OK, I know this question is really out there, but hear me out. My understanding is that it is not unusual for someone with an autoimmune disorder to have more than one. I have probably had type 1.5 since 1991/92 when I was pregnant and delivered a 10.5 lb baby. That was 21 years ago and I don't have another autoimmune disorder. In our family the diabetes is definitely genetic, I am 1 of 5 children 3 of us are diabetic, and lots of cousins also with it. Although there is no medical history it looks like it goes back 4 generations before me. As far as I know no one has any other autoimmune issues.
When I was diagnosed they did a C-Peptide, but not an antibody test, so I don't know if the antibodies exist. I will bring it up with my endo at the next appointment.
Are you a 1.5 with a definite genetic connection? Are you a 1.5 with another autoimmune disorder and my idea is just a fluke in our family?
I myself have both T1 and am hypothyroid (which I'm told is a related auto-immune condition).
You'd be surprised how important the antibody tests (that show it's an auto-immune condition) are to some folks here. To me, I was diagnosed so long ago (31 years ago this summer!), that it seems kind of irrelevant. But for some it is an important diagnosis criteria, which I never actually understood, because it certainly wasn't part of my diagnosis process.
I have never shown either T1 diabetes antibodies or thyroid antibodies. And, well, they both began so many decades ago, that testing for antibodies wasn't common back then, and there wouldn't necessarily be any antibodies left today.
So, for me, whether it is auto-immune or not, I don't really care. I'm sure that some researcher might want to know but I'm not sure 31+ years after diagnosis if I'd show any antibodies, and in any event, I know I'm T1 regardless of any test. (In fact I was initially diagnosed without a blood test. For thousands of years the definition of diabetes was sugar in urine, and I had that in spades, I rember the Tes-Tape turned jet black instantly. Only in the past few years have A1C's and C-peptides and antibody tests been available.)
There are types of insulin-dependent diabetes that aren't caused by autoimmune conditions. e.g. by surgical removal of the pancreas. There are some of those folks here. I personally feel that this is the same, for all intents and purposes of diabetes treatment and management, as T1. But I don't know if this feeling or acceptance is universal. I tend to be the kind of person who tears down walls, rather than builds them.
You know, I hope you don't feel "left out" just because you don't have a related autoimmune condition :-). You're welcome here regardless!
Hi jeannene. There are many experts on this site re the question of types of Diabetes; Melitta, for instance. If by 1.5 you mean late onset type 1, it is definitely an autoimmune disease.
Also, I'm sure there are tons of people with ONLY diabetes, no other auto-immune disorders (like me), so I don't think the fact that you don't have any others rules it out. It's just like how it's fairly certain there is a genetic link, but there are tons of people who are the only ones in their family to have diabetes. Who really knows, though?
There are no other T1D members in my gene pool that I know about. I was diagnosed almost 30 years ago and did not have an antibody test done. Looking back, however, I did have symptoms of diabetes (lethargy, slow wound healing, and reactive hypoglycemia) at least one year before my diagnosis. My dx came at 30 years of age. That fact, combined with its slow onset, leads me to conclude that technically I'm a 1.5 T1. But that's a distinction that has no meaning to me regarding treatment. The biggest meaning for me is that I benefitted from a gluco-normal child and young adulthood.
I received a hypothyroid diagnosis a few years after my T1 dx. That fact further supports the autoimmune nature of my disease. A few years after dx, I had a 24-hour urine collection done to test for c-peptide. That test revealed little to no insulin secretion. Several c-peptide blood tests done over the years continue to confirm that fact.
I am the only T1 in my family. I had severe seasonal allergies when I was younger (and lived near nature). I've been wondering if the 2 could be somehow connected, as I believe T1 is more common in temperate climates, which experience higher seasonal pollen counts. My sister has psoriasis.
Type 1.5 is not a formal diagnostic category. In fact, the latest ADA diagnosis guidelines don't even identify LADA. If you have immune mediated diabetes with primarily insulin deficiency, then you have T1. Some people define Type 1.5 as being about LADA, some define it as being about MODY. MODY is clearly genetic, is autosomal dominant and it basically always expresses. Type 1 and Type 2 both are genetically linked, with T1 having a small set of genes involved (i.e. certain HLA genotype) and T2 being very complex (I saw a claim that 36 genes are involved). But having the genes doesn't mean that you have the genes expressed and get diabetes. The chance of getting T1 if your parent or other close relative has T1 is perhaps 1 in 10. Since environment plays a significant role in whether the gene expresses, there is a real question of whether there is actually something in the environment in a family with a higher rate of T1.
ps. I am T2, my brother, father and uncle all have diabetes.
It is my understanding that T2 has a very stong genetic y link while T1 has only some. Here are some odds with T1 and T2 from Joslins: http://www.joslin.org/info/genetics_and_diabetes.html. I think the stats are about right.
I am a T1 and I believe that T1 and LADA are quite similar. My great uncle was diagnosed with T1 back in the 1930s or 40s and that is the only family history I have of the disease.
A couple of years ago I was diagnosed with the autoimmune skin condition of psoriasis. My grandmother had psoriasis for a long portion of her life. I think diabetes just makes it more likely that you will develop another autoimmune condition.
