me.

WHy does it matter? Because recent research indicates that treating LADA with sulfonylureas (glipizide) can harm the patient. They think it accelerates the disease (apparently by releasing antibody agents faster...I may have that a bit off...it was a pretty technical article).

Also, other research seems to indicate that LADA patients might be able to preserve working beta cells longer by going on insulin earlier!  But I think most Type 2's generally try to stay off insulin as long as possible..do I have that right?

Needless to say...I am going to be interested in seeing what happens....

Anni


Anni
Dx'd 12/2010 BMI 22.5 A1C 5.4 (6/2011 = 5.7; 9/2/11 - OMG - 5.2!!!!!!!)
MODY 3 Diabetes Onglyza & Levemir 5 Units Nightly + Humulin R Bolus 1:25 I:C Ratio
Limit Carbs/Eat to Meter
Walk 3 Mi 3-4X Wk

Fam Hx: Dad/Ptnl Aunt & 2 1st Cousins also presumed MODY3; Likely traces to Ptnl Great Grandmother who is presumed to have developed gestational DM in 1882 and died in Russia when my grandfather was 5 yrs old.

lizzylou
Total Posts: 13,830
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Registered on: ‎10-31-2009

Type 1.5 Diabetes or LADA Diabetes

Well it just so happens that I have to come all of the way out of the closet and say:  My name is Lizzy, and I'm a type 1.5 or LADA, or as I like to call it type-whatever!

I was diagnosed as a type-2 but never really fit the pattern.  After a disastrous try with orals I insisted I be given insulin because I had my suspicions even then.  Luckily the doctor I had at the time agreed and I've been using insulin ever since.

I had no insulin resistance at all.  Even now I use less than a lot of type-1's but my numbers skyrocket if I don't take it (like when I was in the hospital and they wouldn't give it to me until I reached over 200.)

I also always had perfect cholesterol and still do without any drugs.  My BP was also perfect until this summer when I was diagnosed with a fast and irregular heart beat.  Now it's all over the place but not because of the diabetes.  I also have several auto immune diseases and a family history of diabetes.  I did have a weight problem, but was thin for about 8 years before I was diagnosed.

It sounds as though your Dad had the same condition, and you might as well.  But be aware that the tests aren't always definitive.   I wouldn't exactly say that orals harm a 1.5, usually they just stop working.

I still produce some insulin, but not enough to go without supplemental insulin.  I really believe that starting it early has saved me this long, over 8 years and still going.

Your numbers are much too low at this time for insulin.  If the doctors know your type though they might not give you a giant hassle about it when the time comes the way so many people report having to go through.

Lizzy
Knowledge is Power!





Here's some useful links, click on the titles


Testing 101
 
 All About Carbs

Resources For The Un-insured and Discount Medicine and Equipment

LizzyLou Videos



Lizzy's Blog
for lots more  


Established Contributor
gibby767
Total Posts: 1,009
Registered on: ‎11-27-2010

Type 1.5 Diabetes or LADA Diabetes


Thanks, Lizzie....thanks a ton for "coming out." I posted on the Type 1 board,too...I'm so impatient!!!!  Little did I know you were right here with info all along!    Yes, I do suspect my numbers are too low for insulin now...because I seem to have enough insulin to support my basal metabolic needs...but man....I just spike with the carbs...though I still recover quickly. 

The good news is that the Endo is on board and I know she KNOWS to monitor me for LADA...and not just to assume I have Type 2 and just treat me as such. 

I don't know how much I have told you...but I have had a miserable year of being misdiagnosed and not treated correctly for what was hypothyroidism.  Eventually, I found my wonderful Endo who understood that my body did not respond to what works for 90% of the population. Switched meds and I'm fine.  

I've lost a lot of trust in docs and I could just see the possiblity of this going down the same road.....lack of belief that LADA could be a possibility.... I'm satisfied that she'll check it out.  And probably recheck it again if no antibodies show up yet.
 
Thanks for sharing and for listening! It would truly be an unbelievable coincidence if I were LADA.  My best friend in the world of 40 years (we are joined at the hip) has been an insulin dependent diabetic for about 10 yrs now.  She has a pump (changed her life).  Back then, she was diagnosed as Type 1, though her doc was confused by her being a Type 1 because she was so "old' in her mid-late forties.  So, now we go out to lunch with our meters and count carbs together...ah, such togetherness.  I guess maybe we will eventually have matching pink pumps!  Sort of bizarre that life would work out that way!

Anni
lizzylou says:
Well it just so happens that I have to come all of the way out of the closet and say:  My name is Lizzy, and I'm a type 1.5 or LADA, or as I like to call it type-whatever!

I was diagnosed as a type-2 but never really fit the pattern.  After a disastrous try with orals I insisted I be given insulin because I had my suspicions even then.  Luckily the doctor I had at the time agreed and I've been using insulin ever since.

I had no insulin resistance at all.  Even now I use less than a lot of type-1's but my numbers skyrocket if I don't take it (like when I was in the hospital and they wouldn't give it to me until I reached over 200.)

I also always had perfect cholesterol and still do without any drugs.  My BP was also perfect until this summer when I was diagnosed with a fast and irregular heart beat.  Now it's all over the place but not because of the diabetes.  I also have several auto immune diseases and a family history of diabetes.  I did have a weight problem, but was thin for about 8 years before I was diagnosed.

It sounds as though your Dad had the same condition, and you might as well.  But be aware that the tests aren't always definitive.   I wouldn't exactly say that orals harm a 1.5, usually they just stop working.

I still produce some insulin, but not enough to go without supplemental insulin.  I really believe that starting it early has saved me this long, over 8 years and still going.

Your numbers are much too low at this time for insulin.  If the doctors know your type though they might not give you a giant hassle about it when the time comes the way so many people report having to go through.

Lizzy
Anni
Dx'd 12/2010 BMI 22.5 A1C 5.4 (6/2011 = 5.7; 9/2/11 - OMG - 5.2!!!!!!!)
MODY 3 Diabetes Onglyza & Levemir 5 Units Nightly + Humulin R Bolus 1:25 I:C Ratio
Limit Carbs/Eat to Meter
Walk 3 Mi 3-4X Wk

Fam Hx: Dad/Ptnl Aunt & 2 1st Cousins also presumed MODY3; Likely traces to Ptnl Great Grandmother who is presumed to have developed gestational DM in 1882 and died in Russia when my grandfather was 5 yrs old.