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Newly diagnosed. But could be either type 2 or type 1.

L

leylandCal94

Newbie
Messages
2
Type of diabetes
Type 2
Treatment type
Diet only
Newly diagnosed. But could be either type 2 or type 1.

Hello all. 30 years old, male. Newly diagnosed with an A1c of 52 mmol (7.9%). I recently engaged in a study in the UK a few months ago from the university of Bristol which looks for people with T1 in their families. My daughter was diagnosed type 1 last year aged 2 and I have a cousin, uncle and grandad all type 1. The results from the study said i was positive for antibodies in my blood that apparently means you're at an increased risk from developing T1 and the antibody I tested positive for was GADA. This then made me curious to start checking my BG using my daughters lancet and reader which I never did before. I started seeing I was 13 -15 mmol after meals. And 7-9mmol fasting. Which then led me to the doctors for an a1c test which come back at 52mmol 7.9%. But they are now undecided whether I'm type 2 or type 1 due to my family history and then I seen Type 1.5 which has really made me think. Has anyone had experience of this? Or any input?
 
I've no idea, but say welcome anyway!
 
Hi @leylandCal94 , welcome to the forum.

Have you been referred to an endocrinologist or are you under the care of your GP?
As far as I know, the combination of having diabetes (an hba1c higher than 48 = diabetes) and testing positive for antibodies is usually a straightforward T1 diagnosis.

LADA or type 1.5 are T1, it just develops slower than it usually does in children and is often initially misdiagnosed as T2.
 
And when I was young, in the days when there was only T1, T2 and LADA, people diagnosed at 30 were still reckoned to be classic T1 ie quite fast developing....

Of course, people with a lot of diabetic relatives may also want to be tested for MODY (a kind of genetic diabetes which I freely admit I don't understand). In any case, you need a referral to an endocrinologist to get the right diagnosis, as most GPs only know about T2.

Finally, in case you are T1 (not saying you are), let me give you the NHS link to DKA which is the biggest risk for untreated T1s,

Diabetic ketoacidosis

Find out about diabetic ketoacidosis (DKA), including what the symptoms are, when to get medical help and how to prevent it.
www.nhs.uk

And to finish, welcome to the forums whatever type of diabetes you do or don't have.
 
leylandCal94 said:
The results from the study said i was positive for antibodies in my blood that apparently means you're at an increased risk from developing T1 and the antibody I tested positive for was GADA.
Click to expand...

Interesting. This suggests that you can have GAD antibodies without going on to be Type 1. I always thought it meant that your insulin-producing cells were being killed and if you weren't already at the stage where you were classified as Type 1, it was just a matter of time.

then I seen Type 1.5 which has really made me think.
Click to expand...

The terms LADA and Type 1.5 still confuses me as people seem to mean different things by the terms.
For some LADA is just type 1 which develops later in life.
For some Type 1.5 is a different type of diabetes which has half-way being Type 1 and Type 2.
And some people say they are two terms for the same thing.

When I first got diabetes I was diagnosed as Type 2 (mainly due to my age - being over 50 at the time), but later this was changed to Type 1. The endo who confirmed the change also said that he thought I was normal Type 1 and that it didn't look like LADA or 1.5. Unfortunately I was not able to get him to explain why he thought that or what the difference was.

I'm also not sure how important the correct diagnosis is (at least from a medical point of view and ignoring costs/insurance etc) . I don't have any complaints about my misdiagnosis although perhaps I am just lucky. When I was moved from metformin to insulin, but still categorised as Type 2, I raised the question about whether I could be type 1, the endo at the time wasn't really interested and said it did not matter to him as treatment was the same. But when I mentioned that to someone I got an extremely angry response. (I should add, that was not on this forum)

The only reason I pushed for the second endo to do an antibody test was because I felt really,really stupid not really knowing how to response when non-medical people asked me if I was Type 1 or Type 2.
 
Thanks for the information mate. Yep having the antibodies doesn't mean you'll ever get it, it just means your at increased risk. What is worrying me is with my hba1c result being 51mmol (7.9) which puts me in the range for having diabetes. These antibodies are what consultants and specialists use to distinguish between the 2, as type 2 patients don't typically carry these antibodies and are only found in t1 diabetics.
 
Hi there @leylandCal94 , my understanding of LADA is that it is a slow destruction of beta cells due to an autoimmune trigger on the pancreas’ beta cells. The medical community seems to have drawn the line at 30 years old when diagnosing for a possible LADA. It is a slow progressing form of Type of T1. It is often called T1.5 because of the similarities with T2 in the early stages of progression. There seems to be a lot of confusion with many GPs who are not familiar with late onset T1, as they believe it to be T2. A form of confirmation bias because around 90% of people diagnosed with diabetes fall into the T2 category. Initially LADA follows the same trajectory of raised blood sugars as T2, however the two diseases are completely different. Differentiating LADA from T2 requires blood tests to see how much insulin the pancreas is producing and secreting ( Known as a C-Peptide test) A low to normal insulin production does not rule out T1, but raised insulin production makes it far more likely T2. A definitive T1 diagnosis will depend on finding Autoantibodies. These tests are expensive and many Drs will not authorize them until your blood sugar HbAc1 tests are over 9% ( Canada) There are a number of autoantibodies types the body can produce.
  • Glutamic Acid Decarboxylase Autoantibodies (GADA or Anti-GAD)
    This test looks for antibodies built against a specific enzyme in the insulin-producing pancreatic beta cells.
  • Insulin Autoantibodies (IAA)
    This tests looks for the antibodies targeting insulin.
  • Insulinoma-Associated-2 Autoantibodies (IA-2A)
    This test looks for antibodies mounted against a specific enzyme in beta cells. Both the IA-2A and GADA tests are common T1D antibody tests.
  • Zinc Transporter 8 (ZnT8Ab)
    This test looks at antibodies targeting an enzyme that is specific to beta cells.
  • Islet Cell Cytoplasmic Autoantibodies (ICA)
    Islet cells are clusters of cells in the pancreas that produce hormones, including insulin. This test identifies a type of islet cell antibodies present in up to 80 percent of people with T1D.
Some people can temporarily produce autoantibodies or produce antibodies but never go on to develop T1 diabetes or they can produce autoantibodies temporarily due to an insult on the pancreas such as a virus.

MODY or Maturity Onset Diabetes of the Young is a rare form of autosominal diabetes. It is caused by a mutation in the genes. As the name suggests it is diagnosed in younger adults. It is always suspected when 2 or more generations of family have diabetes.
Ed for grammar
 
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