A bridge between type 1 and type 2 diabetes
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May 2010 — I can barely remember when I first heard of it: "LADA? What is that?" It was back in 2007, when we launched our diabetes social network. I had been living with what I considered to be type 1 diabetes. But, let me start from the beginning…
In mid-2002, I showed up to my doctor's office for my scheduled annual checkup. We went over my lab work and he pointed his finger at the fasting blood glucose number: "Too high!" or something to that extent, he said. He put me on the Atkins diet and summoned me to his office a few weeks later. Sure enough, I had lost weight , but the number still refused to go down: "You have diabetes."
He sent me home that day with a prescription that combined diet, exercise and the first of many attempts to help lower my blood sugar through oral drugs. I took his advice to heart: I started training for a half marathon to help raise funds for diabetes and to help lower my blood sugar… and lower it I did! For the months I was training, the treatment "worked" (I would later learn that my pancreas was still not completely dead, so that sure helped too!) But when the race was over and I wasn't running as much every week as I was prior to it, reality set in.
I couldn't keep my blood sugars under 150 no matter how hard I tried. After exhausting every possible oral-based therapy he had in his arsenal for people with type 2 diabetes, my doc gave up and referred me to an endocrinologist. My endo tested me for GAD antibodies and C-peptide levels, the two markers that accompany people with type 1 diabetes. I had high levels of GAD antibodies (meaning my body was "fighting off" beta cells in charge of making insulin in my pancreas) and low C-peptide levels (meaning my pancreas was not producing enough insulin any more). So I heard the new diagnosis: "Type 1 diabetes." It was early 2003.
Starting then, I began taking insulin shots, more specifically shots of peakless basal insulin every night. Over time, I started also taking rapid acting insulin shots. The switch from pills to shots was not an easy one and it gave me a newfound respect for people who have grown up taking shots since they were kids. I now was "one of them" or so I thought… which takes me back to the beginning of this story.
I 2005 I started wearing an insulin pump, continuing to ride the therapy path that many people with type 1 diabetes take. Then finally, in 2007 I realized that I was not alone : there are actually lots of people who lived with this crazy little thing called LADA (Latent Autoimmune Diabetes in Adults), also called type 1.5 diabetes by some. This numerical type, while rejected by some, I think conveys something that makes people with LADA unique in at least two ways:
- Many of us were misdiagnosed as having type 2 diabetes because we were first diagnosed as adults.
- Although we don't know how it feels to go through childhood and adolescence facing the emotional challenges that an insulin-dependent lifestyle imposes, we now live our lives like others with type 1 diabetes.
If nothing else, I have come to find that people with LADA serve as a bridge of sorts that helps connect the type 1 and type 2 worlds.
Do you have LADA too? I would love to hear your story on Twitter @askmanny or you can also send me a send me a private message.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Well maybe not so much a furor as a controversy. The question, bluntly put, is whether or not a single HbA1c reading should be sufficient and adequate to diagnose diabetes — and whether the conditions under which the test was conducted should have any bearing on the diagnostic or non-diagnostic value of the test. The lede from