Why Telomeres Shorten, & What Can Be Done About It
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Telomeres are protective caps at the ends of our DNA, similar to the plastic tips on shoelaces (there’s a repeated “junk DNA” string, TTAGGG in humans, kept safe in a sheathe, which made of shelterin, a protein complex).
They prevent our genetic material from becoming damaged or tangled. However, each time a cell divides, telomeres get a little shorter because the copying process isn’t perfect (DNA polymerase can’t replicate everything inside the sheathe, because it is too well-protected).
So, how do we deal with this?
Lacing up for long life
An enzyme called telomerase (discovered as recently as 2009 by Nobel Prize-winning scientists Dr. Elizabeth Blackburn et al.) can rebuild telomeres. It has two main parts: one part1 that makes new DNA and another part2 that acts as a guide. Most cells don’t produce enough telomerase, so telomeres still tend to shrink over time.
1 TERT (Telomerase Reverse Transcriptase), which synthesizes telomeric DNA
2 TERC (Telomerase RNA Component), which serves as a template
When telomeres become too short, cells stop dividing. Some cells may enter a damaged state (e.g. senescent “zombie” cells) or die. In some cases, cells bypass this limit by reactivating telomerase, which can lead to cancer.
Studies on mice show that when telomerase is missing, they age more quickly and struggle to repair tissues. When telomerase is restored, aging effects are reversed. Human research also links short telomeres to age-related diseases like immune system decline and organ damage.
Researchers have already found some ways to slow aging by:
- Activating telomerase (e.g. with small molecules like TA-65).
- Gene therapy to transiently express telomerase.
- Stabilizing TERC RNA component to prevent degradation.
However, increasing telomerase too much could raise the risk of cancer. So, it’s a bit of a juggling act yet.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
Fisetin: The Anti-Aging Assassin ← kills senescent cells, meaning newer cells are copied rather than older ones, resulting in copied cells with less DNA damage
Take care!
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They Were Injured at the Super Bowl Parade. A Month Later, They Feel Forgotten.
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KFF Health News and KCUR are following the stories of people injured during the Feb. 14 mass shooting at the Kansas City Chiefs Super Bowl celebration. Listen to how one Kansas family is coping with the trauma.
Jason Barton didn’t want to attend the Super Bowl parade this year. He told a co-worker the night before that he worried about a mass shooting. But it was Valentine’s Day, his wife is a Kansas City Chiefs superfan, and he couldn’t afford to take her to games since ticket prices soared after the team won the championship in 2020.
So Barton drove 50 miles from Osawatomie, Kansas, to downtown Kansas City, Missouri, with his wife, Bridget, her 13-year-old daughter, Gabriella, and Gabriella’s school friend. When they finally arrived home that night, they cleaned blood from Gabriella’s sneakers and found a bullet in Bridget’s backpack.
Gabriella’s legs were burned by sparks from a ricocheted bullet, Bridget was trampled while shielding Gabriella in the chaos, and Jason gave chest compressions to a man injured by gunfire. He believes it was Lyndell Mays, one of two men charged with second-degree felony murder.
“There’s never going to be a Valentine’s Day where I look back and I don’t think about it,” Gabriella said, “because that’s a day where we’re supposed to have fun and appreciate the people that we have.”
One month after the parade in which the U.S. public health crisis that is gun violence played out on live television, the Bartons are reeling from their role at its epicenter. They were just feet from 43-year-old Lisa Lopez-Galvan, who was killed. Twenty-four other people were injured. Although the Bartons aren’t included in that official victim number, they were traumatized, physically and emotionally, and pain permeates their lives: Bridget and Jason keep canceling plans to go out, opting instead to stay home together; Gabriella plans to join a boxing club instead of the dance team.
During this first month, Kansas City community leaders have weighed how to care for people caught in the bloody crossfire and how to divide more than $2 million donated to public funds for victims in the initial outpouring of grief.
