Adult type 1 question

I was diagnosed T1 in March at the age of 58 by a GP when I showed up not feeling well, bg over 600, and in DKA. Since then, when I asked my endo if i had LADA, she said, “something like that.” She never did explain. Fast forward six months, and I am trying to piece this all together. I do know I need a new endo, but my GP and a great CDE are helping me. My current endo (who is mildly better than the first) said my T1 was triggered by a virus and was autoimmune. Now I did have a sinus infection 22 yrs ago, and I had vertigo once 5 yrs ago, but other than that I have never been sick. Before my DKA sent me to the er 3/2, I had no energy for most of Feb. so I think my bg was rising for that whole month. In early Jan, I did have a an incident occur that caused severe psychological stress and brought back childhood memories of severe stress–but everyone has stress. Could this have caused the onset of my T1? Thanks for reading and I thank you in advance for any insight.

Type 1 actually takes years and years to develop, even though it might appear to occur suddenly. Even in kids, it may appear very suddenly, but the underlying autoimmune attack has still been going on for years. Diabetes is different than most other autoimmune disease because you don't get diagnosed until nearly all your beta cells are already destroyed. Until that point, your pancreas is able to compensate and there are no symptoms. Type 1 in adults is an even slower process than in kids. So who knows what may have triggered it, it very well could have been something that happened 20 years ago. Type 1 is typically a combination of a genetic predisposition combined with an environmental trigger—but no one really knows specifically what that environmental trigger is, and it may in fact be different things for different people.

Rats Jen! I really want to “blame” someone or something! :slight_smile:

Dee, you came to the right place. We understand LADA here; our founder Manny Hernandez has it, and we have plenty of fold diagnosed in their 50s. here are some resources

here's a blog explaining the tests you need for a LADA dx

and here's some great tips on dealing with it

let us know how you're doing, and if you have any questions.

If you were diagnosed in DKA, you are most likely not LADA. You are more likely "adult sudden onset". Melitta who writes a lot on this board about differential diagnosis was also adult sudden onset. Me, I was also diagnosed at age 58, but since I was slow onset (LADA) I was misdiagnosed as Type 2, and did fine on oral meds for about 15 months.

Your endo saying "something like that" makes me laugh, a convenient phrase for "I don't know" or even "I never heard of LADA!"

I agree with Jen, the etiology of type 1 is complex, and frankly I've never given much thought to how or why I got it, too busy managing it I guess!

There is such a thing as a subclinical virus. That means that you don't have to be sick to have a virus running around in your body.

I agree with Zoe that you're probably adult onset more than LADA because you were in DKA. Overall, they''re pretty much the same and it doesn't matter as long as you're being treated correctly.

Hi Dee,
I agree with Jen, Zoe, Guitarnut all above. I was just dianosed 7 months ago at age 37 with sudden onset Type1. I know it was sudden because I had fasting bloodwork drawn twice at 3 months and 4 months prior to diagnosis and my glucose levels were in the 90s then. Fast forward 4 months and they were up to 386, so the attack was probably happening for months and years prior until the very last of beta cells were killed off. Just like you, I've always wondered "why" but we'll never know for any of us. It's not in my family, and my immune system always seemed to be pretty good. Was it the back-to-back pregnancies I had and c-sections? Was it that mild cold I had a year prior? I guess I'm learning that the reason doesn't matter (though it sure is natural for the mind to wonder about it), so I just manage it the best I can, widdled down my carbs to what I feel is starvation level of 300 per day and manage an A1C of 5.0%-6.4%, and the main thing is keep abreast of the newer treatments on the horizon such as the bionic pancreas and faster insulins to bring down the highs. And let me tell you that you're not alone feeling how you feel about the Endos. I feel that same way about 2 of them I saw so I stuck with the best of the 2. I see it that I listen to my Endo and then make my own choices because this is such a self-managed condition.

Interesting that you mention "having a pretty good immune system", Denise. I actually have what I consider an exceptionally good immune system: I never got the childhood diseases everyone around me got, I rarely get colds and I'm a part of only about 15% of the population that spontaneously cleared the HepC virus. I have a saying: "I never get sick, I just get conditions!"

I have a totally unproved theory that I was subject to autoimmune conditions because I have a super strong immune system! Something like my body works so hard attacking germs that it mistakenly attacks itself!

Zoe-you’ve got to be on to something about a good immune system leading to Type 1. It seems like that’s the underlying culprit for so many of us.

I feel the same way, Zoe. I haven't had a true flu since I was about 13, and these days rarely even get colds. Last year there was a bad cold going around our office that knocked many who caught it out for several weeks and turned into pneumonia for some. I caught the cold, and was worried because for a day or two I did feel like my lungs were filled with crud, but in the end the cold lasted all of five days for me, and I only took one day off work when others had taken a week or two. I've also had several doctors mention that I'm a "good healer" which seems the opposite of what diabetes should do. I can count the number of time I've had to use antibiotics on one hand.

Yet, my immune system seems so hyperactive that it attacks all sorts of other things in the environment and my body. I have asthma, an anaphylactic food allergy, a ton of environmental and seasonal allergies, mild eczema and in general sensitive/reactive skin, and of course Type 1 diabetes. I think sometimes that my immune system is "bored" and has a lot of spare time to attack harmless substances. :) I'm kind of surprised I haven't developed any other autoimmune conditions, seeing as how they are common for people with Type 1 and I also have a family history of them, but on the other hand I'm only 31 so I have a lot of time still for my body to decide to develop one!

Yep, I'm not very scientifically oriented, but it seems logical to me. I mentioned it once before on here and several people said they also had strong immune systems, but it would be interesting to do a larger survey.

Interesting that you commented about the hyperactive immune system. I too, have had a very strong immune system over the years. I am a pediatric nurse and exposed to all kinds of yucky stuff, but never get sick, like all my co workers. But, until you just said it, I never related my seasonal/environmental allergies, reactive airway, cold urticaria, etc... to my immune system. It totally makes sense that those things have to be related to your immune system.

Hi PedsRN. I was mostly thinking of the connection between having a hyperactive immune system and having autoimmune attacks, but sounds like you have another piece of the puzzle. How do you think allergies and such relate to the hyperactive immune system?

Yep, for six years I worked in a school where there are always colds and flues going around. I rarely caught a cold, and never once caught any of the nastier stuff that all the other staff members seemed to catch.

I had bad cold urticaria as a kid and teenager. I've seen others comment here that they had it at some point, too. I didn't even know it was a real condition until I was an adult! I have thankfully outgrown mine (although sometimes lately I feel like it might be coming back), but that too would be related to my hyperactive immune system. :)

An autoimmune condition is your immune system attacking your own cells. An allergy is your immune system attacking some external substance that is actually harmless (pollen, food, etc.). Conditions like asthma and eczema are similar, your immune system reacting to things in the air or things that touch your skin that are harmless to most people.

Ah, so it may be a similar sort of hypervigilance on the part of the immune system!

You have all given me much food for thought and I thank you for that! Now, does anyone have a good link for info on sudden adult onset?

When you find that link for sudden adult onset, let me know. I'd looked for that for a while and could never find anything scientific on that. I think I remember reading that "juvenile" diabetes was a misnomer because it can happen and historically always happened at any age, but like we discussed above, it likely takes months and years to present itself in adults, but in young kids, it only takes weeks to present itself--even though in both populations it actually happens well before it presents symptoms.

I looked for info Denise and could find nothing. Perhaps someone here could write a book on it!

There is a lot of information on the different types of Diabetes in Melitta's blogs: