The two types of type 1 diabetes

[Amity Island]

Hi Everyone,

Not sure about the details, but it was just interesting that there are 2 different types of type 1, one type looking more similar to type 2 diabetes.

Non-immune-mediated versus immune-mediated type 1 diabetes: diagnosis and long-term differences—retrospective analysis - Diabetology & Metabolic Syndrome

Background The American Diabetes Association proposed two subcategories for type 1 diabetes mellitus: type 1A or immune-mediated diabetes (IDM) and type 1B or idiopathic diabetes. The absence of β-cell autoimmune markers, permanent insulinopenia and prone to ketoacidosis define the second...

dmsjournal.biomedcentral.com

 

[trophywench]

I've just had to look up what the word insulinopenia means! Not a word I ever recall having seen before.

I think that this comes under the heading academically useful to some maybe but on a personal need to know scale scores roughly minus figures!

 

[Northerner]

Well, I most closely fit the description of the NIDM type in some respects, but definitely not others. My consultant did mention this as a possibility, although after discussion decided it wasn't a complete enough fit for a firm diagnosis.

This fits, apart from the bit about being able to control with oral agents and diet - I still need insulin with any carbs. I also had a virus in the lead up to diagnosis, which suggested my immune system might have played a part by getting a bit out of control:

NIDM is characterized by acute onset of severe hyperglycemia with ketoacidosis, requiring hospital admission and treatment with insulin and fluid and electrolyte replacement [5]. Insulin therapy is generally necessary for a period going from 6 to 18 months, with subsequent good control of disease just with oral agents and diet [2]. Recurrent ketoacidosis is unusual [5].

The only bit that fits here is that I am male, plus I also match the 'older person at diagnosis' category, I was 49 (I don't consider 49 middle-aged, that's young to me now! 😱 ) Never overweight and no family history of Type 2.

NIDM shows a different phenotype, are more often male, middle aged, overweight, or modestly obese (obesity class I). They have a family history of type 2 diabetes [2, 3, 5, 6]. Due to the presence of some metabolic features of type 2 diabetes,

I've always considered that diabetes is more of a spectrum than a handful of discrete sub-types.

 

[grovesy]

Well, I most closely fit the description of the NIDM type in some respects, but definitely not others. My consultant did mention this as a possibility, although after discussion decided it wasn't a complete enough fit for a firm diagnosis.

This fits, apart from the bit about being able to control with oral agents and diet - I still need insulin with any carbs. I also had a virus in the lead up to diagnosis, which suggested my immune system might have played a part by getting a bit out of control:



The only bit that fits here is that I am male, plus I also match the 'older person at diagnosis' category, I was 49 (I don't consider 49 middle-aged, that's young to me now! 😱 ) Never overweight and no family history of Type 2.



I've always considered that diabetes is more of a spectrum than a handful of discrete sub-types.

Researchers in Exeter have been saying this for a while.

 

[trophywench]

Well yes! - hardly amazing that so many PWD on this forum (and others) agree with Exeter.