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When Type 2 turns to Type 1 Diabetes

guylan

Member
Messages
6
Type of diabetes
Treatment type
Insulin
Hi Everyone, a pleasure to meet you all. I have been a diabetic for approx 7 years and have been diagnosed as type 2 diabetic by a previous Doctor, I am 63 years of age..

I had a new doctor examine me yesterday who was surprised I was type 2 as I follow none of the ordinary rules governing this e.g. not overweight, I am physically fit, no family history etc. I am on insulin, having previously on Metformin as only this seems to control my blood sugars. She suggested I might be type 1 diabetic with delayed onset; that is a big delay! Has anyone come across this before ? Or any comments ?

Thanks in advance

John
 
Hello @guylan and welcome to the forum.

You may want to check out the "type 1.5/LADA" section of our forum - there are many notable members there who will be able to offer advice.

http://www.diabetes.co.uk/forum/category/type-1-5-lada-diabetes.41/

I can maybe ask one of the forum moderators to kindly move your post to the T1.5 section, considering it is feedback from there which will benefit you most. @himtoo, thoughts on shifting this?
 
Diabetes as you will know is defined into several different groups and in general we diabetics fall into one or the other groups. There are however a few individuals who border on a particular group and may encroach into another group and in fact then be classified in more than one group.
Some diabetics start off as being classified as Type 2 and over time the need for Insulin becomes apparant and they are then classified as Type 1.5 Diabetics or sometimes (possibly Miss-classified) as Type 1's.
A 'Gad' blood test will generally show if the individual is Truely a Type 1 diabetic in the true sence, in that their pancreas has failed to produce insulin so I would suggest that you contact your new GP and ask exactly why you are now considered as being classified as a Type1 diabetic as this isn't something that any of us can truthfully answer without knowing your full medical history and what the recent blood test show.
Please let us know what transpires - Best wishes - Lazybones.
 

Thank you for your response. I will be sure to do that. - Guylan
 
Thank you for your reply, that is very interesting and I will research it back Guylan
 
Type 2 doesn't turn into type 1. They are two entirely separate conditions. You might have been misdiagnosed type 2 and always actually been type 1, but type 2 doesn't turn into type 1.

Type 1 is an autoimmune disease. Ithere immune system gets bored/confused and decides to kill off the insulin producing beta cells in the pancreas. Type 1 is clinically acute onset: very high blood sugar (30+) and ketones on diagnosis, dramatic untried for weight loss peer diagnosis. There are antibodies associated with type 1 and a positive gad test will confirm type 1. But a negative gad test is not definitive, about 25% of type 1 are gad negative.

Type 1.5 is type 1. It's just a colloquial term for people diagnosed with type 1 when they are older who retain endogenous insulin production for a while after diagnosis. It take a while for the immune system to kill off all of the beta cells, it doesn't happen in one fell swoop. The period when a type 1 retains insulin production is known as the honeymoon period. For someone diagnosed with type 1 later in life they may have a particularly strong and long honeymoon period which may allow them to avoid insulin for a while.

Type 2 diabetes is anything that isn't autoimmune diabetes (type 1) or genetic diabetes (mody), or other defined types of diabetes (3c, NDM). There are plenty of type 2 diabetics who are slim and fit. There are plenty of type 2 diabetics who need insulin. Neither of these factors make them type 1, they continue to be type 2 diabetics treated with insulin.
 
Thank you

Thank you for your excellent response. I now have a better understanding which is always good
 
Welcome I'm insulin dependant because I no longer produce the insulin I need. I'm still type 2. You may well be type 1.5 or type 1. Then again you just may be the same as me in that you don't produce much insulin and need insulin therapy to manage your diabetes. Being insulin dependant type 2 doesn't make me a type 1.5 or type 1.... they have done the auto immune tests on me (the GAD test has been done 3 times on me) and it always comes back showing that I'm still type 2. But whatever the type, if you need insulin, you need it. The only time you don't need it is when you produce sufficient insulin and you can manage with diet and/or oral medications. I wish you the best.
 
