New member and type 1.5.....I think!

[suevm]

I've just joined this forum as I'm quite newly diagnosed diabetic. However, which type? I was diagnosed in June 2013, when a pre-op urine test showed a glucose level of 28. My op was cancelled and I was thrown into a whirl of doctors, phone calls, appointments, tests etc....
My HbA1c level was 15%, which I now realise is rather high. I was immediately put onto insulin, together with Metformin, and tested for ketones.
However, during all this investigation and testing, nobody could answer my question - type 1 or 2? I begged my GP for a label! She then made a decision and labelled me as type 1.
So today I went to the diabetes centre for my first appointment since my diagnosis. Great news - in the first 4 months my HbA1c had gone down from 15 to 6.5!!! Perfect.
Again I questioned the Prof about type 1 or 2 (for absolute confirmation). Apparently I don't fit either type exactly. The tests indicated that I was missing something which is usual in type 1 - I'm sure all you diabetes experts will know what that is?
So he concluded that, at the moment, I would be called type 1.5.
I'm to continue with the low dose of insulin together with Metformin for the next 6 months, as my results were so good.
Has anyone else had experience like this?
What exactly is type 1.5 and is this also called LADA?
Is this likely to develop into type 1?
Could I become type 2?
I would love to hear your advice and/or experiences.

 

[Andy12345]

hi, welcome

there are some folks here with amazing amounts of knowledge on this subject im sure they will offer some advice

best of luck

 

[mummy78]

Re: R: New member and type 1.5.....I think!

Welcome! I've never heard about this type of diabetes (I'm a banal type 1 :mrgreen: ) but I'm sure you'll find someone who can help you here
This forum is full of amazing people

~ Arianna ~

 

[daisy1]

Hi Sue and welcome to the forum

Whichever type you turn out to be, this information which we give to new members will be useful to you. -When you know more, ask more questions as you need to and someone will help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[Daibell]

Hi. Although the medical profession likes to talk about just the two types of diabetes e.g. T1 & T2 in practice there is complete spectrum as there are many causes for example numerous defective genes, viruses, pancreatitis and so on. Straight T1 is normally experienced in the early years and is due to the destruction of the pancreatic islet cells thru anti-bodies. This reduces/stops insulin output and calls for immediate insulin. T2 normally happens in the later year and in 85%'ish of those diagnosed it is due to being obese. This causes the muscles to block insulin and the body ends-up with too much insulin but can't use it. T1.5 aka LADA or Late onset T1, is a grouping of many conditions arising from slow anti-body destruction to viruses, pancreatitis and so on. The result is low insulin output and is effectively the same condition as T1 but not always as advanced. I'm in the T1.5 grouping. Although diagnosed by default (GP used a urine stick!) as a T2 I fit the T1.5 profile e.g. never been overweight, lost weight just before diagnosis and three types of tablets eventually failed to work. So think of yourself nearer to T1 than T2 as the symptoms will be low blood insulin. This may get worse depending on how far down the curve you are. Never mind as insulin will totally control it especially if you are put on the Basal/Bolus regime i.e. long and rapid-acting insulins. I typically inject the long-acting once day and the rapid once or twice a day currently. You may need more or less to start with. BTW I'm assuming you aren't obese? You can be both T1.5 and T2. T2s normally have a relatively slow rise in their diabetes and it can be brought back to near normal by low-carbing. If you are overweight then do diet thru low-carbing as it makes insulin management much smoother. Good luck.

 

[suevm]

Thank you all so much for your responses.
And thank you, Daibell, for your very informative reply. It's so interesting to hear about other diabetic's situations. I beginning to see where I fit, i.e. type 1.5, although the medical professionals always seem reluctant to commit to a deifinite decision.
Currently, I am slightly overweight (not obese) since starting on insulin. I did lose quite a bit of weight, despite eating loads, before diagnosis.
Maybe things will change in the future, but for the moment, I seem to be doing ok with my little twice daily dose of insulin and Metformin. And I'm calling myself Type 1.5!
Thanks again

 

[JRW]

I'm awaiting my blood test results as to whether T1 or T2, as per my consultants direction. I think I'm what I like to call a "T whatever" due to a bout of acute severe pancreatitis 5 years ago. I use very little insulin, 15 units levemir + 6-9 units Novarapid a day (I don't eat breakfast), I'm a 13st active male, 6ft2.

I hope you get some clarity.

 

[elaine77]

Hi sue,

Diabell is right in that there is lots of variation and the original labels no longer apply and so the NHS in my area now label diabetes as autoimmune diabetes (type 1 and type 1.5) and non-autoimmune diabetes (type 2).

Type 1 is a disease and type 2 is a condition and to distinguish which type you have they usually do an auto antibody blood test to check for antibodies that attack the insulin producing beta cells in the pancreas. If you have the antibodies then you are autoimmune and eventually will be insulin dependent. If you don't then you would only become insulin dependent if your diabetes was badly controlled or your weight was excessive... This is the info given out by my local NHS at the moment and does seem to capture more variables then the original labels which really no longer apply....

There are exceptions of course like pancreatitis and where the doctors can't find a reason and just treat the symptoms but those cases are generally quite rare and the majority of people can be placed into the autoimmune or non-autoimmune category although rates and medication needs differ greatly...

Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

 

[minim1nx]

Returning member after long period of illness. I have not a clue what type 1.5 is or LADA but I find it extremely interesting that a new type of diabetes has been detected and every one involved in it are keeping quiet. Also now I am thinking what type am I? Do the medical profession know what is happening with diabetics?

 

[minim1nx]

Also how can we add our picture please help the elderly in your forum please. I am asking nicely but on a good day my walking sticks can move, yes they can move, :lol:

 

[phoenix]

LADA by definition is autoimmune (latent autoimmune diabetes of adults) . It isn't new, it was first described by researchers from a big Type 2 study which ran from 1977-1997 and it's mentioned as a subset of T1 in the WHO classification of diabetes.

Type 1.5 is sometimes also used for MODY, a genetic form of diabetes which isn't T 1 or T2 (it's a diabetes 'other types' like diabetes caused by pancreatitis, pancreas removal, cystic fibrosis, haemochromatosis, Downs and a whole host of other conditions)



Type 2 diabetes though contains what are probably a whole hotchpot of varied conditions. That's being acknowledged by some doctors

Type 2 diabetes is a disease in search of a definition. It has no hallmark clinical features, is generally diagnosed by default (no other cause for diabetes being evident), has very heterogeneous pathophysiological features, and varies widely between populations in clinical presentation and consequences

http://www.thelancet.com/journals/lance ... 40-6736(12)62207-7/fulltext

 

[ladmug1]

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