How many different 'types' are there? Diagnoses Stories.

Replaying what I put in another post, the discussion with my consultant took a different perspective. Essentially, "Diabetes", whatever type, is the set of symptoms that are the result of something earlier happening to the body that restricts or destroys its ability to produce enough insulin to function properly. If you can stop this earlier event or set of events occurring, or reduce the effects of them, then you can stop "Diabetes".

It's an interesting hypothesis that's very hard to prove.

I would personally say it's way off the mark Tim.

The most accurate way I've ever heard it explained is that there are only 2 main types of diabetes and that is autoimmune diabetes (type1/LADA) and non-autoimmune diabetes (type2). They are completely different with one being a condition(non autoimmune) and one being a disease (autoimmune) and one resulting from insulin deficiency (autoimmune) and the other from insulin resistance (non autoimmune).

You can't 'catch' anything early enough to stop autoimmune diabetes but you can delay insulin dependency sometimes for an indiscriminate period of time.

There are, of course, exceptions like a genetic type of diabetes called MODY and also when someone is diabetic due to surgery/removal of the pancreas etc but these cases are much rarer and most diabetics will fall into either the autoimmune category or the non-autoimmune category.

I was diagnosed with autoimmune diabetes almost immediately but was told it was 'slow onset' because I only had one type of antibody - that being GAD.

elaine77 said:

I would personally say it's way off the mark Tim.

The most accurate way I've ever heard it explained is that there are only 2 main types of diabetes and that is autoimmune diabetes (type1/LADA) and non-autoimmune diabetes (type2). They are completely different with one being a condition(non autoimmune) and one being a disease (autoimmune) and one resulting from insulin deficiency (autoimmune) and the other from insulin resistance (non autoimmune).

You can't 'catch' anything early enough to stop autoimmune diabetes but you can delay insulin dependency sometimes for an indiscriminate period of time.

There are, of course, exceptions like a genetic type of diabetes called MODY and also when someone is diabetic due to surgery/removal of the pancreas etc but these cases are much rarer and most diabetics will fall into either the autoimmune category or the non-autoimmune category.

I was diagnosed with autoimmune diabetes almost immediately but was told it was 'slow onset' because I only had one type of antibody - that being GAD.

Click to expand...

Again, based on the discussion with the consultant (who I appreciate has more knowledge of the research into this than I do, or may be publicly available), he was saying autoimmune, regardless of how it occurs, seems to have a trigger to kick it off. Likewise, type 2 also has a trigger. The result of the trigger is either destruction of the insulin producing cells or a restriction in theability to produce insulin. He said that there are a number of clear genetic markers that suggest a pre-disposition to type 2, and a few far less clear ones for type 1.

In both cases, his opinion was that if you can work out what the trigger is (which nobody has a clule about at the moment, you can stop diabetes from ever occurring. This seems to be the basis for some significant and funded research as well, given the publication in 2013 in Balance of the initial trials of a "Diabetes Vaccine".

I appreciate that this is only one consultant's point of view, but he demonstrated exceptional ability in his graduation class and has been presented with a number of awards so I think it's worth airing.

As many as 15% of diabetics may be misdiagnosed with simple diabetes mellitus (DM) types 1 or 2. But DM presents as more than 50 unique types, and even among correctly diagnosed type 2 patients, 60 predisposing genetic variants exist. - See more at: http://www.hcplive.com/articles/Dia...-Difficulties-of-Subtype#sthash.74wQqGeW.dpuf

tim2000s said:

The result of the trigger is either destruction of the insulin producing cells or a restriction in theability to produce insulin.

In both cases, his opinion was that if you can work out what the trigger is (which nobody has a clule about at the moment, you can stop diabetes from ever occurring.

Click to expand...

I believe this to be true.... I am no expert, but have read up a lot. I think that, whatever the trigger is, it causes high blood sugar levels (illnes, stress, too many carbs etc could be the trigger or more than likely a combination of all).
I still believe very strongly that had I been on a LcHf diet before diagnosis I would have delayed or even deferred indefinitely my diagnosis.
I also believe that maybe I was lucky, with high BG levels my panchreas gave way, and if my panchreas had not been attacked something else would have gone.... heart attack, cancer...who knows.... So I am lucky.

tim2000s said:

Again, based on the discussion with the consultant (who I appreciate has more knowledge of the research into this than I do, or may be publicly available), he was saying autoimmune, regardless of how it occurs, seems to have a trigger to kick it off. Likewise, type 2 also has a trigger. The result of the trigger is either destruction of the insulin producing cells or a restriction in theability to produce insulin. He said that there are a number of clear genetic markers that suggest a pre-disposition to type 2, and a few far less clear ones for type 1.