It's possible too to be both Type 2 and Type 1 ate the same time but that's complicating matters. I too have always been slim and since I wasn't really hanging my condition well enough on oral medication, I was tested last year and I am Type 2, well for the time being. I am now taking insulin.

My understanding in that in time my insulin production will stop and I will be totally dependent on insulin and become 1.5.

I suggest you ask the doctor for a GAD, c-peptide tests to check what the state of play is.
 
PansyP said:
My understanding in that in time my insulin production will stop and I will be totally dependent on insulin and become 1.5.
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Nope. If your insulin production stops as the result of your beta cells dying due to glucose levels being too high, you are still type 2. Type 1.5/LADA is a slow onset version of type 1, and is pretty much only seen in adults. It is autoimmune diabetes, and really should never have been called Type 1.5.

JohnEGreen said:
I think @Kristin251 might give you an argument there. She I believe was T2 for years but is now T1.5 .
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Based on Kristin having Autoimmune Antibodies, that would be that she was misdiagnosed as T2 when she should have been diagnosed as T1. T2 cannot turn in to T1/T1.5.
 
@tim2000s Interestingly, my consultant refuses to use the terms Type 1.5 or LADA.
 
And we wonder why all those non diabetics struggle to understand us, and the different numbers we attribute to that single word that is diabetes.
 

Hi @guylan. I was diagnosed type 2 nearly 10 years ago. However after 18 months of extremely high blood sugars my consultant checked my GAD antibodies and I've been rediagnosed as type 1 so the delayed onset can be quite long as I was well controlled up until this point. That being said, there are type 2s who require insulin as part of their management, my dad being one of them. The only way to be sure if you are type 1 or 2 is to have your antibodies checked. Good luck either way, you will find plenty of support on here.
 
Thank you. I have had an auto immune disease though which meant my antibodies turned on my thyroid cells so surely if I can have this happen, the pancreas too might some day be under similar attack and hence you become Type 1/1.5 or something else?
 
PansyP said:
Thank you. I have had an auto immune disease though which meant my antibodies turned on my thyroid cells so surely if I can have this happen, the pancreas too might some day be under similar attack and hence you become Type 1/1.5 or something else?
Click to expand...

Type 2 does not turn into or become type 1 diabetes. They are separate conditions caused by separate things.

If a type 2 diabetic is later diagnosed as type 1 either:
  • The initial diagnosis with type 2 was incorrect and they were always type 1; or
  • As autoimmune conditions can hit at any age it may be possible that someone with pre-existing type 2 diabetes might suffer an autoimmune attack and have type 1. This would not be type 2 developing into type 1. The auto immune attack would be entirely separate from and unrelated to pre existing type 2. I imagine this would be vanishingly rare/unheard of.
PansyP said:
It's possible too to be both Type 2 and Type 1 ate the same time
Click to expand...

No it's not. It's possible to have type 1 diabetes and be insulin resistant. That is referred to as double diabetes, but technically/medically that is not a thing. It would not be a medically recognised diagnosis or condition to say someone has type 1 and type 2 at the same time.
 
So if a Type 2's pancreas does develop antibodies what name does that illness have?

As for having both Type 1 and later Type 2 as well, I found that information here on the forum .....
 
Hi. I'm one of those mis-diagnosed late onset T1s always being slim etc. As you can see there is grand confusion on the subject with Diabetes UK (not this site) and the NHS being more confused than we are! I will put a different slant on this. If you have a c-peptide test and it shows low insulin then you are probably T1. If you have high insulin you are probably T2. The distinction is important as the medication needed is different. I would argue that a GAD test may or may not show antibodies but overall it doesn't matter why your pancreas has non-working islet cells as the medication needed is that for a T1 pathway and effectively the conditions become the same thing. One exception is T2s who have islet cell damage thru long-term high sugar levels over many years. They have effectively become similar to T1s but may still have high insulin resistance and the medication will vary.
 
I'm now even more confused! And to add to everyone else's confusion, I read that if a Type 2 has started insulin then the GAD and c-peptide tests will no longer be able to confirm or deny a T1 diagnoses! In my case I had started insulin before I was tested .....
 
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