Difference between type 2 and Lada

[Pollyg3]

This probably sounds silly but forgot to ask what the difference is between type 2 and Lada I am a newbie and learning every day off this website

 

[TorqPenderloin]

The best way I've heard it explained is that type 2 diabetes is a diagnosis of exclusion. In layman's terms, that means that it's a group of unclassified types of diabetes rather than a specific type (like type1, 3c, etc).

Type 1.5 is a specific type of diabetes. Unfortunately, there aren't very defined criteria for separating it from type 1. Type 1.5 is an autoimmune disease which separates it from type 2. However, the autoimmune attack on your pancreas is often very slow and could take years (and sometimes even decades) before someone becomes insulin dependent.

Final thoughts:
-There is such a thing as a type 2 who makes no natural insulin. That doesn't make them type 1 or 1.5.
-Eventually, someone with type 1.5 will eventually become type 1.
-Someone with type 1/1.5 can have insulin resistance, but that doesn't make them both type 1 and type 2.

One line answer: Basically, is your body attacking your pancreas or not?

 

[Pollyg3]

Right I sort of get that have you any tips on weight gain I have lost about 6 to 8 pound in a week n wanna try n slow it down a bit I know that's not major just wanna control it a little better my cholesterol borderline at present I did see some info you gave someone but cannot find it now thanks for your help

 

[TorqPenderloin]

Can you explain the 6 to 8 pound loss? Unless you recently made some serious changes to your diet, that amount of weight loss is very concerning. It is common for people to lose that much weight in the first week of a new diet, but that isn't and shouldn't be sustainable. If you can't explain the weight loss, I'd definitely see a doctor to discuss that.

I lost 35-40 pounds prior to my diagnosis, but that's because my blood sugar levels were exceeding 30 mmol/l in some cases. My body was literally eating my muscle to survive. Once I got my blood sugar levels under control, I was actually able to sustain my weight WITHOUT artificial insulin for several weeks as my pancreas made just enough insulin to cover the ~30g/day of carbs I was eating.

EDIT- I don't want to scare you, but to put it into perspective, my a1c at diagnosis was 13.2%. I saw that yours was around 6.1% which is significantly lower.

 

[Pollyg3]

Low carb well apart from 1 maybe 2 whole meal slices of bread a day none much veg eggs steak meat a little fruit n yogurts my diet when I found out was what I used to eat processed potatoes sugar alcohol not major

 

[Pollyg3]

I work nights to so have been eating around 4 hourly I have exercised walking a few mile a day

 

[Pollyg3]

I just think took low carbs too far n need to eat more I told the nurse n she said it was also a lot but it was extreme after all the calorie consumption of previous weeks

 

[TorqPenderloin]

If you recently switched to a low-carb diet, that would absolutely explain the weight loss. Again, many people will lose 4-6 pounds in their first week and some lose more than 10. That's not necessarily pause for concern as most of that is water.

Losing 6-8 pounds of FAT would be highly unlikely as that equates to about a 3000-4000 caloric deficit per day. That would only be possible if you weighed more than 400 pounds and/or exercised for 3+ hrs each day.

Losing that much weight as a combination of water, fat, and protein is the dangerous one. Again, that's what happened to me last year, but my levels were in the 20s-30s.

So if you just started the low-carb diet, I'm willing to bet that you didn't "Overdo it." You're probably just seeing the initial effects of the diet which reduces bloating and water retention. The weight loss should slow to 1-2 pounds/week very shortly.

 

[Pollyg3]

Good and thankyou so much I will test my sugars before n after each meal n watch my weight calories thanks again

 

[Daibell]

Hi. I agree with most of @TorqPenderloins post but would claim that LADA T1.5 is T1. Even T1 shortly after birth has a timescale (very short) to having no insulin. As you age T1 may come on more slowly and be called T1.5 but it's no different from T1. It's due to islet cell destruction and insulin will be needed after tablets. My LADA took around 10 years to come from no-where to needing insulin.

 

[Kristin251]

I was told LADA has characteristics of both T 1 and T 2 until it doesn't. I believe I was LADA for many years until literally overnight castings went from 80's to 250 and no amount of diet change or exercise changed a thing. I had been low carb since Atkins so 25 years. Initially I was put on amaryl and that only exasperated everything. I lost boat loads of weight until finally diagnosed correctly and put on insulin. The rest of my story plays out just like Torks

 

[TorqPenderloin]

Hi. I agree with most of @TorqPenderloins post but would claim that LADA T1.5 is T1. Even T1 shortly after birth has a timescale (very short) to having no insulin. As you age T1 may come on more slowly and be called T1.5 but it's no different from T1. It's due to islet cell destruction and insulin will be needed after tablets. My LADA took around 10 years to come from no-where to needing insulin.

I would absolutely agree that type 1.5 is type 1. In fact, I think the "Type 1.5" diagnosis should be eliminated until better standards are created to better define the disease.

The problem continues to be that many people with type 1.5 are treated similar to a patient with type 2 and are often prescribed only oral medications that can potentially accelerate the process of losing all natural insulin production.