In both cases, his opinion was that if you can work out what the trigger is (which nobody has a clule about at the moment, you can stop diabetes from ever occurring. This seems to be the basis for some significant and funded research as well, given the publication in 2013 in Balance of the initial trials of a "Diabetes Vaccine".

I appreciate that this is only one consultant's point of view, but he demonstrated exceptional ability in his graduation class and has been presented with a number of awards so I think it's worth airing.

Click to expand...

So me being type 1 and there were 'triggers or one trigger', how would I or how on earth could I stop it ?? It just doesn't seem plausable to me
I will have to think more about that one, as it seems a little far fetched to me.

Robinredbreast said:

So me being type 1 and there were 'triggers or one trigger', how would I or how on earth could I stop it ?? It just doesn't seem plausable to me
I will have to think more about that one, as it seems a little far fetched to me.

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I'm also type 1, and the point in my life that seems to have kickstarted the attack on my beta cells was a bad dose of the flu. Something very similar happened to my cousin.... There have been theories relating to a virus kickstarting the process in those who have susceptibility for a long time, so I can very much see that there is a possibility that this would be the case.

I fully understand but, I was diagnosed with type 1 after my Ex left, so what I am thinking o,f on the lines of............that would appear to have been my 'trigger' so how on earth would I of stopped that happening, impossible. Do you see where I'm going with this ?

Sort of. If it was possible to identify clear genetic markers as to the predisposition of Type 1 diabetes, it should be possible to create a vaccine that would stop it from ever happening, in spite of the trigger.

Even if there is a trigger, there may be a way of stopping the white blood cells attacking the beta cells and therefore stopping diabetes from ever happening. Would you agree that's in the realms of the possible, even if improbable?

I was dx T2 sept 2013 (rushed to hospital), then upon my request for a GAD test T1 honeymoon period / LADA dec 2013. My consultant then said to me it doesn't matter what your diagnosis is really, regardless of treatment, everyone ends up on insulin eventually. He also said there was normally a trigger (illness stress etc), but in my case, I had no know trigger I can think of, only possibly high carbs, because at the time I was eating a 'very healthy' low fat everything.

i think one of the problems is, no one knows our BG levels before diagnosis. It's not until you become diabetic that you know your BG levels.... My feeling, we all had high BG levels prior to diagnosis..... The question is.... Why?

Robinredbreast said:

I fully understand but, I was diagnosed with type 1 after my Ex left, so what I am thinking o,f on the lines of............that would appear to have been my 'trigger' so how on earth would I of stopped that happening, impossible. Do you see where I'm going with this ?

Click to expand...

Yes, you couldn't have stopped the stress that caused the trigger, but if there was a way to stop the trigger actually doing anything, which is where they're going with the vaccine, then you wouldn't develop the condition. They want to identify the triggers as it will help with the development of the "vaccine" and allow them to identify what the mechanism is.

And I am sure some of us are more prone to the triggers than others, and this is probably genetic.... Some of us originate from carb eating origins some from fat eating origins. If they could establish this they would really be on to something. They know already Scandinavians are more prone to diabetes, and that historically they were low carb eaters, eating lots of meat. But none of us really know where we originate from now.

Robinredbreast said:

I fully understand but, I was diagnosed with type 1 after my Ex left, so what I am thinking o,f on the lines of............that would appear to have been my 'trigger' so how on earth would I of stopped that happening, impossible. Do you see where I'm going with this ?

Click to expand...

Could stress trip the body into autoimmune attack ?
Certainly possible I feel and believe ...
Stress of seperation/divorce or house moves persons diagnosed with Diabetes known .

What about the few ex service men from active service too ?
Some have developed diabetes since leaving active front line war zones .
Stress factor again ?

Pregnancy too can act as a trigger possibly with the huge body changes and hormones .
Gestational Diabetes ?

Pneumonia and Septis illnesses in my own case .
Lost loads of weight with these illness or so I thought ?
Getting no better or progress with a full recovery .
So more tests were done - ' BOOM ' Diabetes diagnosis

Along with my Hypothyroid and Coeliac and last year Mitochondrial conditions .
All likely autoimmune am told too .
.Mody 6 or 7 been mentioned off to me
Too complex and baffling a diabetes diagnosis TBH .

