Has anyone been labeled type 1.5 (LADA), but type 2 could still be a possibility?

Type 1 and LADA
#1

My endocrinologist has recently labeled by diabetes a type 1.5 (LADA). This was based on my C-Peptide test (0.66 out of range of normal 0.8 - 3.0) and being rather thin (195 on a 6'4 frame)-->lost 25 lbs during test and diagnosis-4 months.
My main question is this. I have been feeling tired for at least 5yrs, but chalked it up to allergies. Is it possible that I have had diabetes type 2 for such a period of time that I have experienced pancreatic burnout of the beta cells and that would account for the low C-peptide test?

Should I request other blood work? GAD antibody?

My endo is so sure that I have late onset, but I am not so sure.

My numbness in my pinkie toes tell me I may have had this for a while. diagnosed with type 2 in June 2014, four days later the numbness started. Was later changed to type 1.5 based on results of C-peptide.

Any insight or guidance with this would be much appreciated.

336 fasting BG at diagnosis (12.3 A1C). June 2014
Running between 95 and 105 fasting and recent A1C registered 6.9
The 6.9 is still too high, but considering its only been 4 months I will let this one slide. Will be getting my next A1C in 2 wks. Expect it to be in the upper 5's based on recent numbers (testing close to 10 times a day).

Sorry about the long post, but just curious if any 1.5's have been reversed back to type 2 diagnosis (usually its the other way around).

Thanks for your time

Chris W.

#2

You definitely need the antibody tests. That's the only definitive way to diagnose LADA.

#3

I would concur with Badlands. Go for the full range of antibody tests that Melitta outlines: http://www.tudiabetes.org/profiles/blogs/positive-autoantibody-tests-indicate-type-1-autoimmune-diabetes

This should give you a conclusive diagnosis.

#4

Hi Chris: It sounds like your endo has diagnosed you as having LADA (which is Type 1 autoimmune diabetes) but that you are hoping it's really Type 2. In your case, IMO, it's probably not Type 2 but Type 1, based on classic T1D symptoms and low c-peptide. I agree with others that doing the autoantibody test can be useful--for some, who are secretly hoping they are Type 2 but are autoantibody positive, the conclusive diagnosis helps the person better accept the diagnosis. Here is a link to my top ten tips for the newly diagnosed adult with Type 1 that you might find helpful. Best of luck to you, I am glad you have found TuDiabetes.

#5

I’m diagnosed with LADA, have had the c-peptide and antibody testing an still don’t feel like I know the answer to this question myself. I think our tendency as people is to look for black and white answers but sometimes the realities are shades of gray. The important thing is that you manage your condition (which it sounds like you’re doing well). Not so much that you name it.

#6

Why would you want to be diagnosed as a type 2 instead of LADA? I find there to be less options for me, for assistance, with a type 2 label. I wish I had not gotten any more bloodwork when I was told LADA. I would have been better off. Be careful what you wish for.

#7

I have to tell you I don't believe T2 is a specific diagnosis. T2 simply means "diabetes of unknown cause." And while your endo has said you are LADA you don't have a confirmed diagnosis of LADA until you get a full antibody panel. Having diabetes means that you have a chronic life long condition and getting a specific and accurate diagnosis is vital to guiding proper treatment. You should demand a full bank of tests.

That being said, I have to tell you, you may not be T1/LADA. Having a low c-peptide in itself isn't enough. If you got the c-peptide test at diagnosis you may just have been suffering from beta cell exhaustion due to the constant high blood sugars. I've heard this happens as the beta cells shut down to protect themselves and as high blood sugars actually poison beta cells (glucotoxicity). You may somewhat "heal" with normalized blood sugars and thus a c-peptide test now might be different. But whatever defects caused you to lose control of your blood sugar are still there and you have diabetes.

And I have to tell you. Personally I am T2, antibody negative and my last c-peptide was 0.4 ng/dl. Even though my endo codes me diagnostically as a T1 so that I won't be denied treatment she can't "prove" that diagnosis. So I remain T2, I have diabetes but it is of unknown cause.

ps. And despite claims, not everyone who gets T2 is old or overweight. And even if you are old and overweight your diabetes still might be T1.

#8

I'm not sure why you or your doc is fiddling around with T1.5 definition. Showing up with 12.3 A1C and 336 bg having lost 25 pounds over just a few months, is pretty clear cut T1. Pure textbook T1.

#9

Chris W. have you been or still taking oral meds to control your diabetes over the last 5 years? I was on orals for 8 years myself as a type 2. After awhile the orals were doing more harm than good. About 4 years in and on 4 different meds, I was starting to feel very tired, no energy, headaches, and muscle aches. The meds even caused me to gain weight that I never could bring down no matter what. At 5'10" I my weight stayed around 200lbs. Blood sugars level went crazy. Last year at this time my A1C was 8.5 I told my doctor about what was going on. For me it was like I was coming down with the flu, then the next day I felt better. That doctor did nothing for me but accused me of not being complaint with my diabetes.

To make long story short. I found and Endo who tested my blood work that showed low c-peptide .6 and some antibodies. Doctor labeled me as a brittle type 1. Doctor then took me off the meds and started me on insulin. Now it has been over 6 months since the change. I've lost 35lbs, blood sugars are running lower, and I feeling so much better. Last check in July my A1C was 6.4. I hope things work out for you as well.