The questions are far-reaching: How does a city compensate people for medical bills, recovery treatments, counseling, and lost wages? And what about those who have PTSD-like symptoms that could last years? How does a community identify and care for victims often overlooked in the first flush of reporting on a mass shooting: the injured?
The injured list could grow. Prosecutors and Kansas City police are mounting a legal case against four of the shooting suspects, and are encouraging additional victims to come forward.
“Specifically, we’re looking for individuals who suffered wounds from their trying to escape. A stampede occurred while people were trying to flee,” said Jackson County Prosecutor Jean Peters Baker. Anyone who “in the fleeing of this event that maybe fell down, you were trampled, you sprained an ankle, you broke a bone.”
Meanwhile, people who took charge of raising money and providing services to care for the injured are wrestling with who gets the money — and who doesn’t. Due to large donations from celebrities like Taylor Swift and Travis Kelce, some victims or their families will have access to hundreds of thousands of dollars for medical expenses. Other victims may simply have their counseling covered.
The overall economic cost of U.S. firearm injuries is estimated by a recent Harvard Medical School study at $557 billion annually. Most of that — 88% — represented quality-of-life losses among those injured by firearms and their families. The JAMA-published study found that each nonfatal firearm injury leads to roughly $30,000 in direct health care spending per survivor in the first year alone.
In the immediate aftermath of the shootings, as well-intentioned GoFundMe pages popped up to help victims, executives at United Way of Greater Kansas City gathered to devise a collective donation response. They came up with “three concentric circles of victims,” said Jessica Blubaugh, the United Way’s chief philanthropy officer, and launched the #KCStrong campaign.
“There were folks that were obviously directly impacted by gunfire. Then the next circle out is folks that were impacted, not necessarily by gunshots, but by physical impact. So maybe they were trampled and maybe they tore a ligament or something because they were running away,” Blubaugh said. “Then third is folks that were just adjacent and/or bystanders that have a lot of trauma from all of this.”
PTSD, Panic, and the Echo of Gunfire
Bridget Barton returned to Kansas City the day after the shooting to turn in the bullet she found in her backpack and to give a statement at police headquarters. Unbeknownst to her, Mayor Quinton Lucas and the police and fire chiefs had just finished a press conference outside the building. She was mobbed by the media assembled there — interviews that are now a blur.
“I don’t know how you guys do this every day,” she remembered telling a detective once she finally got inside.
The Bartons have been overwhelmed by well wishes from close friends and family as they navigate the trauma, almost to the point of exhaustion. Bridget took to social media to explain she wasn’t ignoring the messages, she’s just responding as she feels able — some days she can hardly look at her phone, she said.
A family friend bought new Barbie blankets for Gabriella and her friend after the ones they brought to the parade were lost or ruined. Bridget tried replacing the blankets herself at her local Walmart, but when she was bumped accidentally, it triggered a panic attack. She abandoned her cart and drove home.
“I’m trying to get my anxiety under control,” Bridget said.
That means therapy. Before the parade, she was already seeing a therapist and planning to begin eye movement desensitization and reprocessing, a form of therapy associated with treating post-traumatic stress disorder. Now the shooting is the first thing she wants to talk about in therapy.
Since Gabriella, an eighth grader, has returned to middle school, she has dealt with the compounding immaturity of adolescence: peers telling her to get over it, pointing finger guns at her, or even saying it should have been her who was shot. But her friends are checking on her and asking how she’s doing. She wishes more people would do the same for her friend, who took off running when the shooting started and avoided injury. Gabriella feels guilty about bringing her to what turned into a horrifying experience.
“We can tell her all day long, ‘It wasn’t your fault. She’s not your responsibility.’ Just like I can tell myself, ‘It wasn’t my fault or my responsibility,’” Bridget said. “But I still bawled on her mom’s shoulder telling her how sorry I was that I grabbed my kid first.”
