Like type 1 diabetes, type 1.5 diabetes occurs when the immune system attacks the cells in the pancreas that produce insulin. Photo: Shutterstock.com
While you’re probably familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes.
Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of both type 1 and type 2 diabetes.
More people became aware of this condition after Lance Bass, best known for his role in the iconic American pop band NSYNC, recently revealed that he suffers from it.
So what is type 1.5 diabetes? And how is it diagnosed and treated?
There are several types of diabetes
Diabetes mellitus is a group of diseases that arise when blood glucose (sugar) levels are higher than normal. There are actually more than ten types of diabetes, but the most common are type 1 and type 2.
Type 1 diabetes is an autoimmune disease in which the body’s immune system attacks and destroys the cells in the pancreas that produce the hormone insulin. This results in very little or no insulin production.
Insulin is important for transporting glucose from the blood into cells to be used as an energy source, so people with type 1 diabetes need daily insulin medication. Type 1 diabetes usually appears in children or young adults.
Type 2 diabetes is not an autoimmune disease. Rather, it occurs when the body’s cells become resistant to insulin over time and the pancreas can no longer produce enough insulin to overcome this resistance. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.
Type 2 is most common in adults, but is increasingly seen in children and young people. Treatment may include behavioral changes, such as nutrition and physical activity, as well as oral medications and insulin therapy.
How is type 1.5 diabetes different from types 1 and 2?
Like type 1 diabetes, type 1.5 diabetes occurs when the immune system attacks the cells in the pancreas that produce insulin. But people with type 1.5 diabetes often don’t need insulin right away because their disease develops more slowly. Most people with type 1.5 diabetes will need to use insulin within five years of diagnosis, while people with type 1 diabetes usually need it from the time of diagnosis.
Type 1.5 diabetes is usually diagnosed in people over the age of 30, probably due to the slow-progressing nature of the disease. This is older than the typical age for type 1 diabetes, but younger than the usual age of diagnosis for type 2 diabetes.
Type 1.5 diabetes shares genetic and autoimmune risk factors with type 1 diabetes, such as specific genetic variants. However, evidence has also shown that it can be influenced by lifestyle factors such as obesity and physical inactivity, which are more commonly associated with type 2 diabetes.
What are the symptoms and how is it treated?
Symptoms of type 1.5 diabetes vary greatly from person to person. Some people have no symptoms at all, but in general, they may experience the following symptoms:
- increased thirst
- frequent urination
- fatigue
- blurred vision
- unintentional weight loss
Type 1.5 diabetes is usually initially treated with oral medications to keep blood glucose levels within a normal range. Depending on glucose control and the medication they are taking, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.
When average blood glucose levels rise beyond the normal range, even with oral medications, treatment may progress to insulin. However, there are no universally accepted management or treatment strategies for type 1 diabetes.5
Type 1.5 diabetes is often misdiagnosed
Lance Bass said he was initially diagnosed with type 2 diabetes, but later learned he actually had type 1.5 diabetes. This isn’t an entirely uncommon occurrence. It’s estimated that type 1.5 diabetes is misdiagnosed as type 2 diabetes between 5 and 10 percent of the time.
There are a few possible reasons for this.
First, to accurately diagnose type 1.5 diabetes and distinguish it from other types of diabetes, special antibody tests (a type of blood test) are required to detect autoimmune markers. Not all health care professionals necessarily order these tests routinely, either because of cost concerns or because they are not aware of them.
Secondly, type 1.5 diabetes is commonly found in adults, so doctors might mistakenly assume that a person has developed type 2 diabetes, which is more common in this age group (while type 1 diabetes typically affects children and young adults).
Third, people with type 1.5 diabetes usually initially produce enough insulin in their bodies to control their blood glucose levels without needing to start taking insulin. This can make their condition look like type 2 diabetes, in which people also produce some insulin.
Finally, because type 1.5 diabetes has symptoms similar to type 2 diabetes, it may initially be treated as type 2.
We are still learning about type 1.5
Compared to type 1 and type 2 diabetes, there has been much less research into the frequency of type 1.5 diabetes, especially in non-European populations. In 2023, type 1.5 diabetes was estimated to account for 8.9 percent of all diabetes cases, which is similar to type 1 diabetes. However, we need more research to get accurate figures.
Overall, there has been limited awareness of type 1.5 diabetes and unclear diagnostic criteria that have slowed our understanding of this condition.
A misdiagnosis can be stressful and confusing. For people with type 1,5 diabetes, receiving a misdiagnosis of type 2 diabetes can mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a higher chance of complications in the future.
Getting the right diagnosis helps people get the most appropriate treatment, save money, and reduce the suffering caused by diabetes. If you have symptoms that you think may indicate diabetes or are unsure about a diagnosis you’ve already received, monitor your symptoms and talk to your doctor.
First published: August 27, 2024 | 09:47 IS
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