Type one-and-a-half diabetes

Is there really a physiological difference between T1 and T1.5?  It seems that the main difference that the age of onset is different.  The scenario where a T1.5 goes on insulin a year or so after the inital T2 diagnosis seems pretty analogous to the "honeymoon" period a lot of T1's go thru

Hi Bill: I just wanted to comment re my thoughts about the differences between type 1.5 diabetes and LADA from the pediatric perspective. In our practice at Children's National, we deal with multiple types of diabetes: type 1 (autoimmune), type 1 (idiopathic), type 2, cystic fibrosis related diabetes, medication induced diabetes (steroids, chemotherapy) and type 1.5 diabetes. We define type 1.5 diabetes as characteristics of both type 1 and type 2 DM. Typically, our patients present phenotypically like type 2 (high BMI, obese, acanthosis nigricans etc.) along with autoimmunity with prescence of GAD-65 antibodies. They even can present in DKA. We try to treat with oral medication such as Metformin after stabilization; but often have to add insulin. So, it would seem to me that LADA would tend to present in the adult population whereas type 1.5 could present in either adult or pediatric patients. Just my thoughts.

BTW, I love your posts.

Fran Cogen

As a LADA patient, thanks for writing about this very important topic, as LADA tends to be overlooked!

Here is a video about LADA (or type 1.5 diabetes) I did a while back that goes well with your great post.

I was diagnosed with T2 May of '07 wound up in the ER 07/08 and was told by the ER DR. that I was a T1.5  I thought the DR was crazy at first and then he explained exactly what you said in your article. I have been to the DRs Office many times since the ER and when I am asked what Type I am I say T1.5 and they have said to me there is no such thing, I am very confused and when thinking of all of the complications I have had in my 38 years I wonder if I have been Diabetic all along.  When ever I went to the DR my Husband would ask if they were going to test me for Diabetes and the DRs would say mind your business she not young enough for T1 and not old enough for T2 and not heavy enough for T2.  I am now on 5 insulin shots per day two shots of levemir and 3 shots of Novolog and I am still having a very hard time. Since I was started on the insulin I am gaining weight. I am very unhappy with the lack of knowledge from the DRs including the Endos

Just to comment, I was diagnosed with type two in Jan. 2005.   I was 59 years old, and didn't fit the profile of type 2. My AIC just kept going up and I didn't respond much to oral drugs.  I had a heart attack in May 2007. , then started Byetta,  which made me very sick.  The endocrinologist started me on insulin in 2008,and just now drew blood for GAD antibodies, which were positive. He sent me a copy with the notation: elevated antibodies against the insulin secreting cells of pancreas confirms type 1 diabetes.  I'm glad to know what I am, finally.

My mother was also diagnosed with type 1 at age 50 in 1970 by an endo from the international diabetes center in Minneapolis.  Thanks