Can you be type 1 and type 2?!

[yycdordor]

Hey guys,

Today I was told that I am in between type 1 and type 2. Well, I get extremely confuse as I was thinking how can it be possible?! So I just want to ask if any of you are in the same boat as me?! my test result for GAD ab is 54.4 U/ml and IA2 is 19.07U/ml, both seem very high to the normal level GAD 0-3.9 and IA2 0-1.

Henrietta

 

[andcol]

Welcome
It is called T1.5 or LADA it is basically T1 which comes on slower. There are lots of information on the forum in the LADA section. Have a look here http://www.diabetes.co.uk/forum/category/type-1-5-lada-diabetes.41/ Have a read of some of the threads and ask more questions

tagging @LucySW and @Kristin251 who are both LADA so they can help you

 

[Crimsonclient]

Hi @yycdordor I have just been changed from type 2 to type 1 LADA or as some put it type 1.5. It's a lot to get your head around so best advice is to look around a bit

 

[Mep]

yeh I agree with the others... they'd be referring to type 1.5 which usually gets misdiagnosed as type 2 at first because it takes time before the GAD test shows you have an auto-immune condition. From what I've read about it they usually say it is about 4 years on average... I'd imagine it differs from person to person though. I thought I may have been type 1.5 at one point when oral meds were failing me.... but then I'd had type 2 for about 12 years at that stage. The results for me just showed I have insulin deficiency and need to be on insulin, I'm still type 2.

 

[Daibell]

Hi. Yes, you can be both which is called double diabetes. If you are a Late onset T1 (LADA) with a failing pancreas but also have too many carbs and have excess weight you can develop insulin resistance which is the typical T2 symptom. It took around 8 years for my mis-diagnosed T1.5 to become bad enough for insulin. Note that some T1.5s don't show a high GAD (such as myself) due to other causes of islet failure such as viruses and pancreatitis. Also, the GAD test becomes less reliable as the diabetes progresses. The c-peptide test can be more useful as it proves (or not) that you have low insulin which is what really matters.

 

[the_anticarb]

You can have a non functioning pancreas AND insulin resistance. Happened to me after my pregnancies and massive weght gain. I got into a vicious cycle of taking more insulin to bring the sugars down, gaining weight, becoming increasingly insulin resistant and having to take yet more insulin. Horrible, horrible, situation to be in.

Luckily I got put on Dapaglifozin in addition to other meds which helped me get the insulin down, the weight off and now at a normal weight I am no longer insulin resistant.

 

[yycdordor]

Hi. Yes, you can be both which is called double diabetes. If you are a Late onset T1 (LADA) with a failing pancreas but also have too many carbs and have excess weight you can develop insulin resistance which is the typical T2 symptom. It took around 8 years for my mis-diagnosed T1.5 to become bad enough for insulin. Note that some T1.5s don't show a high GAD (such as myself) due to other causes of islet failure such as viruses and pancreatitis. Also, the GAD test becomes less reliable as the diabetes progresses. The c-peptide test can be more useful as it proves (or not) that you have low insulin which is what really matters.

Hi Daibel, thanks!! Just wonder if GAD is 54.4 is defined as high?!

 

[yycdordor]

You can have a non functioning pancreas AND insulin resistance. Happened to me after my pregnancies and massive weght gain. I got into a vicious cycle of taking more insulin to bring the sugars down, gaining weight, becoming increasingly insulin resistant and having to take yet more insulin. Horrible, horrible, situation to be in.

Luckily I got put on Dapaglifozin in addition to other meds which helped me get the insulin down, the weight off and now at a normal weight I am no longer insulin resistant.

Hi @the_anticarb
Thanks for sharing your experience, my doctor did tell me if im insulin resistance or not, as i was treated as T2 at the beginning of my diabetes journey and few months later my new GP carried out the antibodies check and the lab consultants/speaclists said they are strongly believed im T2 based on the 3 antibodies test, my GP said im in between T1 & T2, but im confused... as i am not sure im insulin resistance based on my weight (BMI within normal range) n active level (at least 3 time gym per week). So a stupid question - how can i found out if im insulin resistance?! Thanks in advance.

 

[eastfield40]

I have not clearly been told my type by my GPs. treatments are fore type 2 though.

