I love the word “idiopathic.” Besides making nice sounds as it rolls off one’s tongue (id-dee-oh-PATH-ick), its definition is positively murky: it’s used to describe a disorder of obscure or unknown cause. At one world-famous authority, it’s stated that the word comes from the Greek:  idios (one's own) + pathos (suffering). Yes, that’s definitely Greek to me.

Down to business. I received an e-mail which read:   “I saw [the following] information in a blog, and wondering about it? It is LADA relabeled? Is her doctor right?” The blog stated:

• “I have Idiopathic Type 1 diabetes, or Type 1b diabetes. I had never heard of this before the doctor called to give me my test results from last week. I had been wondering and wondering about it since last Friday and finally, during lunch, the doctor called to tell me that I have Type 1b diabetes.”

Well, first of all, the American Diabetes Association hasn’t updated its nomenclature to include using letters for subtype designations (e.g., describing a form of diabetes as  “type 1A” or “type 1B”). (BTW, I’ll go with the majority usage that I find on the ‘net and use capitalized letters when discussing these presumed subtypes, and not put a space between the number and the letter.)

Some websites have taken it upon themselves to generate their own definitions. For instance, one website states with pseudo-authoritative confidence that “Type 1 B diabetes is also referred to as idiopathic diabetes, or diabetes of unknown origin. This form of type 1 diabetes is not autoimmune in nature, and tests for islet cell antibodies will come up negative. People with type 1 B have an insulin deficiency and can experience ketoacidosis (a high blood sugar emergency), but their need for insulin injections typically waxes and wanes over time. Patients of African, Hispanic, or Asian descent are more likely to develop type 1 B diabetes.” But that website offers no authorship information whatsoever, and is therefore subject to the usual rule of the Internet: when in doubt, don’t trust information on the ‘net.

The “official” descriptions of various varieties of diabetes mellitus as promulgated by the American Diabetes Association are in a position statement titled Diagnosis and Classification of Diabetes Mellitus. 

As I mentioned recently, the ADA lists type 1 (previously referred to as insulin-dependent diabetes  or juvenile-onset diabetes) and type 2 (non–insulin-dependent diabetes or adult-onset diabetes), and other varieties of diabetes, but none of the others were deemed worthy of having a name that includes “Type-whatever-number-is-next.” Nor has the ADA used letters for subtypes (such as “1A” or “1B”).

But, importantly, in their discussion of what they call type 1, the ADA has a paragraph as follows: