Question: Is there such a thing as “type 1.5 diabetes”? I have heard of type 1 diabetes and type 2 diabetes, someone recently told me they had type 1.5. Are they making this up, or is it for real?
Answer: Yes, type 1.5 diabetes is a real condition, although it is far less often diagnosed. It is also called slow-onset type 1 diabetes or latent autoimmune diabetes in adults (LADA).
This category arose after doctors noticed that there was a group of diabetics that did not fit the physical profile or the treatment profile of either type 1 or type 2 diabetics.
Type 1 diabetes goes by many names, such as insulin-dependent diabetes mellitus or juvenile diabetes. This form of diabetes most often starts during childhood, and nearly always before the age of 30. Type 1 diabetes is a lifelong condition in which the pancreas stops producing insulin, which is necessary for the body to process glucose, one of its main energy sources. A Type-1 diabetic must instead take insulin to control blood sugar levels.
Meanwhile, type 2 diabetes is variously called non-insulin-dependent diabetes mellitus, or adult-onset diabetes. This type of diabetes is much more common that type 1 diabetes. With type 2 diabetes, the pancreas does produce some insulin, but it either does not make enough insulin to effectively regulate blood sugar levels or the body has trouble processing the insulin the way it should. Most type 2 patients can control their blood sugar levels for many years with a combination of oral medications, dietary changes and physical exercise.
Before it received its own diagnosis, type 1.5 diabetes was considered an atypical presentation of type 2 diabetes. Even now, it is estimated that 15 to 20 percent of people diagnosed with type 2 diabetes actually have type 1.5 diabetes. However, both the physical characteristics of people with type 1.5 diabetes and the symptoms of the disease are very different from those of type 2 diabetes.
Type 2 diabetics are usually overweight, with a BMI over 30, high blood pressure and elevated triglycerides. And, although their cells do not respond as they should to insulin, their blood sugar levels do respond to treatment with oral medications.
The typical patient with type 1.5 diabetes is instead slender and fit. Type 1.5 diabetics appear to respond to oral medications at first because their immune system initially produces helpful antibodies. But these eventually fail, and instead insulin treatments become necessary to control blood sugar levels.
About half of the people with Type 1.5 diabetes require insulin four years after diagnosis, while a Type 2 may not never need insulin, or not for ten years or more.
Despite the additional maintenance required with insulin treatment, the major advantage to type 1.5 diabetes is that it does not carry the increased risk for heart disease that comes with type 2 diabetes.