 

[yycdordor]

Hi @yycdordor I have just been changed from type 2 to type 1 LADA or as some put it type 1.5. It's a lot to get your head around so best advice is to look around a bit

Hi @Crimsonclient , so whats your GAD n other antibodies test reading? Im a bit concern now as my doctor put me on strong medication and it managed to control around 10mmol in the first 2 to 3 weeks, now it goes back up to 12mmol in morning, sometime i got 17mmol... now im on straight Low carb diet n vegi only in dinner to see if it helps to managed it down. Im scare to go on insulin
H

 

[eastfield40]

food is crucial. my top record was 30 mol. now I have fives to sevens after taking restrict low carb diet and 4x500mg/day metformin.

 

[TorqPenderloin]

This is a question that's difficult to answer and it's often misunderstood (I'm willing to admit that I don't fully understand it myself).

Clinically speaking, it is not possible to have both type 1 and type 2 diabetes. Type 1 is an auto-immune disorder while type 2 is a disease of exclusion (essentially a group of unclassified diseases).

The common misconception is that type 1.5/LADA is "between" type 1 and 2 and that is simply not true. Type 1.5 is a slow-onset version of type 1 diabetes and has nothing to do with type 2 diabetes.

Now, type 1.5 is often misdiagnosed as type 2 diabetes because it behaves very similar and people often respond to the type 2 medication (sulfonylureas) at least initially. However, that doesn't mean the two are related.

Ultimately, it is possible to have an auto immune disease AND be insulin resistant, but you would be classified as a type 1/1.5 with insulin resistance rather than "both type 1 and type 2."

 

[tim2000s]

Hi Daibel, thanks!! Just wonder if GAD is 54.4 is defined as high?!

You'd need to provide the units of that test to be clear, but from this page, (and normally in the UK and research) if the units are U/ml, your results appear to be in the positive result zone.

Reference Range
Results shoulf be interpreted as follows

Negative result is 0-5.0 U/ml

Equivocal result is 5.1-25.0 U/ml

Positive result is >25.0 U/ml

 

[novorapidboi26]

I believe that the types can be categorized by the way it manifests.......

type 1, autoimmune attack
type 2, defective insulin/insufficient insulin/insulin resistance

for me type 1.5 is still type 1 as it essentially is an attack of the beta cells, just slower.....

now there are other types involving genetics and so on but thats the basic description of my chosen (), understanding.....lol

 

[Mep]

You could also still be type 2 and just have the same as what I do... insulin deficiency. I think a lot of people forget about that for type 2's. Most people assume type 2's all have their own insulin being produced. When I questioned about the destruction of beta cells for people with type 2 with my endocrinologist he did tell me that it varies from person to person. So my guess is some have insulin deficiency a lot sooner than others. Then others may be fortunate to never have insulin deficiency. I like to think of type 2 as a disease with stages as that has been my experience. The downside to what I have is everyone tries to make out you must be type 1.5 or type 1 and you have to reassure you're definitely type 2.

 

[yycdordor]

You'd need to provide the units of that test to be clear, but from this page, (and normally in the UK and research) if the units are U/ml, your results appear to be in the positive result zone.

Reference Range
Results shoulf be interpreted as follows

Negative result is 0-5.0 U/ml

Equivocal result is 5.1-25.0 U/ml

Positive result is >25.0 U/ml

Hi Tim, its U/ml

 

[tim2000s]

Hi Tim, its U/ml

If it's in U/ml, according to that NHS website you have an overwhelmingly positive result there.

 

[TorqPenderloin]

You could also still be type 2 and just have the same as what I do... insulin deficiency. I think a lot of people forget about that for type 2's. Most people assume type 2's all have their own insulin being produced. When I questioned about the destruction of beta cells for people with type 2 with my endocrinologist he did tell me that it varies from person to person. So my guess is some have insulin deficiency a lot sooner than others. Then others may be fortunate to never have insulin deficiency. I like to think of type 2 as a disease with stages as that has been my experience. The downside to what I have is everyone tries to make out you must be type 1.5 or type 1 and you have to reassure you're definitely type 2.

That's an excellent point and a perfect example of why "Type 2 diabetes" isn't something specific, but rather a group of uncategorized forms of diabetes.