What is "Advanced Type 1 Diabetes?"


And you get college credit!


They say it to make you feel better about diagnosis. It’s a white lie when your world turns upside down and you are learning to inject yourself.


Starting to think all Endos should have diabetes. Not really but sometimes they are clueless. But as an RN, I see this a lot in the medical field. Too much emphasis on rote learning. Need to take individual into account. But life is good for this LADA. Take care.


So was I, even though I was 28. T1/T2 wasn’t standard nomenclature when I was dx’d in 1983. My Dr told me about it, because I was as much under the impression as anyone that it was something only kids got, but he explained that wasn’t the case and that’s why they were intending to change the terminology, though it was not yet standardized and he had to put it down as “juvenile type” in my record.

What’s really curious to me, as a semi-professional in etymology, is that the “juvenile” thing comes along really recently. It was never thought of as a specifically childhood disorder over most of the history of the disease. Our longterm member @Melitta has been studying this whole issue for a while, most recently in this thread. The earliest citation I’ve found for “juvenile diabetes” is in 1951, but it’s not clear when it actually came into use as a formal diagnostic term. Some people speculate that it was due to the influence of the JDRF, founded in 1970, though pinning that down etymologically with proper citations takes some library research I haven’t been able to make time for yet.

NOT that I mean to criticize you for using whatever term you prefer personally. It’s just that the effect of the term as a general matter has led to a lot of misunderstanding—and more critically, misdiagnosis—over the decades, persisting quite strongly in spite of the substitution of T1/T2, which was supposed to fix it. Obviously it hasn’t.


My BEST, most productive diabetes medical appointment ever was a consult with a nurse at a diabetes center that was … drum roll…please… a TYPE-1 DIABETIC herself! When I spoke, or responded to her Qs, she instantly understood, and when I asked her something she likewise understood exactly what I said.

PROOF that
it takes one, to know/understand one!


Maybe “advanced” could refer to some sort of alpha cell failure induced by decades of strong BG swings with heavy hypos. We know that frequent severe hypos can erode the body’s counterregulatory response. The result is that hypos become more and more severe. If alpha cells are exhausted as part of this process, then the body’s endogenous glucagon production is gone, meaning that an important part of the BG stabilization mechanism is gone.

The question of course is whether or not this will also happen to younger T1s who got diagnosed when BG meters, sensors, pumps, and insulin analogs were already well established. These probably tend to have less severe lows. Just think of how many lows might have happened because of the action profiles of basals like NPH or Lente.