LADA/Type 1.5? What do we know?

[The Governor]

By total conincidence I met a guy who specialises in Diabetes today, he represents the UK at Primary Care Diabetes Europe and is the editor of the Diabetes and Primary Care Journal (whatever that is), his name is Eugene Hughes.

He took one look at me and said he'd put money on it that I'm not Type 2 and am actually LADA or Type 1.5.

Basically I'm not overweight, in good health otherwise.

I was planning to ask for a C-Peptide next week when I see the GP, now I'm determined too!

 

[hazey276]

Hi governor,

Well what can i say, i wish 5 months ago that he'd of took a look at me and told me that i was type 1.5 i wouldn't have had so many problems that i've had. Did he have a beard and was he walking on water with disciples close behind him because he is some person if he can tell what is going on inside of you just by looking at you :shock: . I'm not disputing what his job role may be but i'd be very sceptical about the verbal exchange regarding your diabetes. Next time i'm in church i'll ask his dad for you was he out and about that day !!!!!!!!!!

good luck and take care

Hazey

 

[The Governor]

lol oddly enough he did have a beard

He was basing his view on the fact that I'm not overweight basically, his view is that weight is the primary factor in insulin resistance, and as I don't have that problem it's unlikely I'm T2.

 

[Dennis]

I was planning to ask for a C-Peptide next week when I see the GP, now I'm determined too!

Hi Gov,
If you really are LADA then a C-Peptide test doesn't give definitive proof. Your pancreas is obviously still producing insulin or you couldn't possibly achieve the excellent control that you currently have in such a short time. C-Peptide is produced from the same Beta cells as the insulin, so as long as you produce insulin then you also produce C-Peptide.

LADA is Latent Autoimmune Diabetes in Adults. The important word here is Autoimmune because that is what determines LADA or not LADA. So the only test that can prove whether you are LADA (i.e. Type-1) or Type-2 is the GAD test for antibodies. GAD antibodies tests are used for differential diagnosis between LADA and type 2 diabetes, but I believe are so rarely done in the UK that I'm not even sure if they are available on NHS.

 

[timo2]

Hello Governor,

Type 1.5! :shock: You've only been here 5 minutes, and you've beed promoted already

:arrow: TYPE 1.5 or SLOW ONSET TYPE 1 or LADA

Regards,
timo.

 

[The Governor]

lol you bastards :lol:

 

[Nellie]

'Latent autoimmune diabetes of adulthood
Unique features that distinguish it from types 1 and 2'

http://www.postgradmed.com/issues/2005/03_05/nabhan.shtml

 

[The Governor]

I was planning to ask for a C-Peptide next week when I see the GP, now I'm determined too!

Hi Gov,
If you really are LADA then a C-Peptide test doesn't give definitive proof. Your pancreas is obviously still producing insulin or you couldn't possibly achieve the excellent control that you currently have in such a short time.

Dennis, it was my understanding that with LADA you can get control, and Metformin works for a while and then eventually it doesn't and you have to go onto Insulin. I though it was best to go straight on to Insulin to try to preserve some beta cell function if you're LADA, hence my interest...

 

[Dennis]

Dennis, it was my understanding that with LADA you can get control, and Metformin works for a while and then eventually it doesn't and you have to go onto Insulin. I though it was best to go straight on to Insulin to try to preserve some beta cell function if you're LADA, hence my interest...

Hi Gov,
You are right, but from all your posts so far I haven't seen anything that would suggest that you have a failing pancreas. Quite the opposite as your combination of diet and metformin seems to have brought your blood sugars under good control very quickly. I'm not saying that you are not LADA, just that I haven't seen any evidence to suggest that you could be.

Personally I regard insulin as the final step when all else fails, and I will go on to it when I need to. At the moment I am doing very well on one of the newer treatments, byetta. My consultant describes insulin as "the biggest spanner in the toolbox" and one that you use when appropriate, not just because it is there. You seem very eager to get onto insulin injections, but I hope you are aware there are downsides if you are a driver?

 

[The Governor]

Hi Dennis, I'm not eager at all to be honest! However, I'm not one of lifes avoiders and if I am LADA then I understand it is best to move to insulin sooner rather than later.

I hope very much I am a "straightforward" Type 2, but don't want to assume anything, hence my questions.

The last thing I want is having to report to the DVLA every three years.

 

[duranie]

Not only overweight people become type 2 - Look at Sir Steven Redgrave 5 times Olympic Gold Medal winner - now you can hardly accuse someone like that of being obese - TYpe 2 diabetic. I still have no clue as to which type I am - and to be honest I don't care. All I know is that I have to take MDI of insulin to control by BG levels. If I don't I become unwell very quickly. Saying that I have a GP who still likes to think I might be type 2 even though insulin therapy was started within days of my DX - go figure as the Americans would say.

 

[chocoholic]

I'm not overweight either and I'm Type 2 on insulin.

 

[TDavies]

'Latent autoimmune diabetes of adulthood
Unique features that distinguish it from types 1 and 2'

http://www.postgradmed.com/issues/2005/03_05/nabhan.shtml

I tried to read this article but it costs a lot of money to access it!

(It wasn’t at the link above so I searched and found it here) :
https://www.tandfonline.com/doi/abs/10.3810/pgm.2005.03.1597

 

[Flora123]

Hi Gov,
If you really are LADA then a C-Peptide test doesn't give definitive proof. Your pancreas is obviously still producing insulin or you couldn't possibly achieve the excellent control that you currently have in such a short time. C-Peptide is produced from the same Beta cells as the insulin, so as long as you produce insulin then you also produce C-Peptide.

LADA is Latent Autoimmune Diabetes in Adults. The important word here is Autoimmune because that is what determines LADA or not LADA. So the only test that can prove whether you are LADA (i.e. Type-1) or Type-2 is the GAD test for antibodies. GAD antibodies tests are used for differential diagnosis between LADA and type 2 diabetes, but I believe are so rarely done in the UK that I'm not even sure if they are available on NHS.

They do the antibody test in the NHS. Mine was negative but endo I told me it can be unreliable - false negatives. Having c peptide next as they’re still not sure what type I am.

 

[barrym]

As has been stated, a GAD test if positive means you are type 1.5, a GAD test if negative doesn't mean you aren't. Mt GAD was negative but my endo said she was pretty darned certain I'm T1(.5).

Anyway, what's the difference? You treat what you've got. There's no kudos for one over the other!

 

[Alexandra100]

Anyway, what's the difference? You treat what you've got

I totally agree. So would Dr Bernstein. What counts is to normalise bg as far as we can, using whatever means work / are available for us.

 

[Alexandra100]

I though it was best to go straight on to Insulin to try to preserve some beta cell function if you're LADA, hence my interest...

This is controversial. Are you on insulin? What seems sure is that keeping bg as low as possible helps preserve beta cells.

 

[Alexandra100]

lol oddly enough he did have a beard

He was basing his view on the fact that I'm not overweight basically, his view is that weight is the primary factor in insulin resistance, and as I don't have that problem it's unlikely I'm T2.

How do you know you don't have insulin resistance as well as insufficiency? I think I have a lot of the latter, but am unsure if I also suffer from the former.

 

[Alexandra100]

Look at Sir Steven Redgrave 5 times Olympic Gold Medal winner - now you can hardly accuse someone like that of being obese

Though due to his muscles his BMI probably puts him in the obese category.