I found this related article sponsored by the ADA: http://clinical.diabetesjournals.org/content/24/1/40.full. It says, "In patients with autoimmune polyendocrine syndromes with a single disease such as type 1A diabetes or Addison's disease, the prevalence of an additional autoimmune disorder is 30-50 times that in the general population." They suggest periodic testing for the more likely autoimmune like celiac, addison, hashimoto and vitiligo.
I have Hashimoto's, my mother had psoriasis, my father has vitiligo. These are all autoimmune. I also have (a LOT of) allergies.
Though my endocrinologist currently considers me more on the T2 spectrum, I met an endocrinologist today who is of the strong opinion that I'm really LADA. I will definitely bring it up with him when I see him--I want to be tested again.
The change in diagnosis would mean a change in treatment for me. I'm currently on Metformin, but a diagnosis of LADA would mean insulin.
That's great guitarnut! I saw another dr today and he was again..totaully useless. He won't give me a referral until he orders MORE bloodwork. He thinks ALL my health issues that I have are from digestion problems. I don't see how asthma relates to digestion nor endometriosis..but whatever. I'm convinced the doctors in ottawa are on some alice and wonderland type stuff..because I don't get how my asthma and endomtriosis related to D and high bg's. He also said he wouldn't prescribe anything til the bloodwork comes back (4 weeks). Good lord..
Glad you are getting attention though guitarnut and that your endo is aware of LADA!
There is some debate about whether endometriosis is autoimmune or not. Asthma is usually defined as autoimmune...which it is, I guess. D, obviously, is if you're T1 or LADA.
Why does it take 4 weeks to get the results back? Is this doctor an MD or a DO? (Sometimes DOs are trained with weird reasons for stuff.)
He's an MD he ordered the regular a1c and fasting BG, thyroid, b12 and some others..but he also ordered other vitamins that he says has to be sent to Toronto copper, zinc, and some others I just cant remember off the top of my head. Hmm I never knew that asthma was considered an autoimmune disorder. Interesting that endometriosis could be an autoimmune disorder...kinda makes sense though if it was. But he said he thinks the asthma and endo and bg are related to a digestive disorder. Your digestion had nothing to do with your lungs..or your reproductive system for that matter.
I thought that it was genetic and autoimmune, because part of the deal was the screwy genes being involved in the autoimmune attack thing. I should read a book or something because we talk about this stuff enough around here!!
I was the only T1 for pretty much my whole life but I learned recently of a distant cousin coming up with it and maybe somebody else, although she's "on hold" dx-wise, waiting for the met to kick in and be effective, or to see if it does.
There are some debates about poor digestion causing other issues. Among those are the "leaky gut" syndrome concerning a gluten sensitivity that does not occur as a result of Celiac disease.
Frankly, I don't believe any of it unless it's really, really well-documented. There's been some documentation for leaky gut, but I haven't seen enough reliable material to convince me. Regardless, leaky gut does not cause diseases but exacerbates existing issues (or helps exacerbate them enough to become noticeable). No matter your status, you definitely have some form of diabetes.
Now that I'm thinking about it, though, are you on oral steroids for your asthma? (Or inhaled, but specifically oral.)
No orals. I take ventolin (salbutamol) and advair sometimes if my asthma is really bothering me but unless its it’s really hot out or the pollen count is really high my asthma is pretty controlled. I was supposed to be put on oral steroids once for my sudden hearing loss but I refused.
My body completely freaked out at inhaled steroids. Even though high blood sugar isn't even listed as a side effect, mine went insane. I honestly believe that if it weren't for that, my blood sugar would've taken years to deteriorate to what it is now. (Then again, I'm completely atypical, and even my endocrinologist admitted it.)
Do you see a difference in your blood sugar on days when you take the advair?
Hi Jeannene: I read your personal diabetes history and IMO it screams monogenic diabetes (aka MODY). There is a great MODY group here on TuD and the Kovler Center is the "keeper of all things MODY" in the U.S. Why do I think MODY? Because of the strong family history without autoimmune diseases.
I have both Type 1 autoimmune diabetes (diagnosed at age 35, rapid onset) and Hashimoto's Disease (autoimmune hypothyroidism, diagnosed at about the same time as the T1). I only have one distant cousin who has Type 1, but Hashimoto's is rampant in my family (mother, grandmother, aunt, cousins).
Type 1.5 and LADA are just "slang" terms, not officially recognized terms. LADA is Type 1a diabetes, but slower onset and usually older age. Monogenic diabetes (MODY) is probably undercounted, because testing is so expensive.
Actually, a low fasting c-peptide test would probably suggest that this is not MODY, rather that she is a T1. As you have pointed out before, a significant number of women (perhaps 15%) who have GD go on to be diagnosed T1/LADA. Jeannene would not likely have been diagnosed with T1 15 years ago unless she had a really low c-peptide.
And in most forms of MODY, the fasting insulin production is "normal," but the response to meals is impaired. So the test recommended by Exeter is to test insulin production (via c-peptide) two hours after meal and if the insulin response to meals is impaired that is suggestive of MODY (most forms except MODY-2).
And as we have been discussing, we often make assumptions about so called T2 diabetes. T2 can run rampant in families with a much greater association than T1 and T2 isn't just about insulin resistance and being overweight. It is possible that Jeannene has a strong genetic family trait towards forms of diabetes that present with insulin deficiency. In either case, if you don't ask the question and test, you have no hope of having an answer.