The two girls have spent a lot of time talking since the shooting, which Gabriella said helps with her own stress. So does spending time with her dog and her lizard, putting on makeup, and listening to music — Tech N9ne’s performance was a highlight of the Super Bowl celebration for her.
In addition to the spark burns on Gabriella’s legs, when she fell to the concrete in the pandemonium she split open a burn wound on her stomach previously caused by a styling iron.
“When I see that, I just picture my mom trying to protect me and seeing everyone run,” Gabriella said of the wound.
It’s hard not to feel forgotten by the public, Bridget said. The shooting, especially its survivors, have largely faded from the headlines aside from court dates. Two additional high-profile shootings have occurred in the area since the parade. Doesn’t the community care, she wonders, that her family is still living with the fallout every day?
“I’m going to put this as plainly as possible. I’m f—ing pissed because my family went through something traumatic,” Bridget vented in a recent social media post. “I don’t really want anything other [than], ‘Your story matters, too, and we want to know how you’re doing.’ Have we gotten that? Abso-f—lutely not.”
‘What Is the Landscape of Need?’
Helped in part by celebrities like Swift and Kelce, donations for the family of Lopez-Galvan, the lone fatality, and other victims poured in immediately after the shootings. Swift and Kelce donated $100,000 each. With the help of an initial $200,000 donation from the Kansas City Chiefs, the United Way’s #KCStrong campaign took off, reaching $1 million in the first two weeks and sitting at $1.2 million now.
Six verified GoFundMe funds were established. One solely for the Lopez-Galvan family has collected over $406,000. Smaller ones were started by a local college student and Swift fans. Churches have also stepped up, and one local coalition had raised $183,000, money set aside for Lopez-Galvan’s funeral, counseling services for five victims, and other medical bills from Children’s Mercy Kansas City hospital, said Ray Jarrett, executive director of Unite KC.
Money for Victims Rolls In
Donations poured in for those injured at the Super Bowl Parade in Kansas City after the Feb. 14 shootings. The largest, starting with a $200,000 donation from the Kansas City Chiefs, is at the United Way of Greater Kansas City. Six GoFundMe sites also popped up, due in part to $100,000 donations each from Taylor Swift and Travis Kelce. Here’s a look at the totals as of March 12.United Way#KCStrong: $1.2 million.Six Verified GoFundMe AccountsLisa Lopez-Galvan GoFundMe (Taylor Swift donated): $406,142Reyes Family GoFundMe (Travis Kelce donated): $207,035Samuel Arellano GoFundMe: $11,896Emily Tavis GoFundMe: $9,518Cristian Martinez’s GoFundMe for United Way: $2,967Swifties’ GoFundMe for Children’s Mercy hospital: $1,060ChurchesResurrection (Methodist) “Victims of Violence Fund”: $53,358‘The Church Loves Kansas City’: $183,000
Meanwhile, those leading the efforts found models in other cities. The United Way’s Blubaugh called counterparts who’d responded to their own mass shootings in Orlando, Florida; Buffalo, New York; and Newtown, Connecticut.
“The unfortunate reality is we have a cadre of communities across the country who have already faced tragedies like this,” Blubaugh said. “So there is an unfortunate protocol that is, sort of, already in place.”
#KCStrong monies could start being paid out by the end of March, Blubaugh said. Hundreds of people called the nonprofit’s 211 line, and the United Way is consulting with hospitals and law enforcement to verify victims and then offer services they may need, she said.
The range of needs is staggering — several people are still recovering at home, some are seeking counseling, and many weren’t even counted in the beginning. For instance, a plainclothes police officer was injured in the melee but is doing fine now, said Police Chief Stacey Graves.
Determining who is eligible for assistance was one of the first conversations United Way officials had when creating the fund. They prioritized three areas of focus: first were the wounded victims and their families, second was collaborating with organizations already helping victims in violence intervention and prevention and mental health services, and third were the first responders.
