We tend to lump things together.
At first there was just Juvenile Diabetes or Sugar Diabetes.
Then (they) renamed them to Type 1 and Type 2.
About 20 years ago the terms Type 1.5 (which later was renamed LADA) and Type 3 (Diabetes with Diabetes Dementia - but that term is still not fully accepted yet) were added.
But is Type 2 simply Type 2?
The answer is NO. Not all Type 2's are the same and we can be "sub-grouped".
Here is the recognized "sub-types" of Type 2:
Severe insulin-deficient… read more
@A DiabetesTeam Member the reason all those drug classes (GLP-1/DPP-4) say not to use if you are Type 1 is because they try to work by Improving your own insulin production.
If you are Type 1 your production is (zero) because the disease killed the cells, so there is nothing for those drugs to do/help.
But there is nothing I have read that would say they would cause a "negative/dangerous" effect.
In fact there is a version of Trulicity/Ozempic that is used purely for weight loss in Non-Diabetics and it is a way higher dose then what is prescribed to Type 2's.
If you have LADA then Trulicity would be a "guideline medication" as long as you still have some (beta cell) function.
And exactly - you do have to trust the Doc - question the decisions absolutely - they should be able to explain "why" they picked that drug.
My wife, who is on a truckload of drugs for her parkinson's, developed some neuropathy a couple of years back and since I dispense all of her meds her Doctors "talk to me" when it comes to the medication decisions.
Anyhow, I was sitting with the Doc while they were trying to find something that would alleviate the nerve pain but "wouldn't" interact with all the other stuff she was taking.
It was actually a fascinating process. It's all computerized now - they poke in what they want to treat and it lists pretty much everything that could be prescribed - most popular first - then next column has other med interactions and then list of most common side effects.
And they just start at the top and keep moving down until there is no contra-indications. She ended up on Lyrica but that was after he discarded 6 or 7 others because they didn't fit with her condition or meds.
With them concerned with malpractice, I am pretty confident that if they prescribe anything, they have at least read the "highlights" of what they are writing the prescription for...
@A DiabetesTeam Member I found information posted on the website of the Salk Institute.
So far they have only being doing studies is rats/mice (to try and treat).
Based on some other studies they have found that (some) more elderly (human) patients that present with Type 2 actually don't have insulin resistance but they have an abnormally high T-Cell count in their body fat (which is actually what they are calling Type 4)
In comparison, Type 2's have a low T-Cell count in body fat.
So they gave the (rats) the same problem and the (Type 4) developed and then they corrected the T-Cell count and the symptoms went away.
They did try normalizing the T-Cell count in Type 2's but it had zero effect (too bad).
But it doesn't sound like any "human trials" are underway "yet".
@A DiabetesTeam Member I had never heard the term "Type 4" - thanks for posting it up.
I can see there has been some research done on this already.
It looks like they are trying to determine if Glaucoma is caused by a form of "Diabetes in the Brain" and Insulin may be a treatment/management tool to deal with this.
Quite interesting - saw a (thread) in the summary of the study that mentioned Insulin is also be trialed as a treatment for Alzheimer's.
Thank-you - you have led me to a bunch more reading on something that sounds quite interesting.
@A DiabetesTeam Member if you have the auto-immune anti-bodies, which is what they test for, given your age you would be diagnosed with LADA (Latent Auto-immune Diabetes in Adults).
LADA is not as "vicious" as Type 1 which totally takes out your pancreas in days or a couple of weeks, rather, it is a slower progressing version that can take months or even years to totally wipe out your ability to produce your own insulin.
It is regularly "misdiagnosed" as Type 2 (because of the slow onset) and at least for a while the (standard) treatment is to treat it as if it was Type 2.
If you have it, once it fully progresses then yes, you would be treated as a Type 1 - insulin treatment would be the only option.
It is not exactly the same auto-immune disease as is seen in children. Type 1 onsets typically in 7 to 9 year old and then again at age 13 or 14 (one theory I read that sounds plausible - because they still don't know Why, is that occurs around the same time as growth spurts).
Last I read there was about 5 different anti-bodies (or maybe gene mutations - I don't do a lot of reading on Type 1) that can (show) Type 1 but there is currently only 1 to confirm LADA.
When they were first isolating LADA they called it Type 1.5 since it had characteristics of both Type 1 and 2. Once they isolated the anti-body and knew then that it is an auto-immune (and not metabolic) condition they renamed it LADA.
It is estimated that as many as 30% of those in their 20's and early 30's that are diagnosed at Type 2 actually have LADA and more recently they have been seeing it at later ages (probably always existed but they never looked for it).
If you have "Type 2" and stops responding to the standard treatment regimen with no mitigating reasons (other diseases or infections) - that is an indicator to test for LADA
The Doc may also do a C-Peptide test which measures how much insulin you are producing (compared to some normal baseline). So even if you have the anti-bodies they can tell how far advanced it is which can help with a treatment plan - whether you continue to treat as a Type 2 "for now" or if Insulin would be the better option going forward.
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