Type 1 1/2?

[lumplump]

My doctor told me that newer revelations in the understanding of diabetes led him to informally diagnose me with what he (and I assume others) call type 1.5.

Is there really an accepted or validated Type 1 1/2 diagnosis or is it just another plausible yet widely and/or ignorantly rejected theory?

Personally I have no problem calling myself type 1.5 because I don't produce insulin and my cells resist insulin. Consequently I depend heavily on insulin injections and pills. Namely Lantus (a godsend) and actos.

[DeusXM]

Type 11/2? Sorry, no such thing.

There are two types of Diabetes Mellitus:

Type 1: The islets of Langerhans, the cells in the pancreas responsible for producing insulin, are for an unknown reason, destroyed, possibly by the body's own immune system. Therefore the individual cannot produce insulin and needs insulin injections. Typically this kind of diabetes occurs in those under the age of 25, hence its alternate name, juvenile onset diabetes. Also known as Insulin Dependent Diabetes (IDDM).

Type 2: The individual still produces insulin, though is unable to use it effectively, resulting in high blood sugar. Can be treated by a low sugar/carb diet, exercise, tablets which boost the effect of the currently produced insulin, or insulin injections. Usually occurs in people over 40, and frequently (though not exclusively) occurs in seriously overweight individuals. Some people though just seem to be plain unlucky and develop the condition without any other prior health problems. Also know as mature onset diabetes and Non-Insulin Dependent Diabetes (NIDDM).

The only exception to these (and what might possibly be your type 1.5) is something called MODY, which is Mature Onset Diabetes of the Young. Basically, someone under the age of 30 or so develops T2. Again this can occur in individuals who were in perfectly normal health and fitness before. However, it is worth mentioning that with the increase in child obesity, there has also been seen a rather worrying increase of T2 in children.

Hope that helps you in some way.

[zookeeper671]

According to diabetesnet (http://www.diabetesnet.com/diabetes_types/whatype.php);

"When 'Type 2' occurs without insulin resistance, it may be referred to as Type 1.5 or Type 2-s (for insulin sensitive) or Type 2-d (for insulin deficient). Type 1.5 occurs in adults who usually are lean or normal weight. These people have normal insulin sensitivity but, like other people with Type 1, their insulin production is deficient. When their blood sugars are controlled, they usually do not have the high risk for cholesterol, blood pressure, or cardiac and vascular problems typically found in true Type 2 diabetes. This type of diabetes shares characteristics of both Type 1 and Type 2. Of all the people with diabetes, roughly 10% will have classic Type 1, 75% will have Type 2 (insulin resistant), and another 15% will have Type 1.5."

Hope this helps.

Angie

[zookeeper671]

Here's another link to some info: diabetes monitor (http://www.diabetesmonitor.com/lada.htm)

Best wishes,
Angie

[zookeeper671]

lol Sorry about the multiple posts... can't seem to get my act together.

Another link: type 1.5 (http://www.diabetesnet.com/diabetes_types/diabetes_type_15.php)

Angie

[DeusXM]

Ooo, hadn't actually heard of that before. So, effectively, individuals with 1.5 still produce insulin, but not enough for their requirements, right? Sounds rather like the preliminary stages of someone developing T1.

Anyone know if people with 1.5 usually go on to develop T1?

However, with reference to lumplump's case, if you say you've got insulin resistance then what is on diabetesnet would suggest you don't have T1.5. Then again, I'm not a doctor.

[Andrea]

Actually, Deus, There is such thing.

Type 1.5 is also known as LADA (Latent Autoimmune Diabetes of Adulthood).

The older you are when you develop autoimmune diabetes, the longer it takes for beta cell destruction to happen. Full destruction can take a number of years when you are diagnosed in your 30s 40s or 50s. So sometimes the diabetes is misdiagnosed as type 2 at the beginning because of age and the fact that insulin might not be necessary from the start. But insulin usually is necessary within months to a couple of years.

There is a good description of type 1.5 at the diabetes mall:
http://www.diabetesnet.com/diabetes_types/diabetes_type_15.php

Not all cases of diabetes fit into the fairly narrow definitions of type 1, type 2 and gestational. Even type 1 can be broadly subdivided into type 1A (autoimmune) and type 1B (idiopathic) diabetes. But there are lots of other sub-types that are not as widely know too.