Specifically, the funds will be steered to cover medical bills, or lost wages for those who haven’t been able to work since the shootings, Blubaugh said. The goal is to work quickly to help people, she said, but also to spend the money in a judicious, strategic way.
“We don’t have a clear sightline of the entire landscape that we’re dealing with,” Blubaugh said. “Not only of how much money do we have to work with, but also, what is the landscape of need? And we need both of those things to be able to make those decisions.”
Firsthand Experience of Daily Kansas City Violence
Jason used his lone remaining sick day to stay home with Bridget and Gabriella. An overnight automation technician, he is the family’s primary breadwinner.
“I can’t take off work, you know?” he said. “It happened. It sucked. But it’s time to move on.”
“He’s a guy’s guy,” Bridget interjected.
On Jason’s first night back at work, the sudden sound of falling dishes startled Bridget and Gabriella, sending them into each other’s arms crying.
“It’s just those moments of flashbacks that are kicking our butts,” Bridget said.
Tell Us About Your Experience
We are continuing to report on the effects of the parade shooting on the people who were injured and the community as a whole. Do you have an experience you want to tell us about, or a question you think we should look into? Message KCUR’s text line at (816) 601-4777. Your information will not be used in an article without your permission.
In a way, the shooting has brought the family closer. They’ve been through a lot recently. Jason survived a heart attack and cancer last year. Raising a teenager is never easy.
Bridget can appreciate that the bullet lodged in her backpack, narrowly missing her, and that Gabriella’s legs were burned by sparks but she wasn’t shot.
Jason is grateful for another reason: It wasn’t a terrorist attack, as he initially feared. Instead, it fits into the type of gun violence he’d become accustomed to growing up in Kansas City, which recorded its deadliest year last year, although he’d never been this close to it before.
“This crap happens every single day,” he said. “The only difference is we were here for it.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Dr. Greger’s Daily Dozen
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Give Us This Day Our Daily Dozen
This is Dr. Michael Greger. He’s a physician-turned-author-educator, and we’ve featured him and his work occasionally over the past year or so:
- Brain Food? The Eyes Have It! ← this is about dark leafy greens, lutein, & avoiding Alzheimer’s
- Twenty-One, No Wait, Twenty Tweaks For Better Health ← he says 21, but we say one of them is very skippable. Check it out and decide what you think!
- Dr. Greger’s Anti-Aging Eight ← his top well-evidenced interventions specifically for slowing aging
But what we’ve not covered, astonishingly, is one of the things for which he’s most famous, which is…
Dr. Greger’s Daily Dozen
Based on the research in the very information-dense tome that his his magnum opus How Not To Die (while it doesn’t confer immortality, it does help avoid the most common causes of death), Dr. Greger recommends that we take care to enjoy each of the following things per day:
Beans
- Servings: 3 per day
- Examples: ½ cup cooked beans, ¼ cup hummus
Greens
- Servings: 2 per day
- Examples: 1 cup raw, ½ cup cooked
Cruciferous vegetables
- Servings: 1 per day
- Examples: ½ cup chopped, 1 tablespoon horseradish
Other vegetables
- Servings: 2 per day
- Examples: ½ cup non-leafy vegetables
Whole grains
- Servings: 3 per day
- Examples: ½ cup hot cereal, 1 slice of bread
Berries
- Servings: 1 per day
- Examples: ½ cup fresh or frozen, ¼ cup dried
Other fruits
- Servings: 3 per day
- Examples: 1 medium fruit, ¼ cup dried fruit
Flaxseed
- Servings: 1 per day
- Examples: 1 tablespoon ground
Nuts & (other) seeds
- Servings: 1 per day
- Examples: ¼ cup nuts, 2 tablespoons nut butter
Herbs & spices
- Servings: 1 per day
- Examples: ¼ teaspoon turmeric
Hydrating drinks
- Servings: 60 oz per day
- Examples: Water, green tea, hibiscus tea
Exercise
- Servings: Once per day
- Examples: 90 minutes moderate or 40 minutes vigorous
Superficially it seems an interesting choice to, after listing 11 foods and drinks, have the 12th item as exercise but not add a 13th one of sleep—but perhaps he quite reasonably expects that people get a dose of sleep with more consistency than people get a dose of exercise. After all, exercise is mostly optional, whereas if we try to skip sleep for too long, our body will force the matter for us.
