What’s Your Diabetes “Type”? Type 1, Type 2, and LADA

When I was studying to become a dietitian and diabetes educator, I was taught that there were three main types of diabetes: Type 1, Type 2, and gestational. And that’s still true. But over the years, I learned that there are other, lesser-known types of diabetes, too. What do you know about Type 1.5? Or LADA? Or MODY? You may or may not have heard of these, but scientists and endocrinologists are getting a better understanding of these “other” diabetes types, and it’s probably a good thing for you to do, as well!

According to the American Diabetes Association (ADA), diabetes is “a problem with your body that causes blood glucose (sugar) to rise higher than normal.” This is a pretty straightforward definition, but the issue is that a number of factors can cause blood glucose levels to be higher than normal. And sometimes those factors aren’t that clear cut, even to health-care providers. Let’s take a closer look at the different diabetes types and their unique characteristics.

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Type 1 diabetes
Type 1 diabetes was formerly called “juvenile diabetes” or “insulin-dependent diabetes.” These two terms aren’t accurate because 1) Type 1 diabetes occurs in adults and 2) many people with Type 2 diabetes need to take insulin. So Type 1 it is.

Facts
• Type 1 accounts for only about 5% to 10% of diabetes cases.

• Seventy percent of Type 1 cases occur before the age of 30, but anyone at any age can get Type 1.

• Type 1 diabetes is an autoimmune disease in which the immune system turns on the body and attacks and destroys the beta cells (which make insulin) in the pancreas.

• The exact cause of Type 1 isn’t known — it could be autoimmune, genetic, or environmental factors, such as a virus, that trigger it.

• People with Type 1 must take insulin by injection or pump to survive.

• Symptoms of Type 1 include thirst, hunger, weight loss, frequent urination, extreme fatigue, slow healing wounds, numbness and tingling in the hands and feet, and blurred vision.

Type 2 diabetes
Type 2 diabetes was formerly called “adult-onset diabetes” or “non-insulin dependent diabetes.” These terms aren’t correct because children get Type 2 diabetes, and we know that many people with Type 2 need to take insulin.

Facts
• Type 2 diabetes is the most common type, accounting for 90% to 95% of diabetes cases.

• Type 2 diabetes has been steadily increasing in children over the past 20 years.

• About 80% of those with Type 2 are also overweight.

• In Type 2, the body either does not use its own insulin properly or it doesn’t make enough of its own insulin.

• About 40% of those with Type 2 will eventually need to take insulin because the body gradually stops making enough insulin.

• Type 2 diabetes is just as “serious” as Type 1 diabetes, meaning that if not controlled, it can lead to serious complications, such as eye, heart, and kidney disease and nerve damage.

• Type 2 can be prevented in many cases through weight control, healthful eating, and physical activity.

• Symptoms may be similar to those of Type 1, or there may be no symptoms at all.

Latent autoimmune diabetes of adults (LADA)
LADA is a fairly new term for a type of diabetes that is considered to be a form of slowly progressing Type 1 diabetes.

Facts
• LADA is often misdiagnosed as Type 2 diabetes because it’s usually diagnosed in adults over 30.

• LADA occurs due to an autoimmune response that destroys beta cells.

• It’s sometimes called “Type 1.5″ diabetes.

• This type of diabetes is very commonly misdiagnosed — many health-care providers don’t have the training to pick up on it sooner.

• LADA often “looks” like Type 2 diabetes because the pancreas initially still produces insulin.

• You may have LADA if you are lean, don’t have high blood pressure or high cholesterol levels, and have no family history of Type 2 diabetes but do have a family history of autoimmune disease (thyroid disease, rheumatoid arthritis, etc.).

• Initially, LADA can be managed with healthful eating, physical activity, and diabetes pills. Eventually though, the person will need to take insulin.

• If you think you may have LADA, ask your doctor to order a C-peptide test (a test that tells how much insulin you’re making) and a glutamic acid decarboxylase (GAD) antibody test. If it’s positive, it means that your body is attacking itself, and you should ask your primary-care doctor to refer you to an endocrinologist.

More diabetes “types” next week!

  • scott

    Great info.
    Explains a lot

  • Joe

    Is it possible to be affected by more than one kind? What if you have Metabolic Syndrome *and* a history of autoimmune disorder(s)?

  • Onoosh

    Thank you for including LADA. We “1.5s” are usually overlooked in discussions of Diabetes, and you’re right about its misdiagnosis. It was only when my blood sugar kept rising, and my weight falling, on drugs only that I did some research for myself. I discovered LADA, convinced my doctor it was worth doing the appropriate tests, and we found out that I was what I continue to call–despite my nurse’s shaking her head and smiling–“Type Weird.” ;-)

    I have managed my condition (which continues to try to manage me!) so far with slow-release insulin, 500mg of Metformin, a very low carb diet, and exercise. We have no clue what led to my Diabetes, since no one in my immediate family had ever had it before me, but I’m glad I was proactive in looking for such answers as there are.

    Thank you again for discussing an often-overlooked form of our mutual–all types–medical challenge.

  • Vickie Jackson

    Great article, going to pass this on to as many as I can. What about the current misinformation, however, being promoted by many stating that diabetes (not even specifying which type) can be reversed and totally cured within 2 weeks or less, of course by buying their products. This is so dangerous! Hope you will write something about that soon.

  • Sherrie

    I too was misdiagnosed as a Type 2 diabetic. I did some research, and realized that I didn’t fit the Type 2 profile at all. Nobody in my family was diabetic, and I exercise every day (water aerobics, cycling, machines at the health club, walking, stretching)Did some more research and discovered Type 1.5. I do have autoimmune diseases (CFS/ME/FM), which run in my family.

    The thing about Type 1.5 is that it seems harder to control, because my glucose levels are erratic. They correspond more to how I feel that day in general than to my food intake. With Type 1.5, the autoimmune disease is essentially attacking my pancreas. On a good day, not so much, but on a bad day, no matter how well I eat, my levels are all over the place.

    I’m taking Metformin, Januvia, and Glyburide, and am doing pretty good at keeping it under control. My A1c is usually 6.4 or 6.5.

  • Henry

    I sometimes wonder if LADA is the type of diabetes I have. I was diagnosed Type 1 at age 22. The reason I wonder if LADA or 1.5 is what I have is that my onset of diabetes was slow. I had symptoms, thirst, tiredness and weight loss for several months before diagnosis. Also, my body kept making some amount of insulin for several years after diagnosis. Not sure it really matter, never did have any c-peptide or GAD tests done.