What is the difference between Type 1 & LADA....

[Sammi87]

I have seen a lot of people diagnosed in later life with type 1, I have been told after original mis diagnosis of type 2 I have LADA. is this a new way of just describing late onset type 1 or is there truley a difference?

 

[DaveB]

Hi. It's the same as Late onset T1 which is T1 that appears later in life aka LADA. It's different names for essentially the same thing. Commonly LADA comes on more slowly with a honeymoon period as it appears to reflect slower decay in the beta cells than in children. One aspect which I personally challenge is the assumption that they are all due to antibodies and I've seen some posters on another forum say if it wasn't caused by antibodies then it's T2 which is pretty silly. Viruses are one known cause of beta cell death (I suspect for various reasons that mine was) and you could even argue that the viruses trigger antibodies but who cares as the end result is beta cell destruction with the longer term need for insulin. Sadly the recent changes in diabetes condition definitions have not corrected any of these silly aspects of naming.

 

[Sammi87]

Hi. It's the same as Late onset T1 which is T1 that appears later in life aka LADA. It's different names for essentially the same thing. Commonly LADA comes on more slowly with a honeymoon period as it appears to reflect slower decay in the beta cells than in children. One aspect which I personally challenge is the assumption that they are all due to antibodies and I've seen some posters on another forum say if it wasn't caused by antibodies then it's T2 which is pretty silly. Viruses are one known cause of beta cell death (I suspect for various reasons that mine was) and you could even argue that the viruses trigger antibodies but who cares as the end result is beta cell destruction with the longer term need for insulin. Sadly the recent changes in diabetes condition definitions have not corrected any of these silly aspects of naming.

Ahhh I see, my symptoms progressed within a week. They originally suspected T1 I was placed straight on insulin then they said they had run a GAD antibodies test which was negative (hospital has told me since they never took the test) and change my diagnosis to T2 basically has been a year or me in and out of hospital with ketone issues, ops on abscesses and permanent hyperglycaemia until may this year. That's where I was confused as my symptoms literally came out of nowhere no issues previous, no family history etc. Only picked up there was an issue as I was urinated constantly and drinking excessively for about a week so I dipped my urine at work and asked someone to check my BG after finding ketones and glucose in my urine which came back 17. How long were your symptoms and how did you eventually get the correct diagnosis?

 

[runner]

Hi, I was originally diagnosed as T2 in 2007, age 52, but after lifestyle changes and meds, not the improvement they expected. Also diagnosed with Hypothyroidism at the same time. Went onto insulin almost a year later and found out through a comment in a letter from the hospital DSN that he considered me T1, or to be more precise T1.5, because of my sensitivity to insulin. Went on a DAFNE course and when we had a session with a consultant, asked if I was likely to get Parkinsons like my Dad, and was told no, but I can blame him for my diabetes - all autoimmune conditions. I was also told it developed probably as a result of a virus. As the GP surgery still had me as T2 and seemed reluctant to change it, I asked the hospital for a cPeptide test (I think it's called) and that confirmed the T1 diagnosis. Hope that helps!

 

[Sammi87]

Hi, I was originally diagnosed as T2 in 2007, age 52, but after lifestyle changes and meds, not the improvement they expected. Also diagnosed with Hypothyroidism at the same time. Went onto insulin almost a year later and found out through a comment in a letter from the hospital DSN that he considered me T1, or to be more precise T1.5, because of my sensitivity to insulin. Went on a DAFNE course and when we had a session with a consultant, asked if I was likely to get Parkinsons like my Dad, and was told no, but I can blame him for my diabetes - all autoimmune conditions. I was also told it developed probably as a result of a virus. As the GP surgery still had me as T2 and seemed reluctant to change it, I asked the hospital for a cPeptide test (I think it's called) and that confirmed the T1 diagnosis. Hope that helps!

I'm awaiting my date for the DAFNE course. Not sure how long the course is as I work 12 hour shifts 4 days a week. Yes sadly GPS seem to be the reason for all these misdiagnosed T1 sufferers even when I went to mine for my new prescription last week she was arguing my new diagnosis basically because you don't fit the tick boxes they have in front of them. I'm not sure what may have caused mine I caught a few sickness and diaorreah bugs previous don't know if that possibly was the cause. The hospital have just carried out the GADs test after explain the GP never did even they they apparently used its results for my original diagnosis all very strange I'm still awaiting the results for that one not sure how long it will take. I will ask the DSN about the c peptide test they currently are going from my long term symptoms and issues for current diagnosis.only issues I've had in my family are thyroid issues my mum had hers removed 30 years ago but my bloods confirm no thyroid issues and both my parents have had breast cancer which obviously I am at high risk for.

 

[trophywench]

DAFNE is every day for a week Sammi - but it is the most valuable week you can ever wish to spend, should you wish to have really good control of your diabetes.

 

[Sammi87]

DAFNE is every day for a week Sammi - but it is the most valuable week you can ever wish to spend, should you wish to have really good control of your diabetes.