Further 10almonds notes:
- We’d consider chia superior to flax, but you do you. Flax is a fine choice also.
- We recommend trying to get each of these top 5 most health-giving spices in daily if you can.
Enjoy!
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The Exercises That Help Keep Breast Cancer At Bay
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For women, our lifetime risk of being diagnosed with breast cancer is about 1 in 7, before we take into account any added risk or protective factors.
For men, it’s more like 1 in 556, which again, is before taking into account any added risk or protective factors.
Here’s a good place to start on improving those odds: How To Triple Your Breast Cancer Survival Chances
And for that matter, check out: 8 Signs On Your Breast You Shouldn’t Ignore
And for those concerned (or even just curious) about the pros and cons of menopausal HRT when it comes to breast cancer:
The Hormone Therapy That Reduces Breast Cancer Risk & More ← this is actually very important to understand, as otherwise it’s easy to accidentally self-sabotage and increase one’s overall mortality risk
So, what’s this about exercise and breast cancer?
There are two things to focus on
No, not those.
Well, yes, those, but also: aerobic exercise and resistance training.
A research team (Dr. Alice Avancini et al.) analysed data from 22 randomized controlled trials (total n=968 participants) that investigated the effects of exercise on various pro-inflammatory biomarkers (mostly interleukin variants, but also c-reactive proteins) that are known to increase breast cancer reoccurrence risk.
What they found was:
❝Exercise induced small to large significant reductions in IL-6 (SMD = -0.85; 95% CI = -1.68 to -0.02; p = .05) and TNF-α (SMD = -0.40; 95% CI = -0.81 to 0.01; p = .05) and a trend for a decrease in CRP.
When stratifying by exercise mode, trends toward reduction in IL-6 and TNF-α were observed for combined exercise, whilst changes were not generally affected by exercise program duration❞
The “combined exercise” mentioned?
Aerobic exercise and resistance training.
This is important, because as regular 10almonds readers may remember…
What Your Metabolism Says About How Aggressive Breast Cancer Is Likely To Be For You ← this makes a huge difference to survival chances
So, this study’s findings are very consistent with that, because:
- Aerobic training increases cardiovascular fitness, improving metabolism
- Resistance training increases muscle mass, improving metabolism*
*because muscle “costs” calories to maintain, prompting an increase in metabolism, whereas fat prompts our metabolism to slow, to conserve energy to face the obvious food shortage that must be coming
See also: Stop Cancer 20 Years Ago
Want to learn more?
Here’s the best book we’ve read on breast cancer survival:
The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
Take care!
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Resistance band Training – by James Atkinson
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For those who’d like a full gym workout at home, without splashing out thousands on a home gym, resistance bands provide a lot of value. But how much value, really?
As James Atkinson demonstrates, there’s more exercise available than one might think.
Did you know that you can use the same band to strengthen your triceps as well as your biceps, for instance? and the same goes for your quadriceps and biceps femoris. And core strength? You bet.
The style here is not a sales pitch (though he does, at the end, offer extra resources if desired), but rather, instructional, and this book is in and of itself already a complete guide. With clear instructions and equally clear illustrations, you don’t need to spend a dime more (unless you don’t own a resistance band, in which case then yes, you will need one of those).
Bottom line: if you’d like to give your body the workout it deserves, this book is a potent resource.
Click here to check out Resistance Band Training, and get training!
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Optimism Seriously Increases Longevity!
