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5 types of diabetes? What do we think?

There are plenty of studies. Here is an interesting start.
https://www.ncbi.nlm.nih.gov/pubmed/29589073

Also, 'LADA is not included in international guidelines for classification/treatment.'
https://www.ncbi.nlm.nih.gov/pubmed/29589073
They classify type 1 and type 2 based on the following:
Gold standard type 1 diabetes was defined as continuous insulin treatment within 3 years of diagnosis and absolute insulin deficiency c-peptide (UCPCR<0.2 nmol/mmol; all others classed as having type 2 diabetes.
 
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There was no semi-colon.
 
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I have enough trouble with medics/nurses and others that don’t understand the fundamental differences between T1 and T2. Throw a reclassification and new labels at them and the confusion will be unimaginable.
 
Makes it too complicated for HCP's. It's hard enough for them on how to treat any one of the condition, most of the time its us who manage our own condition.
 
JohnEGreen said:
Looks like I've been left out again I don't seem to fit anywhere.
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Me too lol!

26 years old, 21 BMI, anti body negative, low c peptide, MODY negative.

I’ve now seen two consultants and been told they cannot diagnose me.

I’m treated on a basal bolus regime and, to be honest, it’s working quite well. I asked if I could come off insulin and onto tablets and I was told maybe we could try it in a few years.

I’ve given up waiting for a diagnosis. I’m treated as T1 and my notes call me ‘an insulin requiring diabetic’. I’m just trying to get my hba1c under 48 - that’s the most important short term goal for me
 
Ok I’m going to derail my own thread again, as a learning point for me

Why would they not call that type 1? Is it because GAD is negative? Despite low c peptide, age, bmi all pointing otherwise?
 
HSSS said:
Ok I’m going to derail my own thread again, as a learning point for me

Why would they not call that type 1? Is it because GAD is negative? Despite low c peptide, age, bmi all pointing otherwise?
Click to expand...

I have no idea..... the consultants don’t have cases like me so they are not sure what to do. All I know is I am definitely diabetic. I also think it’s because I didn’t have ketones on diagnosis....

I’ve given up trying to get a diagnosis - I’ll just take the insulin as makes me feel better and keeps my levels at bay (most of the time).
 
I thought ketones were just high in dka. Again please correct me if I’m wrong.

And whatever works is good.
 
HSSS said:
Ok I’m going to derail my own thread again, as a learning point for me

Why would they not call that type 1? Is it because GAD is negative? Despite low c peptide, age, bmi all pointing otherwise?
Click to expand...
Low c-peptide means low insulin production, but any insulin production remaining means not a standard type 1. If the c-pep decreases, that would show decreasing insulin and probably point to LADA. The presence of GAD antibodies is an easy yes-check to auto-immune type 1, but unfortunately the absence of GAD doesn't mean not type 1, as other antibodies exist (just not tested for).

They can't diagnose SB.25 YET. If c-pep goes up that'll be type 2. If c-pep goes down, that's either slow-onset type 1/LADA or type 2 with a knackered pancreas (and you can tell the difference by the insulin resistance). If c-pep stays the same, well, welcome to type idiosyncratic.
 

Yup basically that’s it.

Slightly strange as on diagnosis I had some other usual T1 symptoms such as losing a stone in weight in 3 weeks! Which wasn’t lovely at the time, but as I was thing already a lot of people were worried.

Will just see what happens over the next few years I guess. Either way even if it is T2 the consultant said I am not the ‘usual T2’ and so will always be under consultant care or T1 care - which I guess is sort of good as I seem to get additional support
 
pixie1 said:
Makes it too complicated for HCP's. It's hard enough for them on how to treat any one of the condition, most of the time its us who manage our own condition.
Click to expand...


Who knows maybe reclassification would mean they actually have to learn what each (new) type actually is this time and what the appropriate treatments are and bring some of them out of dark ages (optimism I know)
 
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