Recently Diagnosed & New Members

[cinnamonspice]

I was recently diagnosed type 1.5 diabetes.  At present, I am on medications.  I was told eventually I may be on insulin.  So far, my BG numbers have been good.  Is type1.5 a rare disease and how long would it take before I start on insulin more or less?

[LeadSinger]

You say you are not on insulin.  I could be wrong (but I don't think so), but since you are only on oral meds at this time, you have Type 2.  Type 1.5 is basically an older adult diagnosed with Type 1 (insulin dependent).  Just for the heck of it, check back with your doc on this.

In any event, welcome to our not-so-little club of those with diabetes (irregardless of type).  Jump on into the forums and ask whatever Q's you have.  We try to be a helpful bunch.

[trisha01 Diabetes Brain Trust]

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cinnamonspice wrote:

I was recently diagnosed type 1.5 diabetes.  At present, I am on medications.  I was told eventually I may be on insulin.  So far, my BG numbers have been good.  Is type1.5 a rare disease and how long would it take before I start on insulin more or less?

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Cinnamon,

For starters....

The only official recognized Types are ...Type 1...Type 2...and Gestational. There is NO Type 1.5.

If you are Type 1, you will be on insulin, and for life. Your body and your physician, will be the determinant factors, as to when you start insulin. When Type 1's are diagnosed, they may still have a few (I think about 10 to 20%) beta cells in the Islets of Langerhans (in the pancreas), that have not been killed off yet.

You will want to come to the Type 1 forum, which is here:

http://community.diabetes.org/t5/Adults-Living-with-Type-1/bd-p/Adults-Living-with-Type-1

and you will specifically want to start with reading this discussion here, titled LADA (1.5):

http://community.diabetes.org/t5/Adults-Living-with-Type-1/LADA-1-5/td-p/195980

Once you come over and do a little advanced reading, jump in with starting your own thread. Tell us more...such as how and when you were diagnosed (doc's office, sick, injured, in hospital, etc.). Also include the medications and dosages you were put on. It is possible that you are a Type 2, so keep that in mind as well. If you are, we'll send you over to the Type 2 forum. They will be the ones that will help with medications that you are on, as Type 1's can only survive with insulin.

Sorry to hear of your DX, regardless of the type.

Trisha - Type 1 almost 30 years

[ronaka]

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cinnamonspice wrote:

I was recently diagnosed type 1.5 diabetes.  At present, I am on medications.  I was told eventually I may be on insulin.  So far, my BG numbers have been good.  Is type1.5 a rare disease and how long would it take before I start on insulin more or less?

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As far as statistics go, I don't know the exact ones, but approximately there is about 10 type 2 diabetics for every type 1. I've not seen any real good statistics but I believe it is estimated about 10% of those who are diagnosed as type 2 in the end turn out to be type 1. These are the ones that are classed as type 1.5 or LADA. It is a condition that is very frequently misdiagnosed as type 2, so if you really do have it, you are very fortunate to have been diagnosed correctly from the beginning. More often because it happens later in life (I assume you are older?). It is assumed to be type 2, and type 2 medications like metformin are incorrectly prescribed. To diagnose 1.5 you need to estimate insulin production. Typically the C-Peptide test is used to do that.

But to be clear type 1.5 is not a mix of type 2 and type 1. It is really a late in life and slow developing type 1 disease. Type 1 is an autoimmune disorder that causes the destruction of the beta cells, and as a result insulin becomes inadequate. In youth type 1 this burnout of the beta cells is rapid. But in the type 1.5 or LADA version it happens late in life and slowly. Some estimate the average time it takes to got to full loss of the beta cell function as 4 years. The cause is the same autoimmune disorder, so it is really a subclass of type 1.

The importance of all this is that type 2 diabetics almost always suffer from insulin resistance. They have almost the opposite condition -- an excess of insulin rather than a deficiency. Some type 2 drugs address this by increasing sensitivity to insulin. They are a good choice for true type 2's, but a poor choice for true type 1.5's. Type 1.5's need more insulin so insulin stimulating drugs work the best. Poor choices then are metformin, Actos, and Avandia. Good choices would be Prandin, Starlix, or one of the sulfonylureas like Glipizide. They all stimulate insulin.

However, over the 4 years or however long it takes the insulin stimulating drugs will become less and less effective, and at some point supplemental insulin is needed. Your BG readings will tell you when that is necessary.

Hope that helps some. If you have any questions just ask.

[cinnamonspice]

Thanks, Ron.  Yes I am 59.  I was told my pancreas is secreting some insulin and they want me to continue on medication before I am put on insulin.  I am being monitored closely and I am to go back to the office in another month.  LADA is what I was diagnosed as.  Very confusing.