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Always look on the bright side for life
❝I’m not a pessimist; I’m a realist!❞
~ every pessimist ever
To believe self-reports, the world is divided between optimists and realists. But how does your outlook measure up, really?
Below, we’ve included a link to a test, and like most free online tests, this is offered “as-is” with the usual caveats about not being a clinical diagnostic tool, this one actually has a fair amount of scientific weight behind it:
❝Empirical testing has indicated the validity of the Optimism Pessimism Instrument as published in the scientific journal Current Psychology: Research and Reviews.
The IDRlabs Optimism/Pessimism Test (IDR-OPT) was developed by IDRlabs. The IDR-OPT is based on the Optimism/Pessimism Instrument (OPI) developed by Dr. William Dember, Dr. Stephanie Martin, Dr. Mary Hummer, Dr. Steven Howe, and Dr. Richard Melton, at the University of Cincinnati.❞
Take This Short (1–2 mins) Test
How did you score? And what could you do to improve on that score?
We said before that we’d do a main feature on this sometime, and today’s the day! Fits with the theme of Easter too, as for those who observe, this is a time for a celebration of hope, new beginnings, and life stepping out of the shadows.
On which note, before we go any further, let’s look at a very big “why” of optimism…
There have been many studies done regards optimism and health, and they generally come to the same conclusion: optimism is simply good for the health.
Here’s an example. It’s a longitudinal study, and it followed 121,700 women (what a sample size!) for eight years. It controlled for all kinds of other lifestyle factors (especially smoking, drinking, diet, and exercise habits, as well as pre-existing medical conditions), so this wasn’t a case of “people who are healthy are more optimistic as a result. And, in the researchers’ own words…
❝We found strong and statistically significant associations of increasing levels of optimism with decreasing risks of mortality, including mortality due each major cause of death, such as cancer, heart disease, stroke, respiratory disease, and infection.
Importantly, findings were maintained after close control for potential confounding factors, including sociodemographic characteristics and depression❞
Read: Optimism and Cause-Specific Mortality: A Prospective Cohort Study
So that’s the why. Now for the how…
Positive thinking is not what you think it is
A lot of people think of “think positive thoughts” as a very wishy-washy platitude, but positive thinking isn’t about ignoring what’s wrong, or burying every negative emotion.
Rather, it is taking advantage of the basic CBT, DBT, and, for that matter, NLP principles:
- Our feelings are driven by our thoughts
- Our thoughts can be changed by how we frame things
This is a lot like the idea that “there’s not such thing as bad weather; only the wrong clothes”. Clearly written by someone who’s never been in a hurricane, but by and large, the principle stands true.
For example…
- Most problems can be reframed as opportunities
- Replace “I have to…” with “I get to…”
- Will the task be arduous? It’ll be all the better looking back on it.
- Did you fail abjectly? Be proud that you lived true to your values anyway.
A lot of this is about focusing on what you can control. If you live your life by your values (first figure out what they are, if you haven’t already), then that will become a reassuring thing that you can always count on, no matter what.
Practice positive self-talk (eliminate the negative)
We often learn, usually as children, to be self deprecatory so as to not appear immodest. While modesty certainly has its place, we don’t have to trash ourselves to do that!
There are various approaches to this, for example:
- Replacing a self-criticism (whether it was true or not) with a neutral or positive statement that you know is true. “I suck at xyz” is just putting yourself down, “Xyz is a challenge for me” asks the question, how will you rise to it?
- Replacing a self-criticism with irony. It doesn’t matter how dripping with sarcasm your inner voice is, the words will still be better. “Glamorous as ever!” after accidentally putting mascara in your eye. “So elegant and graceful!” after walking into furniture. And so on.