I think there are so many different triggers, genes related issues and so on that it is impossible to correctly diagnose and classify many conditions. LADA is a conveniet grouping for those who weren't born with T1 but have developed T1 type symptoms between birth and death. The latest NICE DEC 2014 Diabetes Guidlelines recommend taking weight loss around diagnosis as a strong pointer to T1/LADA and not even bothering with the GAD/c-peptide tests. This makes some sense as it isn't only GAD anti-bodies that cause LADA. There are several other anti-bodies that aren't tested for and then there are pancreatic viruses, pancreatitis and so on. I think the only reliable thing is to assume that someone who is strongly overweight is very likely to be an insulin resistant T2 and if there is no evidence of excess weight then assume a T1 style diabetes needing insulin stimulating tablets and/or insulin. Yes, there is MODY, double-diabetes and so on as well just to add to the confusion. I presented as a thin person at diagnosis with very high blood sugar (measured by GP with urine stick!) but I knew I was hyper and I was labelled as a T2 and still am). Using the latest NICE guidelines I would come out as a LADA and fitting in the 15% of 'T2s' that are mis-diagnosed. It's far too convenient for the NHS, DUK and so on to use the two categories of T1 and T2. Note that DUK doesn't even acknowledge LADA.

Ian DP said:

i think one of the problems is, no one knows our BG levels before diagnosis. It's not until you become diabetic that you know your BG levels.... My feeling, we all had high BG levels prior to diagnosis..... The question is.... Why?

Click to expand...

I have been checking my b.g. for years due to reactive hypoglycaemia. In the years prior to my diabetes diagnosis I only checked it about every 6 months, but I'm pretty sure that 6 months before diagnosis my fasting glucose wasn't elevated.
I think my trigger was going over a certain weight (for me a BMI of about 28) together with family history. And in my opinion STRESS - long term is at the root of most diseases because it causes chronic inflammation and that really messes you up.

tim2000s said:

Yes, you couldn't have stopped the stress that caused the trigger, but if there was a way to stop the trigger actually doing anything, which is where they're going with the vaccine, then you wouldn't develop the condition. They want to identify the triggers as it will help with the development of the "vaccine" and allow them to identify what the mechanism is.

Click to expand...

Yes 'what if there was a way', how could they, how would they do it, would they test children of diabetics or have to test the whole of the adult population? No one would of known that I was going to get type 1, so would there be a test for me and my siblings, because my uncle had type 1, my mum's brother and apparantely their mother, my nan, who died when my mum was just 6 years old, or would it just be their children. This is what I find confusing about the whole thing, how on earth is it plausable? Not the actual trigger, but finding it.........................
If you saw someone with a loaded gun and they had his or her finger on the 'trigger' would we know whether to interevene or not, disregarding the location, a possible crime scene or facial expressions, body language etc and we didn't know much about the power of guns, because I see this senario in the same light as the 'what if there was a way'
(Just my mind working overtime on this one today )

All the best RRB

Ian DP said:

i think one of the problems is, no one knows our BG levels before diagnosis. It's not until you become diabetic that you know your BG levels.... My feeling, we all had high BG levels prior to diagnosis..... The question is.... Why?

Click to expand...

anna29 said:

Could stress trip the body into autoimmune attack ?
Certainly possible I feel and believe ...
Stress of seperation/divorce or house moves persons diagnosed with Diabetes known .

What about the few ex service men from active service too ?
Some have developed diabetes since leaving active front line war zones .
Stress factor again ?

Pregnancy too can act as a trigger possibly with the huge body changes and hormones .
Gestational Diabetes ?

Pneumonia and Septis illnesses in my own case .
Lost loads of weight with these illness or so I thought ?
Getting no better or progress with a full recovery .
So more tests were done - ' BOOM ' Diabetes diagnosis

Along with my Hypothyroid and Coeliac and last year Mitochondrial conditions .
All likely autoimmune am told too .
.Mody 6 or 7 been mentioned off to me
Too complex and baffling a diabetes diagnosis TBH .

Click to expand...

Exactly anna, your use of the words 'complex and baffling', is how I'm feeling about 'finding that trigger/gene' and why it goes off, like a gun ?

RRB