[NATbag]

Dear fellow members,

I seek your advise on this type 2 / type 1.5 confusion.
Before that, this is my history:
Diagnosed for diabetes during routine checkup (A1C 9.4) at age 32.5. My doc told me to be of Type II and started Actos 15 mg. At this point, I stopped smoking completely, started regular exercise and controlled diet. A1c came down to 6.2 in three months and has been constant to 5.8 thereafter (with Actos 7.5 mg). It had been 15 months since I was diagnosed with Diabetes. Family history : dad had Type II (?) and maternal relatives too had it though my mom doent have. I assumed that I had Type II but more I started reading on this disease, more I got confused about it. Am I type II or 1.5?
What shall I do to find it out? Is it more pathological tests like presence of GAD65 antibodies OR C-peptide test Or the fact that my diabetes is controlled with Actos means it is insulin resistance and hence Type II.
Kindly advise.

[kgm0612]

I was 40 when I was dx'd with Type 1. A C-peptide and GAD confirmed this. I also have a family history of Type 1, but never expected to be dx'd at that age!

Karen

[HelenM]

There is no official classification of 1.5. My doctor used it to define slow developping, type 1 diabetes (probably autoimmune) with little or no insulin resistance. This is otherwise known as LADA. Others define it differently and include MODY which is a genetic type of diabetes. The more I read the more I'm convinced that there are many different types of diabetes, all with slightly differing nuances.

As far as I can see from people on here.Some were initially diagnosed with type 2 but didn't fit the 'normal' pattern, conventional oral drug treatments didn't seem to work or they stopped working relatively quickly. Many but not all seem to have experienced weight loss.
For myself I was initially diagnosed as type 1.5 in hospital when I was admitted with high blood sugars and high ketones. I think that what caused the 1.5 diagnosis was:
a) I'd had symptoms for some time ( I privately had thought I had type 2 and thought all that a doctor would prescribe was a healthy diet and exercise which I already did) therefore not classic type 1, it was a slow onset... over at least 3 years.
b) Was by then very thin.
c) my age,52
d) once BS was lowered I needed 'normal' quantities of insulin to control it. I didn't apear to have much insulin resistance.
It was only then that they did the other lab tests as confirmation. They'd already told me I had 1.5. I understood that the tests (particularly anti GAD which is not positive in all cases) are not definitive in themselves


For a fairly recent summary of the various of LADA see Bandurska-Stankiewicz, LADA (just google it, my link didn't work )

[MJB]

Diet, exercise and Actos and your're under good control. In my opinion that all points to your being a T2. But I'm not a doctor.

More important than type labels is the fact that you have good control now. If things are working, and it appears that they are, don't worry about it and keep up the good work!

[lottadata]

Actos and weight loss would do nothing for your blood sugars if you weren't a true Type 2.

I lost 18% of my body weight, exercised almost every day for a year and saw my blood sugars get worse. Avandia did squat. That kind of story points to a non-Type 2 explanation.

But that said, the bottom line for all of us, no matter what the diagnosis is to get those blood sugars down as close to normal as possible, and it looks like you are doing that.

So congrats, and, most importantly, keep at it!

[grace girl]

Well, I'm going to disagree with some of the other posts here.
I was originally dx'ed type 2, and put on oral meds and a diet. I never had "perfect" control during that time, but it was decent enough for the doctors to totally miss the problem. I think it had to do with the fact that I was still in the honeymoon stage. After about a year I started dropping weight like crazy and all of the original symptoms cames back in triplicate. Due to insurance I was forced to switch doctors, and my new one did the gad antibodies and c-peptide on me (which had never been done before) because he suspected type 1, and he was correct. I was 32.
I personally refuse to use the term "type 1.5" because I have learned that even the doctors haven't actually made up their minds about it. Basically, you're either type 1 or type 2. The only way to know is the blood tests. And considering a recent report that I read that stated that over 40% of type 2's are actually undiagnosed type 1's, if it were me, I'd have the tests done so I would know. If I had known all of this back then, I could have saved myself an entire year of living ****.
If you really are type 1, then what your doing now won't keep working forever.

[Emm]

As Holly said, a LADA in the honeymoon stage CAN seemingly get control with pills, diet, exercise. This could go on for weeks, months, even a year or two for some people depending on control and genes.

Really you wont know your type without getting an endo to do the tests. They probably wont bother with testing unless they have reason to suspect you're misdiagnosed. To me, it sounds like everything points to you being T2 at the moment, but I'm no doctor

I am yet another case of a type 1 being incorrectly diagnosed to start with. I went through a year of trying soooo hard to get control - I gave up all my fav foods, took a bundle of pills every day, but I just couldn't get decent numbers So if you find things just aren't working for you, don't be shy to speak up with the docs and ask for those tests! This happens to a lot of people, docs often assume that an older person must be a T2.

[steamfan261]

I fit the definition of a Type II pretty well. I was horribly overweight when diagnosed, started on something called diabeta, that quickly failed, then Metformin, which also failed and then insulin.

Lost 126 pounds, and my insulin requirements dropped, but not as low as my Type I friends. Still using about 140 units a day. Was up to 300u of humalog when I weighed 336 pounds.

Anyhow, on MDI, and my control has been getting worse and worse, went from an A1c of about 6.5 three years ago to 13.5 today. Went to Endo (do not like endos much) he ran GAD and c-peptide. GAD was inconclusive, c-peptide was 0.0. No endogenous insulin. Sigh.

Not a type 1, not a type 1.5 and not really a type II. Type II whose pancreas quit? I dunno.

But they switched me to a pump with CGMS and in the first 4 days I haven't set off the high or low alarms yet. I dunno if that is good, but I'm hoping. I don't really care what type I am as long as I can control this.

I believe this little pump thingie is going to be my good friend for a long time. It takes away all my excuses for poor management. And that is good.

Please pardon me for rambling...

Doug

[lottadata]

Doug,

Have you tried cutting the carbs? The technique described here is well worth a try:

Newly Diagnosed

[steamfan261]

Yup, cutting carbs, new diet, doing everything I can. My numbers on the pump continue to be good, both CGMS and by meter (Accucheck Advantage). Yesterday, I ended up using less than 100u for the first time in a long time.

Gawd, I wish I'd done this a LONG time ago.