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Type 2 Differences between T2 and LADA

Discussion in 'Ask A Question' started by Flora123, Sep 10, 2020.

  1. Flora123

    Flora123 Type 2 · Well-Known Member

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    I was told last week that someone can be T2 and have a lack of insulin lowering over time or be insulin resistant. I thought a lowering of insulin supply over time was the honeymoon period for LADA. I’m so confused.
     
  2. Daibell

    Daibell LADA · Master

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    Hi. You are right. A true T2 will not have a lack of insulin but will be insulin resistant. A LADA (which is late onset T1) will have a lack of insulin which continues to go down during the honeymoon period. The confusion comes from the fact that the medical profession, Diabetes UK (not this site) etc have used T2 as dumping ground for anything that isn't T1 from birth hence the 20% slim T2s who may well be LADAs. Don't always rely on the experts!
     
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  3. Flora123

    Flora123 Type 2 · Well-Known Member

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    So if I’m possibly getting lower in my insulin output I should be classed as LADA? I’m waiting results of a new c peptide test. They won’t do a gad test as I “had one a few years ago and it was negative”. It’s all such hard work!! I was told LADA have antibodies. So confused!
     
  4. Tophat1900

    Tophat1900 Type 3c · Well-Known Member

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    I think your insulin production would have to get down to a certain level before being classed as LADA and keep lowering. This is pretty much what I have experienced over some time. Was labeled T2 at diagnosis almost 20yrs ago, but I am clearly very insulin deficient nowadays thanks much due to steriods.

    A bit of a different path for me, but insulin deficient I am.
     
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  5. barrym

    barrym LADA · Well-Known Member

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    I'm LADA. Perfectly Ok to 60yo then a 12 month honeymoon until total insulin dependence. GAD test was inconclusive. Not negative as proving a negative is not the same as being able to see positive. Or that is how my consultant explained it.

    Anyway, what's in a label. The outcome is the same, living with it is a full time PITA☹️
     
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  6. Flora123

    Flora123 Type 2 · Well-Known Member

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    Thanks for the replies. I find this all so confusing as I seem to get told a different thing from every HCP I speak to!
     
  7. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    LADA is a type of Type 1 diabetes. Someone with no antibodies can't be LADA. If you haven't got antibodies, you are most likely Type 2. Insulin production also declines with Type 2 diabetes. By the time blood glucose goes up and diabetes is diagnosed, 40% of the insulin producing beta cells have already been lost. Glucose toxicity from high blood glucose also destroys beta cells, which is why keeping blood glucose down is important for preventing progression of the diabetes.
     
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  8. Daibell

    Daibell LADA · Master

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    There is an assumption by the medics that all beta cell death is caused by antibodies yet that may not be true. It is true that viruses can cause beta cell death and whether that involves antibodies seems to be unknown. I know someone who had a liver virus which also caused her to become T1. My GAD was negative and I believe my LADA was caused by a virus as I had a high white cell count at the time of diagnosis. The cause is almost irrelevant but the C-Peptide test is probably the most useful as it points to the right treatment needed. My honeymoon period has lasted 8-10 years whereas for some it's a year; explain that.
     
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  9. Flora123

    Flora123 Type 2 · Well-Known Member

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    8-10 years! That’s the longest I’ve heard of.
     
  10. Flora123

    Flora123 Type 2 · Well-Known Member

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    Thanks. You say insulin production declines with T2 but I keep reading on here that people with T2 produce too much insulin because they are insulin resistant. Are you saying there can be two different types of T2?
     
  11. bulkbiker

    bulkbiker Type 2 · Oracle

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    I think this is where diagnostic terms have got it wrong personally. There are insulin over producers and under producers.
    A c-peptide test should show which you are.

    Over producers are "classic" T2 but over time it may be possible that their pancreas can no longer cope with making huge amounts of insulin and starts to fail. Hopefully all the over producers will be caught before that time.

    Anyone under-producing is a form of "T1" for whatever reason they aren't producing enough. They can have long honeymoons or none at all but at the end of the day they are likely to require exogenous insulin to a greater or lesser extent.
    That's why quite a few experts talk about "hyperinsulinemia" as opposed to "insulin resistance" as T2.
     
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  12. Brunneria

    Brunneria Other · Moderator
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    Hi flora,

    it is really very simple.
    T1 is auto immune. If the body's own immune system kills off the beta cells then it is T1, whether it comes on fast, or slow (as in LADA).

    there are other reasons why beta cells can die or stop functioning. Certain meds (e.g. steroids), certain illnesses, a fatty liver and pancreas, genetics, exhausted over production after years of being T2, Pancreatitis, and so on.
    If the amount of insulin produced declines far enough, these people may need to inject insulin, on a temporary or permanent basis, but they won’t be T1 or LADA. Instead, they will be ‘steroid induced diabetes’, or T2, or 3c, or whatever, depending on their personal situation.

    Having said all that, some researchers think that there may be an autoimmune factor for some T2s, but the research is not conclusive, and the idea is not widely accepted. Plus, the nature of that autoimmune factor is different from the T1 autoimmune situation, so I only mention it in passing.
     
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  13. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    A while back I had a private IR test.

    It came back with the results that my insulin production was on the low side of normal, and that I had some level of IR.
    That is, I was still producing insulin but my BG was higher than it should be so there was some resistance to the insulin being effective.
    I am a "slim T2" for some values of slim.
    I am, with others, still wondering what is definitive for LADA. If it is an antibody test.
    At the moment I still think of myself as T2 because I still seem to be producing at least some insulin.
    If I am LADA (Latent Auto Immune Disease in Adults) I may win the race for the longest honeymoon period. :)
    [12.5 years and counting.]

    <https://www.diabetes.co.uk/diabetes_lada.html>
    Says:
    "LADA is defined as initially non-insulin requiring diabetes diagnosed in people aged 30-50 years with antibodies to GAD – glutamic acid decarboxylase."
    So I was diagnosed at 57 (so outside the age range) and I have never had an antibody test.
    However age ranges are notoriously inaccurate.

    At the moment I still think I am T2 with a very weary pancreas.
    I would be very happy to be an over producer of insulin.

    Footnote: my blood test was in the morning, and I have extended Dawn Phenomenon. I do now wonder what the results would be if I had waited until the afternoon to have the blood test.
     
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  14. Flora123

    Flora123 Type 2 · Well-Known Member

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