I was diagnosed a few months ago and I’m still confused about some things. Recently, I met 2 people who told me that they were type 1, but that they were able to control their BG without insulin for years (using diet/exercise or oral meds). They are both slim/athletic and diagnosed around their 30’s. The nurses in the hospital told me that type 1 means that I would die without insulin. Is it possible for someone to have type 1 and control their BG for years without insulin?
In some cases of LADA, especially age ranges and physical characteristics like you describe, the “honeymoon period” can extend for many years. During the honeymoon bg control may well be accomplished without insulin.
Me, I was diagnosed at age 14, and had a brief honeymoon (about a week) nearly a year after diagnosis where my bg’s were controlled OK without insulin.
Wow… they were lucky. My son was diagnosed 11/14/09 and his honeymoon period where he still made some insulin was pretty much over in a month. However at diagnosis he needed insulin and never has been w/out it since.
I’m fairly sure they would die… unless like they have stated your in a permanent honeymoon phase or your reallytype 2… there’s no way to live without insulin… believe me millions of diabetics would loveee to take no shots LOL
this might be a stupid question, but is LADA considered to be type 1?
The awareness of LADA in the medical community was nonexistent 20 or 30 years ago and back then most of then would’ve been diagnosed as “adult onset insulin dependent” or later on “type 2 insulin dependent”. The awareness is far from perfect today but slowly improving.
Due to the stigma of diabetes, back in the stone knives and bearskins days diagnosis was often done too late, and the categorization was often done favoring the least stigmatized category (e.g. regarding “insulin dependence” or later “Type 1” as a last resort). These attitudes still persist today but with different twists, thus you see a lot of folks using terms like LADA or “Type 1.5”.
The NIDDK defines LADA as “a condition in which Type 1 diabetes develops in adults.”
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (Diabetes Care, Volume 30, Supplement 1, January 2007) does not recognize the term LADA; rather, the Expert Committee includes LADA in the definition of Type 1 autoimmune diabetes (“Type 1 diabetes results from a cellular-mediated autoimmune destruction of the beta-cells of the pancreas. In Type 1 diabetes, the rate of beta-cell destruction is quite variable, being rapid in some individuals (mainly infants and children) and slow in others (mainly adults).”)
I think those two people are confused. I was confused once. I was told I was a type 1 insulin dependant diabetic when I was first diagnosed. All the test indicated that I was a type 1. A year later I was off of insulin and was on nothing for 2 years and now on oral meds and excercise. What am I today, I am assuming type 2. If I would not ask I would of thought I was a type 1 who does not need insulin. I guess things change and I think sometimes doctors dont even tell you what type you are. Some people just make assumptions on their type based on what they read.
Personally I dislike labels (be they “juvenile diabetes” or “adult diabetes” or “Type 1” or “Type 2” or “LADA” or “Type 1.5”) but for better or worse we live in a world where a label is applied and folks get confused if not all the connotations of the label are true all the time.
I am somewhat resigned to the fact that at least in the US Medical system, having the right label or ICD code will help you get the most appropriate care. I’ve lived through at least one major shake-up in labeling (it was “juvenile diabetes” and “adult diabetes” when I was diagnosed 30 years ago, but still today I have health care providers who are confused because I’m Type 1 = Juvenile diabetes, but I’m not a kid anymore, in fact my hair is definitely gray and maybe in a couple of years I’ll have grandkids! Sadly lots of T1’s from my generation did not survive to adulthood.) But everyone should get the most appropriate care even if they don’t fit into the simplistic categories.
Quite simply NO it is not possible. These people are not type 1 if they are not on insulin
I am in the honeymoon stage diagnosed in March this year my Endo put me on insulin because it would help my pancreus. So I might be in the stage a lot longer than taken meds. I had a few lows but my A1C readings are good,But don’t forget diet and exercise . LADA T1 is some times mistaken for T2 ,
I now use a insulin pump all is great so far.
we should label this situation as the Halle Berry syndrome
I agree they are T2 not T1 or T1.5
It sounds like they were not truely type one rather what has become known as type 1.5 which is either LADA or another one that I can’t remember. But in answer to your question yes it is possible .
It’s not really related to what you said, but I was diagnosed with gestational diabetes during a pregnancy (with BG’s in the 400’s and higher), and after my baby was born I was told NOT to test and NOT to take any more insulin for SIX WEEKS! So of course because I didn’t have an RX for strips I didn’t test. I have no idea what my BG had been running, but I failed the GTT they gave me by a very large margin… then I was told by the doctor my OB referred me to that I could treat it with oral meds… that obviously didn’t work.
So I went without insulin for a while, and I didn’t die, and I didn’t go into DKA… I was in what I believe was a strong honeymoon. I have never truly considered myself LADA though, as that’s not what I was ever diagnosed with. Antibody testing (after I had already begun using insulin again) confirmed that I am definitely a T1.
Thanks everyone! this is good to know. I had never heard of LADA or type 1.5 before. It is kind of confusing. I definitely know that I can’t control my BG with diet and exercise alone, and it made feel bad when they said I could.
T1 = insulin dependent. That’s our story. I don’t make any insulin. T1s don’t do oral meds because they aren’t effective with us. Without taking insulin I would die. One thing I’ve found out about medical professionals is that many times they don’t understand what’s going on anymore than most folks when it comes to diabetes. It’s rather shocking.
That was wrong. That kind of thing makes people think that if they need the meds they are somehow failing at good care. Your insulin needs don’t mean that you aren’t doing it right, it means that your body requires it. It is hard enough to do all of this without people giving you misleading ideas that make you feel bad about yourself.
Ilana, are you seeing an endocrinologist (diabetes specialist)? An endo is more likely to give a correct diagnosis and to prescribe the best treatment.
There is research being done on long term type 1’s at the Joslin Diabetes Center, in Boston. They have examined 600+ type 1 diabetics who have lived with their diabetes for 50 or more years, and have no serious complications. Some of the participants were found to still have some living Beta cells, and were producing a small amount of insulin. That means they also had some C-peptide, which helps protect us against diabetes related complications. The study is scheduled to conclude in April, 2011. Dr King, the doctor in charge of the study, hopes to find the factor(s) responsible for the long, healthy lives these participants have led. If the factor(s) are revealed, then a treatment might be found that would help younger and more recently diagnosed type 1’s to also enjoy long, healthy lives. I participated in Dec, 2009, and have been type 1 for 64 years (it will be 65 years on Sept 15).
Excuse me, please don’t make definitive statements without learning more. I am LADA. I am Type 1. I had good numbers for about 14 months with oral meds. As stated above, many of us have LADA which is a SLOWER ONSET form of Type 1. It is bad enough when the medical profession dismisses us.
There’s really only three possibilities for this:
- They are really MODY, and not just a Type 1;
- They are Type 1.5, with a much, much slower onset and a very long honey moon phase, and maybe even with some insulin resistance (which sometimes happens in Type 1); or
- They are confused, and are really Type 2’s who were told they are Type 1 simply because they are fit and slim.