View Full Version : Definition
rachelb
01-07-2007, 07:54 PM
What is the definition of 1.5?
I am type 2 but have never found the perfect combination of food/exericise/medicine to bring my bsl to normal - in almost 10 years!
Can anyone tell me the difference between 1.5 and 2? Perhaps I am not really what I think I am and am not treating the problem correctly.
Thanks.
R
SuzannaOR
01-07-2007, 09:26 PM
Here is a definition of a type 1.5 I copied from a website (see below). Do you fit the description? I believe one difference is a type 2 is insulin resistent, whereas a type 1.5 is not. Another possibility is your pancreas may be worn out and you need insulin to help you with your blood sugars. You may need to have the GAD anitbody test done, as suggested in the article below. Lots of possibilities I am sure you will want to discuss with your doctor.
Hope this helps.
Suzanna
Type 1.5 Diabetes
aka Slow Onset Type 1 and LADA
Type 1.5 is one of several names now applied to those who are diagnosed with diabetes as adults, but who do not immediately require insulin for treatment, are often not overweight, and have little or no resistance to insulin. When special lab tests are done, they are found to have antibodies, especially GAD65 antibodies, that attack their beta cells. This sort of diabetes is sometimes called Slow Onset Type 1 or Latent Autoimmune Diabetes in Adults or LADA.
About 15% to 20% of people diagnosed as "Type 2" actually have this type. They are often diagnosed as Type 2 because they are older and will initially respond to diabetes medications because they have adequate insulin production. The treatment the person is first put on may be diet, exercise, and standard Type 2 medications.
Since insulin resistance is minimal or non-existent, medications designed to reduce insulin resistance such as Avandia and Actos are not effective. Other meds that stimulate the pancreas to produce insulin, slow digestion of carbs, or reduce excess glucose production by the liver are often effective in controlling the blood sugar for a few years.
A little more info on T1.5 - excuse me if I repeat a little of what's already been said:
Lots of T1.5s are misdiagnosed at T2, at least for a short while, because docs tend to assume that adults are T2. Especially if you're overweight. If they asked more questions and sent the patient for the antibody test, they'd know the truth straight away...
T1.5 can hit at any age, generally from 20s onwards. It IS the same as Type 1 - auto-immune Diabetes - but with a slower onset. It is NOT related to insulin resistance or any of the usual things you hear about T2, but a T1.5 (and any T1) can get insulin resistance on top of their diabetes, especially if they gain weight. Type 1.5s are often skinny - especially at the time of diagnosis as they've probably been losing weight from high BGLs. They can be any size or shape though, of course :)
T1.5s often have a honeymoon period, while the pancreas is sputtering and still trying to do its job, but not quite doing it right. So after diagnosis you might find that diet/exercise/pills appear to work wonders for a while... but at some stage that wont cut it. The pancreas is eventually unable to produce insulin at all, and it'll be time for injected insulin. ALL T1.5s end up on insulin.
Rachel, after 10 years I'd have to doubt that you could be a T1.5 - I guess it's not completely impossible, but your pancreas must be giving you one heck of a honeymoon ;)
What meds are you on? Are you doing anything about diet? Exercise? Just how bad are your numbers, if you don't mind me asking :D
JediSkipdogg
01-08-2007, 04:00 AM
Both above me have hit it dead on. Personally though, I'm one that says if you have the antibodies you are type 1. I don't fully understand the special name Type 1.5 just because you have the same exact cause as a type 1. Yes, it may take 2-3 times longer to fully develop, but you still have the same cause, just a difference in age.
Is alzheimers different if a person is 30 and diagnosed with it? How about breast cancer at age 15? Age doesn't matter anywhere else if the cause is the same, so why here. To me it just adds to more confusion on the treatment and "lingo" side of things.
Cyborg
01-08-2007, 04:44 AM
Since insulin resistance is minimal or non-existent, medications designed to reduce insulin resistance such as Avandia and Actos are not effective.
Not sure about this statement. Perhaps I'm an exception, but I certainly do have insulin resistance...
rachelb
01-08-2007, 07:34 AM
Thank you to all of you for the information, I really appreciate you taking the time to share it with me!
I tend to think, based on what you've written, that I am really just a Type 2, but I think it helps to have a lot of information to consider.
I have just scheduled an appointment with the doctor for next week and I may ask him to run the GAD antibody test, just to rule things out.
