Am I Type 1.5?

[test_positive]

Not long after diagnosis of T2, I asked my DN if I could be Type 1.5 (after reading this forum). She said there was no such thing. Since then, I've looked into it more and wonder if I could be Type 1.5 - which I think is late onset T1.

Some facts:
1. I am relatively young for T2 at age 42
2. When diagnosed I was slightly overweight (BMI 26)
3. I have done a number of things since diagnosis: cut out carbs significantly, CV exercise for 30mins per day plus 30 min walk, lost 12kg (now BMI 22) and saw my blood glucose readings come down at first. But since the initial improvement they have not changed. At no time do they go below 6.0 - normally sit about 7.5.
4. I have been on statins for 10 years due to high cholesterol
5. Since diagnosis with T2 I am now on 1500mg Metformin, 75mg Aspirin, 5mg Ramipril, 20mg Lipitor per day
6. I have no relatives I know of who are/were diagnosed with diabetes

The stubborn readings make me think that perhaps insulin resistance is not my problem - it is more to do with insulin generation. This is why I'm wondering about type 1 (or rather late onset T1 i.e.T1.5)

I welcome thoughts/ideas. Is it worth me pushing my doctor to take tests to see if I am late onset T1?

In some respects, perhaps it doesn't matter. I assume the early treatment is the same.

:?:

 

[hallii]

The treatment might be quite different. It depends on what sort you are.

Ask the doc. for some simple tests that will indicate what sort you are. I say indicate because you can be a T1 with T2 a bit as well. Or then you might be T2 with a bit of T1. Or you might be something else entirely. But only the blood tests will show which way you lean, so to speak.

H

 

[AMBrennan]

Firstly, diagnosis usually works as follows: If you're a child or have acute DKA, then you're T1; else you're T2. So there is plenty of margin for error since we're both starting to see adults with late onset T1 and children with T2.

She said there was no such thing.

She's arguably correct here since the definition for T1 doesn't have an age limit.

I assume the early treatment is the same.

I think that early insulin treatment works better; the alternative would be putting you on more and more ineffective medication and waiting for it to fail before ultimately starting insulin therapy. Initially, it will sorta work - exercise and Metformin increase insulin sensitivity (making the insufficient insulin go further), and other drugs increase insulin secretion. If you do have T1.5, however, more and more of the pancreas will be destroyed and these drugs will stop working.

If nothing else, it will be better psychologically to make sure you have efficient treatment now.

Ask the doc. for some simple tests that will indicate what sort you are. I say indicate because you can be a T1 with T2 a bit as well. Or then you might be T2 with a bit of T1.

I'm not quite sure what you mean by this. For T1/LADA/T1.5, there are primarily two tests: GAD antibodies and C-peptide. T1 is an autoimmune condition, and GAD antibodies are usually but now always present; they are not present in T2 patients. The C-peptide relates to insulin production and you'd expect a low result in T1/T1.5/LADA patients only; T2 patients produce normal amounts of insulin but it doesn't work effectively.

If they come back positive, then you definitely have a T1-spectrum condition.

Testing for insulin resistance directly is possible as well (glucose clamp - simultaneous glucose and insulin IV adjusted to give stable BG and settings are compared to reference values) but this is mostly done for clinical studies.

 

[test_positive]

Thank you so much! I don't know where I'd be without this site and you great people.

I will talk with my doctor about a C-Peptide and GAD test. If the early treatment is different, then I definitely need to know.

Thank you! :clap:

 

[Daibell]

Hi. My gut feel is that you are probably a T2 with some insulin resistance. Why do I say that? You say you are slightly overweight and your meter readings are 7.5 or below. That is quite a good figure and if you were T1.5 I suspect it would be going higher over time and you would have lost weight at diagnosis. Yes, the right tests for T1.5. are GAD and C-Peptide but as these are a bit expensive and many GPs have a simple T1/T2 view of the world they won't offer tests.

 

[test_positive]

Thanks Daibell,

I was actually diagnosed 'by chance' in that I was having a test due to the statins I take for high cholesterol. I had no symptoms of diabetes - although my fasting level was quite high at 11.

One of the frustrating things about this whole thing (same with the cholesterol) is that I have never felt unwell in any way!

I guess there's nothing lost in asking - worst is that he says no.

 

[hallii]

What I was trying to say in simple terms was that T1 can also have reduced insulin sensitivity, and T2 can also have a non or poorly functioning pancreas.

"AM Brennan " puts it so much better.

H