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type 1 or 1.5

GlitterSparkles

Well-Known Member
Messages
83
Location
South UK
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Diabetes
Hi i was diagonsed as type 1 but we are now looking into the fact i could have a rare type like 1.5 and not type 1 i would like it if you could comment the differnces

Thank you
 
Hi Glittersparkles, I think that Type 1.5 is the same as LADA diabetes but I’m sure someone will come along soon and explain the difference. LADA is usually found in older people and a slower onset of diabetes.

Hope this helps a little

Paula
 
From what I understand, T1 comes on very quickly - in my case a viral gastric flu sent my immune system into overdrive and it just killed my pancreas pretty much overnight. With LADA, I believe the beta cells pack up much more slowly, hence the slow onset of the symptoms, and why a lot of people are initially diagnosed type 2. But eventually the beta cells stop producing insulin, and then it’s treated just the same as T1, with insulin. It seems to be the speed at which the pancreas stops producing insulin, as far as I understand it.
 
GlitterSparkles said:
Hi i was diagonsed as type 1 but we are now looking into the fact i could have a rare type like 1.5 and not type 1 i would like it if you could comment the differnces

Thank you
Click to expand...

1.5 or Lada is a subset of type 1 meaning type 1.5 is always type 1. It just means late on set and have a longer honeymoon period.
 
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Unless my memory is worse than I thought, @GlitterSparkles is one of our younger members, and certainly still of school age. I just thought I'd add that to the mix.
 
Hi glitter, I think you're 11 or 12 aren't you?, can you tell us why they think possibly 1.5/lada? x
 
 
At a high level it is useful to say type 1.5 is a kind of type 1. The numbers do not mean anything. Using those numbers has been clumsy over many years but better than jargon for any high level use.

The statement that type 1.5 shares features with type 2 is very outdated. It relied on poor understanding of both. This poor understanding was highly prevalent at the level of primary health care provider (e.g . doctor) who dispensed care by the numbers not by any knowledge. That's how so many of us around the world got wrongly diagnosed.

Even at the level of specialist health care providers (e.g. endocrinologist) they did not know the pathologies of what was lumped in as type 1.5. In the absence of a functionally useful body of clinical knowledge about something that looked close to type 1 but had differences (e.g. late onset; honeymoon period, higher microsecretions of insulin) common medical approaches included: not treating it differently from type 1 since there would be less liability in the absence of medical guild or national government endorsed guidelines and position statements on care; deliberately less advice on interventionist approaches*; and medication for type 2 which had the effect of masking the outcome of the pathologies of type 1.5 but not actually treating the pathologies (e.g. metformin).

Only in the last 18 months or so have there been published decent, science based papers on the various pathologies that could be grouped as type 1.5.
The 2004 etc papers were brave but in a very early phase of clinically relevant knowledge. That stage is reflected by asking the question: "what are types 1 and 1.5?".
Since "type 1.5" was an abstract notion of just being somehat different from type 1 but not type 2, it became apparent that it was the wrong question.

Skipping over a few years and ideas, the better question (for now!) is: what are the pathologies that matter that we can find out in a reaonably practical way for patients?

That's the question that I think matters most, especially for the younger patient (with "type 1.5").

Answering that gives the best info on what actually is happening inside the patient (not just seeing an almost total loss of insulin making capacity).

The anti-autoimmunity bodies are both biomarkers of deficiencies and responses to deficiencies - I don't think it is correct to assume an assay of test results reflects a simple map of pathologies of type 1.5.
That could be the same kind of logical and scientific errors as assuming that a high serum level of LDLs is a marker of CVD (or, worse, of absolute risk of CVD).

On a similar point, some are pushing for redefining diabetes categories into numerous groups. The explanations are very disappointing: almost nothing on pathologies and mostly on a statistical basis of grouping for the sake of safe treatment by doctors. It virtually locks in assumptions of appropriate treatment for pre-chosen groupings.
This approach would be a triumph of stats based bueacratic risk mitigation for health care providers over personalised and optimised treatment and without regard to science based knowledge of pathologies.

So, instead of asking " am I type 1.5?", the question should be: "what am I?"

This begs the question: what should I be looking for that matters?
("looking for" means affordable biomarker tests)
The 2004 papers are way behind current knowledge and hypthotheses. Doctors and endos are also miles from current advanced insight.

I am reluctant to cite the several papers that I found to be most helpful. They have a standard of evidence less than appropriate for clinical care (and were never intended for that).
They expect to be superceded.

*Anyway, apart from a better understanding of the pathologies and biomarkers of "not quite fully the same as type 1" there is diddly squat in the thousands (and I absolutely mean thousands) of published papers on interventionist treatments.
By this I mean the things that can be done to improve the body's overall system for managing what it has to deal with, not just respond to the obvious shortcomings.

This is a huge topic and with lots of speculation.
That's risky for assuming relevance to an individual.
Just for helping illustrate this:
Doctor / endo #A: I have decided you are type 1.5. This means you will have a honeymoon period but end up totally insulin dependent (wrong!). Take metformin and ... for now. It will help. When on insulin, start to learn to carb count. Tough. (Non interventionist).

Doctor / endocrinologist #B: hmmm. We'd class you as type 1.5 but that does not tell you what's going on and what you can do to help everything going on.
I'm going to tell you of your options but I appreciate that not everything is possible in daily life or suits you. Better that you know of you options than just take pills.
Frankly, we don't know much about what's going on so we don't really know what's best.
It should be trial and error for you. Don't be afraid to make mistakes (just not deadly overnight hypos!). There's no fixed menu of successful interventions and we are far from having sufficient evidence for clinical application that have been endorsed by our protectioniat guilds but they can still work for you so I feel bound to tell you of them.

So, here goes... [I'll work on this list for another post ... this already far too long].
 
I seem to remember the diagnostic criteria for LADA includes being over 30.
 
My simplistic view has always been that the start point in classifications should be whether the pancreas is over or underproducing insulin as the causes and treatment are very different. The use of 'T2' as a dumping ground for anyone who isn't GAD positive either thru testing or lack of any testing is remarkably stupid and certainly caused me to have the wrong medication for a few years. One day the 'experts' will wake up to this but thankfully NICE appears to be getting it.
 

Diabell, at the risk of derailing this thread, which I obviously don't want to do, I would comment that there seems to be, in my observation, a lot of diagnosis on the basis of best guessing going on - particularly in a sliding scale set of conditions, like Diabetes and to an extent other endocrine issues.
 
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