14 Responses

  1. tmana
    tmana October 19, 2011 at 6:28 am | | Reply

    One thing I have been told by physicians that makes LADA diagnosis difficult is that, until insulin production drops down to levels that show up in c-peptide tests, GAD tests will be negative for antibodies.

    A big issue in the patient community which Dr. Crowe is confounding (as well as compounding) is that having no insulin production and no antibodies does NOT make you a “Type 1b”. It makes you a “late-stage Type 2″ (of whichever variation is appropriate). Type 1 diabetes is, by definition, autoimmune diabetes.

    This sort of confusion is one reason I support the idea of using some sort of staging criteria for describing Type 2 diabetes.

  2. Jasmine
    Jasmine October 19, 2011 at 6:48 am | | Reply

    I appreciated all of these different voices, but it definitely shows just how confusing all of this is. I most appreciated Dr. Bode’s comments because it described me perfectly: 26 at diagnosis, slow-ish onset, but needed insulin immediately upon diagnosis.

    I was especially intrigued to read Dr. Guzman’s submission, although I will admit it put some fear in me. I have managed to keep my A1C 6.3 or below after diagnosis (going as low as 5.7) without too much difficulty (of course, take that with a grain of salt. We ARE talking about diabetes after all). I do have fairly low insulin requirements and so I’m definitely still producing something, but not enough to not need 12-16 units of insulin a day. I do not look forward to when my beta cells take the final plunge…

    Thank you for this incredibly informative post.

  3. riva
    riva October 19, 2011 at 1:31 pm | | Reply

    I’m probably LADA but didn’t know enough about it when I was diagnosed 39 years ago to identify as such. I was 18 so of course they thought it was type 2 and I was on orals, no insulin. Five years later a doctor told me I was type 1 and I went on insulin.

    But thinking I was type 1 for the past 30+ years it would be even weirder for me to start calling my diabetes LADA. A real identify shift, likely with an accompanying identity crisis ;-)

    So as Popeye said, “I is what I is.” And whatever that is, so be it, as long as I know how to treat what I is.

  4. Diabetic Survival Kit
    Diabetic Survival Kit October 19, 2011 at 3:51 pm | | Reply

    Interesting article. No matter what it is called, the important thing is to monitor the sugar and do what it takes to get under good control. It does help people understand why they need insulin and why they have diabetes despite maintaining an appropriate body weight. It also can be significant for family members. I am often asked to see patient because it is hard to tell if they are type I or type 2. It does clarify things for the patient and help them understand that the natural history of their disease will be somewhat different than that of the people with type 2 diabetes.

  5. Hamish
    Hamish October 19, 2011 at 4:38 pm | | Reply

    This is me. Diagnosed at 39 after a period of almost two years during which I lost 1lb of weight a month every month, no matter what I did or ate. Actually self-diagnosed using a home-health book and realising I had all the symptoms – unexplained weight loss, thirst, excessive urination. Fortunately received excellent medical advice and treatment from the outset, on Lantus from almost day one, but admittedly there were a lot of puzzled looks and head-scratching when I first presented. “Hmmm … I think … you’re a 1.5!” Whatever that is. Initially Lantus got great results – A1C at 6.0 for over a year, but things got gradually worse until I hit 8.0 earlier this year and my endo insisted I start fast-acting mealtime insulin too, and now back around 7.0 heading downwards. Pretty classic case of LADA in hindsight it seems – and Amy do you remember telling me you thought that’s what it was way back when I was first diagnosed in 2005? Good call!

  6. Paul Sorensen
    Paul Sorensen October 19, 2011 at 7:44 pm | | Reply

    I’m sorry, I don’t see the reason for any friction about “types” of Diabetes.
    My brother and I are type 1, our younger sister is type 2. Do we all need to test frequently? YES. Do we need to be concerned about our A1C’s? YES. Do we face complications from bad control? YES. End of story.
    Diabetes 1.5, welcome to the table. Wer’e all in this together.

  7. Natalie
    Natalie October 20, 2011 at 6:00 pm | | Reply

    Amy, thank you for presenting the various opinions — they do highlight the controversy. I have had diabetes for 20 years, and have never fit squarely into one box or the other. I was on Glucotrol (a sulfonylurea) for 5 months after diagnosis, but it didn’t lower my BGs at all. But it was all that was available at the time. And there were no antibody tests available, either. So I went on insulin, and it has controlled me excellently. When Metformin came out, I didn’t even want to try it, because of GI issues. I am normal weight, and average about 28-29 units of insulin a day. I just got a fasting C-peptide, which showed 0.9, with a normal range of 1.1-4.4. Fasting BG was 95. So I’m clearly insulinopenic, but not demonstrably ANY type. So shall I call myself LADA, too? Or shall I just stick with Type Weird? :-)

  8. Kelly Rawlings
    Kelly Rawlings October 21, 2011 at 5:58 am | | Reply

    Great roundup of some top experts in the field–thank you. Dr. Guzman’s remark, “There seems to be a sense of loneliness associated with this diagnosis,” served to remind me that there’s a sense of loneliness with ANY type of diabetes diagnosis. Got diabetes? Then you’re my type. We’re in this together and the more we know and help each other use the best treatment and care practices, the better.

  9. Melitta
    Melitta October 23, 2011 at 9:04 pm | | Reply

    Really awesome perspectives. I think most of these diabetes experts are saying much of the same thing in different ways. I love Susan Guzman’s perspective and sensitivity; having just met her and heard her speak at the DiabetesSisters conference in San Diego, I can say that Susan Guzman is the real deal. Thanks for such an excellent post, it is heartening that FINALLY there is better awareness of adult-onset Type 1 diabetes and the need for correct treatment.

    ANDREEA May 1, 2012 at 9:18 am | | Reply

    Hi, ,any chance anybody can recomend a doctor specializing in type 1.5?

  11. NewsFlash: TCOYD Launching Type 1 Track! : DiabetesMine: the all things diabetes blog

    [...] Adults with type 1 diabetes, rejoice! Whereas we were once “square pegs” in a world dominated by “juvenile diabetes” and type 2, there is more and more recognition that we exist, and more and more great events that welcome us grown-up type 1s and LADAs. [...]

  12. Girl Glycosylated
    Girl Glycosylated June 6, 2013 at 2:17 pm | | Reply

    I know I’m way behind in leaving a comment on this article that was written years ago.

    How long as LADA been a known term?

    My husband was dx with T2D fourteen years ago. Even then they said, “you’re one of the weird ones.” Or called him “type 1.5″

    Fast Forward 14 years and in the mean time he has also been diagnosed with Addison’s Disease.

    Now, our 6 year old daughter has been diagnosed with Type 1.

    It really hadn’t occured to use to watch the kids closely for diabetes because we really weren’t ever clearly told that he has a form of Type 1. Additionally, the Addison’s dx added risk for our kids. My understanding is the combination of Addison’s & LADA means our kids have a 1 in 2 chance of developing T1D.

    THAT’S why it’s important to get the diagnosis correct, because my kids were ticking time bombs and I didn’t even know it.

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