Practice radical acceptance
This evokes the “optimistic nihilism” approach to life. It’s perhaps not best in all scenarios, but if you’re consciously and rationally pretty sure something is going to be terrible (and/or know it’s completely outside of your control), acknowledging that possibility (or even, likelihood) cheerfully. Borrowing from the last tip, this can be done with as much irony as you find necessary. For example:
Facing a surgery the recovery from which you know categorically will be very painful: with a big smile “Yep, I am going to be in a lot of pain, so that’s going to be fun!” (fun fact: psychological misery will not make the physical pain any less painful, so you might as well see the funny side) ← see link for additional benefits laughter can add to health-related quality of life)
Plan for the future with love
You know the whole “planting trees in whose shade you’ll never sit”, thing, but: actually for yourself too. Plan (and act!) now, out of love and compassion for your future self.
Simple example: preparing (or semi-preparing, if appropriate) breakfast for yourself the night before, when you know in the morning you’ll be tired, hungry, and/or pressed for time. You’ll wake up, remember that you did that, and…
Tip: at moments like that, take a moment to think “Thanks, past me”. (Or call yourself by your name, whatever works for you. For example I, your writer here, might say to myself “Thanks, past Nastja!”)
This helps to build a habit of gratitude for your past self and love for your future self.
This goes for little things like the above, but it also goes for things whereby there’s much longer-term delayed gratification, such as:
- Healthy lifestyle changes (usually these see slow, cumulative progress)
- Good financial strategies (usually these see slow, cumulative progress)
- Long educational courses (usually these see slow, cumulative progress)
Basically: pay it forward to your future self, and thank yourself later!
Some quick ideas of systems and apps that go hard on the “long slow cumulative progress” approach that you can look back on with pride:
- Noom—nutritional program with a psychology-based approach to help you attain and maintain your goals, long term
- You Need A Budget—we’ve recommended it before and we’ll recommend it again. This is so good. If you click through, you can see a short explanation of what makes it so different to other budgeting apps.
- Duolingo—the famously persistence-motivational language learning app
Don’t Forget…
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Learn to Age Gracefully
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What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed
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While you’re likely 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 he has it.
So, what is type 1.5 diabetes? And how is it diagnosed and treated?
Pixel-Shot/Shutterstock There are several types of diabetes
Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood 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 condition where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production.
Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need insulin medication daily. Type 1 diabetes usually appears in children or young adults.
Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to overcome this resistance. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.
Type 2 is more common in adults but is increasingly seen in children and young people. Management can include behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy.
People with diabetes may need to regularly monitor their blood sugar levels. Dragana Gordic/Shutterstock How does type 1.5 diabetes differ from types 1 and 2?
Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin immediately because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within five years of diagnosis, while those with type 1 typically require it from diagnosis.
Type 1.5 diabetes is usually diagnosed in people over 30, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2.
Type 1.5 diabetes shares genetic and autoimmune risk factors with type 1 diabetes such as specific gene variants. However, evidence has also shown it may 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?
The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following symptoms:
- increased thirst
- frequent urination
- fatigue
- blurred vision
- unintentional weight loss.
Typically, type 1.5 diabetes is initially treated with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.
When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are no universally accepted management or treatment strategies for type 1.5 diabetes.
Type 1.5 diabetes might be managed with oral medications, at least initially. Dragana Gordic/Shutterstock Type 1.5 diabetes is often misdiagnosed
Lance Bass said he was initially diagnosed with type 2 diabetes, but later learned he actually has type 1.5 diabetes. This is not entirely uncommon. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes 5–10% of the time.
There are a few possible reasons for this.
First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special antibody tests (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them.
Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults).
Third, people with type 1.5 diabetes often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin.
Finally, because type 1.5 diabetes has symptoms that are similar to type 2 diabetes, it may initially be treated as type 2.
We’re still learning about type 1.5
Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in non-European populations. In 2023, it was estimated type 1.5 diabetes represented 8.9% of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers.
Overall, there has been a limited awareness of type 1.5 diabetes and unclear diagnostic criteria which have slowed down our understanding of this condition.
A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road.
Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce diabetes distress. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.
Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University and Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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