Ah see this is going to be an issue for me I cannot afford that amount of time off work. I understand it is very important and people say your health is more important etc but I literally cannot afford to lose such a large amount of my wage. They suggested a day course to me I'm not sure what this is.

 

[everydayupsanddowns]

Ah see this is going to be an issue for me I cannot afford that amount of time off work. I understand it is very important and people say your health is more important etc but I literally cannot afford to lose such a large amount of my wage. They suggested a day course to me I'm not sure what this is.

Speak to the DUK Careline Sammi.

You should be able to negotiate this as paid leave - because your employer should make ‘reasonable adjustments’ to support you, and because this training and information should mean that your management improves and you have fewer days off in the future due to severe hypos, Diabetes-related illness etc.

They should see this not as a cost, but as an investment into your better performance and productivity at work in the future.

 

[runner]

Hope you get some answers and are able to attend the DAFNE course.

 

[trophywench]

It's actually worth taking it as a week of your holiday - but don't you dare offer to do that until you exhaust every other option.

 

[Sammi87]

I don' have any holiday remaining as I have booked all mine up for the year to cover childcare for the year and hospital appointments.

 

[trophywench]

Sorry - you should not need to use holiday entitlement for hospital appointments - please telephone the DUK helpline as soon as you can after the holiday weekend because that is Not On.

 

[Mark T]

Sorry - you should not need to use holiday entitlement for hospital appointments - please telephone the DUK helpline as soon as you can after the holiday weekend because that is Not On.

However, there is no legal right to paid time off for appointments. Your employer has to make reasonable adjustments, but that doesn't mean they have to pay you.

 

[trophywench]

Good grief - I'm amazed that it's legal. Spend you own time having a chronic condition not ours - how the HELL (and that isn't the word I'd prefer to use) is that NOT discrimination?

 

[SB2015]

Going back to your original question, whilst a virus might be linked to the onset of the beta cell destruction, it is not the virus that destroys the beta cells. My diagnosis was late in life, and in the final week before my diagnosis it was a rapid deterioration losing 1 1/2 stone in 1 week, and feeling awful which is no surprise with ketoacidosis. My understanding is that the antibodies will have been triggered maybe as much as a year before (and who can pinpoint the trigger that long ago), and then set to work on you ur beta cells. We proabably don’t notice the symptoms at first, but then once enough have been destroyed, our bodies cannot make enough insulin, and the final few beta cells just give up, leading to our bodies giong into crisis and a diagnosis being picked up.

I think that the foggy bits in diagnosis come where people are picked up a bit earlier and often misdiagnosed at T2 as there are still some active Beta cells, even though the antibodies are diong others stuff. If correctly diagnosed early, with basal insulin some manage to keep their beta cells working for a lot longer, eg Northerner.

 

[DaveB]

Ahhh I see, my symptoms progressed within a week. They originally suspected T1 I was placed straight on insulin then they said they had run a GAD antibodies test which was negative (hospital has told me since they never took the test) and change my diagnosis to T2 basically has been a year or me in and out of hospital with ketone issues, ops on abscesses and permanent hyperglycaemia until may this year. That's where I was confused as my symptoms literally came out of nowhere no issues previous, no family history etc. Only picked up there was an issue as I was urinated constantly and drinking excessively for about a week so I dipped my urine at work and asked someone to check my BG after finding ketones and glucose in my urine which came back 17. How long were your symptoms and how did you eventually get the correct diagnosis?

Hi. My symptoms came on very quickly and I had the complete set. I had been losing weight unexpectedly despite the gym which in retrospect was a warning sign. I never did get the right diagnosis and am still listed wrongly as T2. I gave up with my GP and had GAD and c-peptide tests done privately. The GAD was negative but the c-peptide result was at the bottom of the normal range which confirmed my insulin level was low. NICE confirms that GAD tests taken a long time after initial diagnosis are very unreliable. My GP refused to accept I was LADA and refused insulin. A year later she said I needed it (what a surprise) and have had super DNs since. My concern is that the national statistics are messed up with up to 20% of thin T2s possibly being LADA and not T2 and this affects research studies.

 

[Matt Cycle]

c-peptide result was at the bottom of the normal range

Isn't the bottom of normal still normal though? Presumably that's why they have a range because not everyone's is going to be exactly the same.

 

[DaveB]

Isn't the bottom of normal still normal though? Presumably that's why they have a range because not everyone's is going to be exactly the same.

Yes, but the 'normal' range is quite wide with a 4:1 ratio top to bottom so being towards the bottom probably means low insulin which my uncontrollable BS indicated. I was certainly producing some insulin but I gather even long-term T1s can sometimes have some beta cell activity. The thing about c-peptide is that if you are a 'normal' T2 your results might be towards to top end so it can be useful in differentiating between insulin resistance (T2) and low insulin (T1)

 

[Mark T]

"normal range" depends on the accuracy of the test. There is always a finite accuracy to any test. It sounds like the c-peptide test isn't all that accurate.

When I had my GAD done I was in-between the positive and negative ranges (in limbo!).