Lumplump, i don't know what type of diabetes you have, or how your doctor reached the conclusion that you have type 1.5, but i wouldn't necessarily doubt it if all of the factors were looked at in detail. I assumed s/he looked at factors like your age, your C-peptide level, if you presented with DKA at diagnosis, the amount of exogenous insulin you need, your antibody levels... among other things. The one thing that surprises me is that usually people with LADA or type 1.5 are not very insulin resistant. So if you do have an autoimmune form of diabetes (type 1A, type 1.5, LADA), then maybe you also have type 2. You mentioned in another post that it runs in your family.

Andrea

[Andrea]

LOL - i got interrupted in my answer and in the mean time angie posted the same info!

Deus, it's not that people with type 1.5 go on to develop type 1. Type 1.5 is already an autoimmune form of diabetes, just one that usually is developed at a later age and whose onset is slower.

Andrea

[DeusXM]

So, in individuals with 1.5, does the immune system just destroy some of the insulin cells? Or does it eventually destroy all of them (over a longer period of time than those developing T1)?

[Andrea]

In my understanding, it is all of them, just like in type 1. It is just that the older you are when the autoimmune process starts, the longer it takes for the complete destruction to happen. That's why some people can manage their blood glucose levels for a time with no exogenous insulin. It could take years and years for there to be no endogenous insulin fuction left, but dependancy on exogenous insulin might come after a couple of years.

All that said, i think there are still things to learn about the various subtypes of diabetes.

Andrea

[HeatherP]

Hello and Welcome.

Actually, talk to Rzrbks, he's a T1.5 too.

HeatherP

[DeusXM]

So, effectively those with T1.5 will eventually end up in the same position as those with T1, but in a timescale more like 4 or 5 years rather than 4 or 5 months, right?

Wow - I never considered myself an expert on diabetes but I though I was pretty clued up....looks like you learn something new every day!

[snakeye]

We're made of flesh... we give the names Type1 or 2 or 1.5.
The body is much more irregular than we think it is. So why not anyway?

[lumplump]

Wow, thanx for all the responses.

My onset was fairly rapid(about 6mo.) At which time I lost about 80lb. and very nearly died of extreme dehydration from ketoacidosis. The nurse in the ER had difficulty drawing blood because it was thick like syrup. All of this happened after a bad case of the flu, so there is not much doubt it's an auto immune type. In fact my mother has been a sufferer of autoimmune hepatitus for many years, so immunity seems to be an underlying factor in our genetics.

I recently read an article about baiting the anti-bodies that would be responsible for killing insulin producing eyelets. Knowledge that could be useful in preventing T1.

As Angie said, I don't have any issues with high cholesterol or blood pressure. Alot of that is probably because I refuse to intentionally put myself in high stress situations. Some people seem to look for it. I've
never been particularly lean (or obese)though.

Boy am I glad to be a diabetic in this day and age. I probably wouldn't have made it this far if it were 20 yrs ago. It's nice to be able to talk about it to y'all. Being diabetic can be a pretty lonesome path to travel at times. It's so misunderstood by nondiabetics myself included "before".

[Jean Cusick]

I am a type 1.5 diabetic. Diagnosed as type 2 three years ago (at age 62) although I am not overweight and have normal blood pressure. Oral meds worked for nine months. Switched to insulin two shots per day. Last May changed to Lantus and Novolog (4 shots a day) and started carb counting. Decided that since I am counting carbs, might as well go on the Pump. Started pumping December 2003. Type 1.5 is also called "Late Onset Type 1". I am still playing catchup with all there is to learn about diabetes but am thankful that I didn't have it any any younger.

I am in awe of all you folks who have been dealing with this for years.

[lumplump]

I've only been at it for 3 years and it was like 3 years of medical school.

In fact I was just out of the hospital on 9/11 I had also just recieved the sad news of a death in the family. The stress at the time seemed overwhelming. Diabetes, terrorists, car accidents. The world was turning inside out. As if that werent enough, a year later my father died of complications from dialysis. Strange how it happened litterally within hours of his medicare running out. Not to mention the hospital he was in was 1500 miles away.

Enough plainin' I guess what I'm trying to say is that no matter how tough things get it also passes and you'll be moving on before you know it. Diabetes is a lifestyle and it's not hard to turn it into a positive thing. I'm probably healthier now than I've been most of my life.