A little background – my mom was dx’d with type 1 at age 17 (40 something years ago). My 9 year old son was dx’d with type 1 at 9 months old. And I was diagnosed with who knows what kind of diabetes a little over 2 years ago when I participated in the Trial Net research study. I had ALL of the antibodies for type 1 (no surprise there given my family history), and I went on to do the OGTT every 6 months for 2 years. In 2007, my numbers were all of a sudden high, and I was dx’d with diabetes. I’ve been honeymooning for the last 2 years and only taking lantus once a day.
The TrialNet doctors and my endo at the time all said it was definitely type 1 because I had the antibodies. My new endo now is calling it LADA. What’s the difference? Once I read that LADAs have the antibodies for type 1 but also show insulin resistance like type 2. Is that correct? (I don’t have any characteristics of type 2. I also have hashimotos and celiac. Autoimmune city here.)
Can you go from LADA to type 1 once you’re out of the honeymoon? I’m asking because I got the H1N1 virus and I think my honeymoon ended yesterday. Literally. I’m over the virus pretty much and my numbers are high. I’ve broken my own personal records for high numbers! I knew the honeymoon was starting to end because my last A1C had gone up. But it’s pretty abruptly ended now I think!
So do I have LADA, or just type 1 with a long honeymoon – is there a difference? Not that it matters – I’m still going to have to start counting carbs and taking insulin! Just wondering what other LADA’s have experienced.
“do I have LADA, or just type 1 with a long honeymoon”
Hi Brenda!, IMO - LADA is a short way of saying “T1 with a loooong honeymoon”. That’s all. so to all your follow up qestions - you will eventually stop making insulin, just like us old time T1’s. Sorry to hear about your diagnosis and about how affected your family is. jeez, that’s a lot of folks with T1. Hope you are well.
The main differences between LADA and Type 1 are the rate of onset and often the age at diagnosis. LADA stands for LATENT auto-immune diabetes in adults. I think I’m a fairly typical LADA in that I was (mis)-diagnosed at age 58 with Type 2. I managed well on oral meds for about a year when my numbers started climbing; that seemed way too soon for Type 2 and I learned about and diagnosed myself as LADA. A true Type 1 can rarely go for over a year before needing insulin. No, LADA’s don’t “turn into” Type 1’s. Even though my pancreas will produce less and less insulin over time and end up similar to a true Type 1, I will still be LADA/1.5 because the diagnosis is based on etiology (how it began). Also LADA’s often have pancreas “spurts” for a while where there insulin production comes backfor short periods of time before it dies completely.
No, LADA’s don’'t have insulin resistance as well as a rule, though some can. Some true Type 1’s can also develop insulin resistance over time, one reason the “I can eat anything at all and cover it with more insulin” school is not without risks in the long run.
I agree with everything that was said. LADA is a just a slower-onset type 1. I’ve been told that it’s common for LADAs to only have antibodies to GAD65 proteins (that islet cells make) rather than the islet cells themselves. It sounds like you tested positive for more antibodies though.
I’m LADA diagnosed at age 40. I spent 6 months on about 7 U Lantus/day; then I needed to supplement with Humalog for meals and now I’m on the pump, using 16-25 U Humalog/day. Very little insulin resistance though. Some type 2s use about 100 U insulin/day.
I think the difference I was hearing was between LADA and type 1.5 – with the 1.5 showing characteristics of both type 1 (antibodies) and type 2 (insulin resistance).
Anyhow, I was diagnosed at age 30, needed insulin from the beginning – 10 units of Lantus/day – and I’ve stayed there for 2 years with beautiful numbers. And yes, I had extremely high levels for 3 antibodies, including the GAD65. No more beautiful numbers, though, the swine flu has made my pancreas kick the bucket I think!
In response to Zoe’s post, I think I would have to consider myself a type 1 since I needed insulin from the beginning. It was fascinating (and terrifying) to watch my islet cells burn out almost before my very eyes! When I was at that last Trial Net OGTT, my fasting was only 120, but my 2 hour number was almost 300. However, it took me 3 weeks to get in to see an endo after that test, and in that 3 week time period, my fasting number went all the way to 180. The diabetes was caught in the very beginning and I was fortunate not to be misdiagnosed and put on insulin right away. I think the immediate start of insulin has led to a longer honeymoon.
The TrialNet doctors all say it’s type 1, not 1.5 because I have all 3 antibodies.
I guess I was confused because I hear people talk about LADA and 1.5 as being the same and some articles I’ve read have talked about them being different. Just trying to wrap my brain around it. Thanks for the responses!
Yes, I have heard the differentiation between LADA and 1.5 as well, but I have also heard them used interchangeably. Just getting docs to acknowledge it as a separate type is difficult enough, because the ADA STILL doesn’t recognize LADA/1.5 at all.
Diabetes is a result of several different things. Clearly one thing that happens with diabetes is there is an out of whack autoimmune response that attacks the pancreas and results in an insulin deficiency. This happens in the vast majority of type 1 cases (quickly), in LADA (over a period of months), and when it happens in type 2 (over a period of years). It is thought that perhaps 15% of type 2s have a positive response to the antibody tests and are having an autoimmune response.
Of course another thing that occurs is insulin resistance, which is the hallmark of type 2, but that can also happen with any diabetic. There are also a range of other things that occur with diabetes, like messed up signaling as in Maturity Onset Diabetes of Youth (MODY). The designation type 1.5, which is unofficial, includes LADA as well as MODY. I believe there have been 8 types of MODY identified and they result in a variety of problems with insulin responses. I suspect that I might have MODY, but I’ve never been successful in getting any of the antibody or genetic tests needed to properly diagnose.
From a guy who has been type 1 for 26+ years, I really like this question. I’m betting there are others “out there” who have wondered this very same thing but didn’t want to ask.
So thanks Brenda. Anyway we can educate ourselves as well as others is for the good.
Me, I’m asking Santa for a new pancreas this Christmas, but I’m keeping my pump and my cgms and my meter cuz I’ve been a bad boy most of the year. I just want to ask him for it anyway
