Borderline Type 1/2??????????

[grainger]

Hey all,

Just a quick question, a colleague of mine told me recently that she'd been type 2 diabetic since she was 19 but that the hospital had recently put her on insulin because they thought actually she might be type 1 (she's now mid 20s).

She got her results last night and has just told me that the hospital said she is type 2 but borderline type 1 so she can have tablets or insulin and it's her choice ...

I've never heard of this?? Is this normal??
If i'm honest i'm tempted to tell her to go to another hospital as that really doesn't seem right to me?

 

[LeeLee]

Maybe they mean Type 1.5 LADA?

 

[Northerner]

Maybe they mean Type 1.5 LADA?

This would be my thoughts also - a slow-onset version of Type 1. Some people also exhibit insulin-resistance characteristic of Type 2 diabetes, sometimes referred to as 'double diabetes'. She ought to have a C-peptide and GAD antibody test to try and determine whether her diabetes is caused by autoimmunity and how much insulin her pancreas is producing.

Diabetes is not a clear-cut condition sometimes - look at me, diagnosed Type 1 5 years ago, but still producing some of my own insulin!

 

[lauraw1983]

This would be my thoughts also - a slow-onset version of Type 1. Some people also exhibit insulin-resistance characteristic of Type 2 diabetes, sometimes referred to as 'double diabetes'. She ought to have a C-peptide and GAD antibody test to try and determine whether her diabetes is caused by autoimmunity and how much insulin her pancreas is producing.

Diabetes is not a clear-cut condition sometimes - look at me, diagnosed Type 1 5 years ago, but still producing some of my own insulin!

I was told the GAD test only worked in the first few months after diagnosis, as after a while the antibodies are away, once they have done their destroying work!! Grrr.

C-peptide though would help determine how much insulin she is maybe producing of her own.

What have her Hba1C results been like since diagnosis? Does she test her own BG regularly too?

 

[everydayupsanddowns]

I was told the GAD test only worked in the first few months after diagnosis, as after a while the antibodies are away, once they have done their destroying work!! Grrr.

C-peptide though would help determine how much insulin she is maybe producing of her own.

What have her Hba1C results been like since diagnosis? Does she test her own BG regularly too?

I've read some stuff on these tests recently and they do seem to be rather less clear cut than we would like

I hadn't realised that both T1 and T2 can show evidence of GAD (or other autoimmune) markers, but they are not guaranteed to be there/not there in either case.

I think they can be a useful piece of the puzzle, but they are not very conclusive in themselves and as I understand it need to be properly interpreted in the context of factors in the individual case (weight loss/not... ketones/lack of... speed of onset...). I think they are also quite expensive to get done.

 

[lauraw1983]

I caught my diagnosis early, and seeked medical help when I test at 24.9 on my mums blood sugar meter at home! I didn't get to the stage of having many ketones present when I was admitted or had the rapid weight loss before - if I hadn't have gotten the WORST bout of thrush (sorry tmi) alongside the extreme thirst though I'm not sure I would have realised so fast. I had just put the tiredness and feeling awful down to having 2 young children etc, partner who was away a lot working.

They questioned me as a Type 2 for those early few days (I was a bit overweight too, not hugely but a bit) but as soon as I got the 2 tests about I had v high antibody levels present (tests done within a month of diagnosis I think, can't quite remember, results took a while though to come back!) and quite low c-peptide (though not non existant, honeymoon period meant I was definitely producing some insulin though which is normal in everyone really.

That along with how I never really responded to metformin, byetta AND victoza meant it was pretty conclusive I was and am Type 1, but quite possibly a bit slower onset than say a child who gets it? I also have family history of Type 1 AND 2 though.