I am starting over with my diabetes treatment - I took a six-month break from it because I was feeling overwhelmed by my life. Given everything that was going on at the time, I felt like ignoring my condition and not being on medication was the thing I had the most control over. Iron huh, given that control is the one thing that eludes most diabetics?!?
Thank you again for all of this information.
R
SuzannaOR
01-08-2007, 08:01 AM
I have to agree with you, Jedi ... A type 1.5 is really a type 1 diagnosed later in life! But I like being unique, therefore, I like being classified as a type 1.5!! :proud:
Also, those of us diagnosed late in life have never experienced diabetes like a juvenile diabetic. I admire my friends who have had diabetes since childhood! I don't feel like I am in the same class as them as far as life experiences go.
Suzanna
It Ain't Over
01-08-2007, 12:56 PM
Not sure about this statement. Perhaps I'm an exception, but I certainly do have insulin resistance...
I asked my endo about this, his anwer is that anything that causes excess insulin needs is insulin resistance by definition.
Of course the BIG difference here is that in a type 1 the insulin comes from somewhere else. T2's are still producing it. Makes the effective treatments vary.
And like all things having to do with diabetes, it varies all over the map from here.
JediSkipdogg
01-08-2007, 01:03 PM
I have to agree with you, Jedi ... A type 1.5 is really a type 1 diagnosed later in life! But I like being unique, therefore, I like being classified as a type 1.5!! :proud:
I was diagnosed under 12 months old. THerefore, I want to be a type .5. Ok, it's settled, I'm type one half.
I was diagnosed under 12 months old. THerefore, I want to be a type .5. Ok, it's settled, I'm type one half.
I like it!
Then I'll take type 7. I just like the sound of it.
Heck, people don't understand the different types anyway, so why not confuse them more!
Perhaps I'm an exception, but I certainly do have insulin resistance...
You are not alone. I'm even on Metformin. Blergh. Want to join the type 7 club? I might even print some dorky T-shirts!
Not sure about this statement. Perhaps I'm an exception, but I certainly do have insulin resistance...
Yeah, that's why these classifications are really limiting. On the one hand, I feel like I agree with Jedi 100%. In the years I have been here on this forum, I have seen a few members come in here declaring they are a 1.5 when in reality they are a Type 2. Or they come in and say they are 1.5, and then, after further testing or time, they say they are now diagnosed as Type 1. Then, there are apparently some truly valid Type 1.5's. But even then, they seem to not fit neatly into that box that is being sold to us as the one-size fits all "Type 1.5-Box". Sigh.
HelenM
01-08-2007, 04:05 PM
For me I was very glad to discover the category 1.5 as it explained a lot of my own circumstances. I'm officially (for French beaurocracy) diagnosed with type 1. Two years on since diagnosis I'm beginning to feel that the speed of onset and progression of diabetes is very varied and many do not fit into neat tick boxes.
What concerns me is that the general info given on many websites and books is that type 1 only occurs in young people and has a rapid onset. This led me and perhaps others to defer treatment until quite late, perhaps leading to complications in the future . In my case I knew I ate sensibly and did loads of exercise so I decided that I was already doing what a doctor would advise for type 2 diabetes. Of course it didn't go away and I ended up in hospital.
grace girl
01-08-2007, 04:38 PM
Well, according to the doc's I've been everything!
The endo I saw this summer was the one who told me that I really wasn't type 1, but 1.5. He based this solely on the fact that I was 32 at dx. My new endo told me she doesn't go in for all that...that the results of the c-peptide and the GAD-antibodies test reveal either type 1 or type 2 and there's too much confusion in between. I tend to agree with her.
jeggeman31
01-08-2007, 06:05 PM
Not sure about this statement. Perhaps I'm an exception, but I certainly do have insulin resistance...
I have it also Cyborg!
Simon
01-10-2007, 02:50 AM
There are a few cases of type 1.5's never needing insulin. If the antibody count is low enough, the pancreas can recover as fast as it's destroyed. I read somewhere about a random study being done that showed that the honeymoon period can be any length including so long that symptoms of diabetes never happen.
Kimber
04-22-2007, 11:05 AM
Emm,
Thank you for a heart felt smile and laugh out loud! There is sooooo much confusion with the labels that I agree, why not add to the hubub? I like to be different and if there is little agreement anyway, ...
Make the tshirts! I'll buy one. Having been diagnosed at age 44 with tons of confusion as to exactly what I am I don't know what number I will need. Perhaps my shirt should say, "The doctors are discussing the matter, haven't agreed yet, check back later!"
Kimber
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