Understanding the Different Types of Diabetes (Continued)
Discovered relatively recently, latent autoimmune diabetes in adults (LADA) – sometimes called type 1.5 – accounts for an estimated 10 percent of people with diabetes. LADA has been characterized as a slowly progressing version of type 1, with insulin dependence usually developing over a period of about 6 years (rather than the immediate dependence at the time of diagnosis seen in people with type 1). LADA is considered to be closer in nature to type 1 than type 2 because people with LADA have the antibodies characteristic of type 1 in their blood. People with LADA tend to have a lower body mass index (BMI) than people with type 2, and are less likely to be able to manage their blood sugar levels with diet changes and oral medications. Research about the definition and development of LADA is ongoing.
Atypical, or ketosis-prone type 2, diabetes
Atypical diabetes is a rare form of diabetes. Atypical diabetes, like type 1, is diagnosed when an individual presents with diabetic ketoacidosis. However, unlike type 1, people with atypical diabetes spontaneously go into remission and become insulin-independent, usually a few weeks after being diagnosed. They also do not have the antibodies found in people with type 1. A dramatic decrease in the amount of insulin needed in the weeks following diagnosis may be a sign of atypical diabetes. (This may also be a sign of the honeymoon period in type 1). Many people with atypical diabetes relapse within 2 years of diagnosis and require oral medications or low dose insulin therapy to manage their blood sugar. Others, however, remain insulin-independent for the rest of their lives.
Other types of diabetes
There are also other types of diabetes, which account for less than 5 percent of people with diabetes. These include diabetes as the result of surgery, infections, and disease, as well as maturity-onset diabetes of youth (MODY). Click here for more information on MODY.
Why does it matter?
It is important to know whether you have type 1, type 2, or something else because the treatment strategies for each differ. Some studies suggest that early insulin treatment in people with LADA may help keep beta cells alive and functioning for longer. Whereas people with type 1 need to take insulin, people with type 2 may not. Type 2 diabetes can usually be managed with lifestyle changes and, if needed, medication. The ADA recommends that all people diagnosed with type 2 be started on Metformin, unless contraindicated. However, it is possible to reduce or eliminate the need for medications with lifestyle changes. Because type 2 is progressive, many people who start out on oral medications may eventually need insulin therapy. This does not mean that you have failed at managing your diabetes, or that your type 2 has become type 1. Instead, it simply means that your type 2 diabetes has progressed to a more advanced stage.
Knowing how your disease is affecting your body is important, and can help you better manage your diabetes. Speak with your healthcare provider if you have questions about what type of diabetes you have.
Reviewed by Joy Pape, RN, BSN, CDE, WOCN, CFNC. 2/13
- 1 – American Diabetes Association. Standards of Medical Care in Diabetes – 2012. http://care.diabetesjournals.org/content/35/Supplement_1/S11.full. (Accessed 4/12).
- 2 – Bagust A, Beale S. (2003). Deteriorating beta-cell function in type 2 diabetes: a long-term model. QJM: An International Journal Of Medicine 96(4).
- 3 – Centers for Disease Control and Prevention. Diabetes: success and opportunity for population-based prevention and control at a glance 2011. http://www.cdc.gov/chronicdisease/resources/publications/AAG/ddt.htm. (Accessed 5/12).
- 4 – Gebel E. (2010). The other diabetes: LADA, or type 1.5. Diabetes Forecast.
- 5 – Imran S, Ur E. (2008). Atypical ketosis-prone diabetes. Canadian Family Physician 54.
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