Diabetic Living article on LADA, featuring our very own Cherise

Type 1 and LADA
1

http://www.diabeticliving-digital.com/diabeticliving/fall2010?pg=45#pg43

Some facts are really wrong (for example, LADA is not some small subset of Type 1 diabetes, it is the vast majority, and starting intensive insulin therapy as soon as possible after diagnosis is the correct treatment, not Type 2 meds) but it is good that the word is getting out there that "your Type 2 diagnosis may be wrong." We have had so many new TuD members recently who fit the classic profile of adult-onset Type 1/LADA, but who have been diagnosed as having Type 2.

2

This is SO funny!! I was JUST about to post about this. I am so happy DL published this article. We need more awareness around LADA. ROCK ON, CHERISE!! Thanks to Diabetic Living for helping shed light on LADA!

3

Thank you, Melitta and Manny;) I was honored to speak on behalf of the LADA community. There are way too many people misdiagnosed with T-2.

4

I did not even realize Diabetic Living was available on-line. It is good to see some more visible recognition for LADA even if there are some flaws in the article. I looked up the author, she is just a student. Given the lack of knowledge the so-called medical professsionals have about LADA it is not surprising that it was difficult for the author to wade through to find the “truth.”

ps. Kudos to Diabetic_Iz_Me for being an outstanding advocate!

5

Speaking of LADA, here’s a recent article from Diabetes Forecast magazine.

6

I would like to mention that students having papers are normally under the guidance of pretty good mentoring faculty. So student papers should have great respect! “Just a student” will be up to date! Bettern a 50 year old practicing for 20 years and not able to go to enough meetings to get it all. Impossible! Grab all the students you can find. They’re great to discuss things with. Author-students are leaders for tomorrow!
Professional training is lifelong among medical professionals.
Unfortunately, some areas of medicine change to the point that even sub-specialists find themselves behind.

7

So Kelly, let me ask you. I know there has been a bunch of discussion about articles in Diabetes Living recently. I thought this article was well written, but a few of us have nits with the article. How do you go about editing and fact checking a piece like this? I know you have a staff of “medical professionals,” primarily RD, CDEs and an endo. I’ve not met any RDs and few CDEs that understand much of anything about LADA. Something like this it must be difficult.

ps. And I read the Diabetes Forecast piece, that was by a staff writer who is actually a PhD. I also have some nits with even that.

8

My own take on LADA from a few months ago:
http://www.dlife.com/diabetes/information/daily_living/Viewpoints/Manny_Hernandez/lada.html

9

Wonderful seeing more attention being given to LADA.

Yay, Cherise!

10

Good to see some press on LADA but one more incorrect fact is the recommendation to have GAD autoantibody testing only. If you think you might not be a Type 2 you should ask for the full panel of autoantibody tests. I was negative for GAD but positive for islet cell IgG autoantibodies.

11

I’m participating on tudiabetes as a person living with diabetes, not in my specific role as editor, so I’ll answer in general.

Ask a handful of editors and you’ll get a handful of answers about how stories for magazines, newspapers, and online are researched, written, and fact-checked. Unfortunately, fact-checking is a function that has become increasingly neglected thanks to downsizing in the publishing industry and the flurry of content now available online.

Stories in popular media may be fact-checked but are not necessarily reviewed by an independent panel of experts. A general-interest publication that has an advisory board benefits from professional eyes reading the articles–if those articles are actually sent to and reviewed by the advisory board members. Sometimes a list is just a list.

I’ve appreciated working with advisory board members who have lots of clinical experience and who are actively involved in professional organizations, volunteer work, and continuing education. A journal may benefit from advisory board members devoted to research.

The interesting thing about reporting and writing is that just about every facet of the process is open to interpretation–by the researcher/writer, by the editor, and certainly by the reader. It seems so simple to present both sides of a story–as if there were only two sides! But that is just not the case. The experts selected, the amount of time spent in discussion with them, the particular emphasis of the experts, the skill of the writer at gauging and conveying meaning (not everyone speaks in sound bites), the purpose of the story, the intended audience for the story, the amount of space allotted to the story, etc., all help shape the finished piece. Even a so-called fact can be misleading or incorrect if not placed in context. Which “facts” should be included? Which “facts” are not necessary for a particular article in a particular publication at a particular time for a particular audience? And even if the facts are correct, is the writing clear, engaging, meaningful to the reader?

It’s pretty difficult to have one piece of content be the “ultimate” piece about a particular topic. I’m always eager for people to show me pieces they consider ultimate. That helps me improve my skills.
(It might be a fun project to challenge people on tudiabetes to write what they consider to be the ultimate piece about LADA! I would love to read that.)

Fact or fiction, I appreciate the rich pageant of thought and words devoted to diabetes.

12

Thanks for responding to this. Let me apologize for dragging you out to speak in your professional role. I actually would be unhappy if you did that to me and I’m sorry. I do appreciated your being here just as a PWD.

That being said, I think I understand better the process. As I noted before, I thought the article was well written, but anything that is written for a general audience is perhaps going to be found wanting by someone who has looked deeply into the subject.

13

I appreciated that you took the time to ask!

14

This past weekend, I had the pleasure of meeting with an 81-year-old gentleman who has lived with diabetes for about 40 years. We’re pretty sure that he was LADA, but at the time it was diagnosed as type 2. Fortunately, he was put on insulin fairly quickly and has done very well all these years. I hope I’m as spry in my 81st year–of course, I’ll have lived with diabetes for 77 years by then!

15

So why do you think he was LADA? Did he have positive antibody tests? Was it because he was never overweight? There are some that think that a loss of beta cells is a natural progression of T2s. Either way, I hope I can still be kickin when I’m 81.

16

Were the positive antibody tests performed way back ? When I was diagnosed at age 42 , 1983 I was put on medication ; had to have blood drawn weekly at the lab , numbers did not come down , on insulin 2 months later …and that worked : numbers came down . A matter of which treatment worked…

17

When I was diagnosed in 1995, I met several people who had been diagnosed as “Type 2” years before, and called themselves insulin-requiring Type 2 diabetics. All of them were thin or very thin. Those who had been started on insulin very early were doing quite well. Those whose doctors delayed insulin treatment for many years had severe complications (amputations, kidney transplant, etc.).

18

Hi Nel: I am not sure when antibody testing came into more routine use for diagnosing Type 1 autoimmune diabetes, but the autoimmune nature of Type 1 diabetes was only identified in the 1970s and ICAs were identified in 1974. Amazingly enough, a 1976 article in The Lancet (by WJ Irvine et al) documented the presence of ICAs in a group of people with slower onset of diabetes. So by the time you were diagnosed in 1983, LADA was already known but not yet named.

19

Thanks Melitta for your added info … I was always sure that I was not the first :slight_smile: …maybe the gent Kelly R was referring to …actually it does not matter, as long as he( incl. all those others before and after him ) received the correct treatment as I did 2 months later …in my case , because I was pro-active and did not stand for the BG numbers well over 200 all of the time ( only Lab tests told me that in 1983 !!) .