I personally believe people with type 1.5 should be treated similar to a type 1 patient (if not identically) and should start intensive insulin therapy as soon as it becomes necessary to regulate blood glucose levels. The worst thing I've seen happen is that people are prescribed Metformin and/or a sulfonylurea (like Gliclazide) and they're forced to keep their levels in the 8+ range because their doctor won't prescribe them insulin. While 8mmol/l may not have a HIGH likelihood of leading to permanent complications, it is certainly possible and it's a choice people should be able to make themselves rather than be forced.

In short, I agree with you.

/End rant

 

[JohnEGreen]

Brother in law has always considered him self type 1 since he was diagnosed at age 30 years.

 

[Kristin251]

The problem continues to be that many people with type 1.5 are treated similar to a patient with type 2 and are often prescribed only oral medications that can potentially accelerate the process of losing all natural insulin production.

Exactly what happened to me and amaryl was prescribed and made me much worse. I completely believe it killed my pancreas. Not to mention the no rhyme or reasons to severe bs fluctuations. Dang near killed me

 

[Daibell]

I would absolutely agree that type 1.5 is type 1. In fact, I think the "Type 1.5" diagnosis should be eliminated until better standards are created to better define the disease.

The problem continues to be that many people with type 1.5 are treated similar to a patient with type 2 and are often prescribed only oral medications that can potentially accelerate the process of losing all natural insulin production.

I personally believe people with type 1.5 should be treated similar to a type 1 patient (if not identically) and should start intensive insulin therapy as soon as it becomes necessary to regulate blood glucose levels. The worst thing I've seen happen is that people are prescribed Metformin and/or a sulfonylurea (like Gliclazide) and they're forced to keep their levels in the 8+ range because their doctor won't prescribe them insulin. While 8mmol/l may not have a HIGH likelihood of leading to permanent complications, it is certainly possible and it's a choice people should be able to make themselves rather than be forced.

In short, I agree with you.

/End rant

Hi again. I followed exactly the route you describe and my diabetes GP refused me insulin initially. She had never heard of Late onset T1 and was surprised when I told her my nephew ended-up with DKA at age 22 i.e. LADA. In the UK diabetes training for GPs is very narrow.

 

[TorqPenderloin]

Hi again. I followed exactly the route you describe and my diabetes GP refused me insulin initially. She had never heard of Late onset T1 and was surprised when I told her my nephew ended-up with DKA at age 22 i.e. LADA. In the UK diabetes training for GPs is very narrow.

I don't know if it's necessarily your GP's fault (although I understand where you're coming from). Remember that she has to know how to treat and diagnose much more than just our endocrine system. Type 1.5 may be more common than we think, but it's still very rare in comparison to many other diseases.

Here in the US, the situation isn't that much different. I was prescribed Metformin by the emergency room doctor who thought I had type 2. His job was to get me stable and release me, and I respect that. My GP's job is to find any irregularities in my health and get me to a specialist who is an expert in that part of the body.

The two biggest differences between the US and UK healthcare systems are that I can see any doctor/specialist I want and I don't need a referral. Plus, my doctors don't work for the insurance companies so there isn't a possible conflict of interest to save the system money and keep me off medication (some might argue the opposite is true).

 

[LucySW]

This probably sounds silly but forgot to ask what the difference is between type 2 and Lada I am a newbie and learning every day off this website

Polly, Your original Q. It's correct that the difference is autoimmune islet cell destruction, but that's only half the answer. T 2 is the result of insulin resistance - of chronically raised circulating insulin because the body's insulin receptors have been desensitised. It's what happens after that has been going on for many years - the final result of hyperinsulinemia. That's why the best treatment is not forcing BG levels down, but lowering insulin resistance. (Which no drug can do, but carb restriction and/or intermittent fasting can. Which is why the Newcastle Diet works and can put Type 2 into remission.)

The clearest statement of all this is Jason Fung's blogposts. Many of those on his blog, below: see anything on what causes Type 2.

https://intensivedietarymanagement.com/

Whereas for Type 1 and 1.5 (1.5 is a gentler and slower late-onset form of Type 1), the problem is not enough insulin. So we have to inject.

 

[Totto]

To say that T2 is insulin resistance isn't exactly true. A lot of people, diabetic or not, have insulin resistance. T2 is a large group of different kinds of non-autoimmune diabetes varieties, mainly poly-genetic.

As to T2 and LADA they seem to share a lot of the diabetic genes but in LADA you also get antibodies, at least sometimes.

 

[TorqPenderloin]

I agree with @Totto.

A T2 diagnosis is basically like saying "We know you have diabetes, but it's not type 1, MODY, or any specific type."

A T1.5 diagnosis is basically like saying "We know you have diabetes caused by an autoimmune attack, but it seems to be taking its time killing off your pancreas."

The classifications of diabetes really are pathetic for reasons like this among many others.

 

[LucySW]

To say that T2 is insulin resistance isn't exactly true. A lot of people, diabetic or not, have insulin resistance. T2 is a large group of different kinds of non-autoimmune diabetes varieties, mainly poly-genetic.

As to T2 and LADA they seem to share a lot of the diabetic genes but in LADA you also get antibodies, at least sometimes.

To clarify: Type 2 isn't the same as insulin resistance, bit it's caused by insulin resistance. It's the final stage of hyperinsulinemia. It's the *result* of insulin resistance.

Yes, lots of people are insulin-resistant. If they continue to be, they will probably develop Type 2 diabetes.