[techguy87114]

cinnamonspice,

First off, welcome! glad to have you.

now... reach out and dig in ( here in the forums) as there are lots of great people, resources and information. I myself have been recently diag'd (02/07/2012) and have turned here to get answers and learn. so far so good! Biggest things.. stay in touch with your doc(s), follow the meds regimine and eat right. Log everything for a while so you can see your trends and share that with your care givers.

best medicine of all ( at least for me has been A-T-T-I-T-U-D-E AND KNOWLEDGE. )

 feel free to reach out if you have questions.. these folks are here to help. We are one in the same!

Best,

Techguy87114

[ronaka]

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cinnamonspice wrote:

Thanks, Ron.  Yes I am 59.  I was told my pancreas is secreting some insulin and they want me to continue on medication before I am put on insulin.  I am being monitored closely and I am to go back to the office in another month.  LADA is what I was diagnosed as.  Very confusing.

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For sure staying on an insulin stimulating type 2 medication is a good plan as long as the beta cells can respond. Natural insulin does work better than injected, and you should make use of it as long as you can. Some think that if you start injected insulin early it can help extend the life of the beta cells, but I'm not sure there is good evidence to support that view.

[Talvie]

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ronaka wrote:

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cinnamonspice wrote:

I was recently diagnosed type 1.5 diabetes.  At present, I am on medications.  I was told eventually I may be on insulin.  So far, my BG numbers have been good.  Is type1.5 a rare disease and how long would it take before I start on insulin more or less?

---

As far as statistics go, I don't know the exact ones, but approximately there is about 10 type 2 diabetics for every type 1. I've not seen any real good statistics but I believe it is estimated about 10% of those who are diagnosed as type 2 in the end turn out to be type 1. These are the ones that are classed as type 1.5 or LADA. It is a condition that is very frequently misdiagnosed as type 2, so if you really do have it, you are very fortunate to have been diagnosed correctly from the beginning. More often because it happens later in life (I assume you are older?). It is assumed to be type 2, and type 2 medications like metformin are incorrectly prescribed. To diagnose 1.5 you need to estimate insulin production. Typically the C-Peptide test is used to do that.

But to be clear type 1.5 is not a mix of type 2 and type 1. It is really a late in life and slow developing type 1 disease. Type 1 is an autoimmune disorder that causes the destruction of the beta cells, and as a result insulin becomes inadequate. In youth type 1 this burnout of the beta cells is rapid. But in the type 1.5 or LADA version it happens late in life and slowly. Some estimate the average time it takes to got to full loss of the beta cell function as 4 years. The cause is the same autoimmune disorder, so it is really a subclass of type 1.

The importance of all this is that type 2 diabetics almost always suffer from insulin resistance. They have almost the opposite condition -- an excess of insulin rather than a deficiency. Some type 2 drugs address this by increasing sensitivity to insulin. They are a good choice for true type 2's, but a poor choice for true type 1.5's. Type 1.5's need more insulin so insulin stimulating drugs work the best. Poor choices then are metformin, Actos, and Avandia. Good choices would be Prandin, Starlix, or one of the sulfonylureas like Glipizide. They all stimulate insulin.

However, over the 4 years or however long it takes the insulin stimulating drugs will become less and less effective, and at some point supplemental insulin is needed. Your BG readings will tell you when that is necessary.

Hope that helps some. If you have any questions just ask.

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According to Diabetes Forecast:  "LADA can be classified as a more slowly progressing variation of type 1 diabetes, yet it is often misdiagnosed as type 2. As of now, there is still a lot of uncertainty over how exactly to define LADA, how it develops, and how important it is for patients to know if they have it."

I'm thinking that the doctor has "boots on the ground" so to speak, and while I might suggest further testing to find out if the OP is in a honeymoon phase or might continue for some time without needing insulin, as many Type 2s do, I would not try to diagnose without the test...and the appropriate initials behind my name.

[sunritef]

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ronaka wrote:

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cinnamonspice wrote:

Thanks, Ron.  Yes I am 59.  I was told my pancreas is secreting some insulin and they want me to continue on medication before I am put on insulin.  I am being monitored closely and I am to go back to the office in another month.  LADA is what I was diagnosed as.  Very confusing.

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For sure staying on an insulin stimulating type 2 medication is a good plan as long as the beta cells can respond. Natural insulin does work better than injected, and you should make use of it as long as you can. Some think that if you start injected insulin early it can help extend the life of the beta cells, but I'm not sure there is good evidence to support that view.

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When you produce insulin with T1(.5), your body starts atttacking the beta cells.  If you are taking insulin injections, there is less attacking as you are producing less.  I also believe that it is easier to learn how to use insulin when your body is giving you some buffer by producing some, as opposed to having to be perfect when you start.

[ronaka]

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sunritef wrote:

When you produce insulin with T1(.5), your body starts atttacking the beta cells.  If you are taking insulin injections, there is less attacking as you are producing less. 

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Can you provide some references to support that statement?