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?
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.
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 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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Healthy Habits For Your Heart – by Monique Tello
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Did you guess we’d review this one today? Well, you’ve already had a taste of what Dr. Tello has to offer, but if you want to take your heart health seriously, this incredibly accessible guide is excellent.
Because Dr. Tello doesn’t assume prior knowledge, the first part of the book (the first three chapters) are given over to “heart and habit basics”—heart science, the effect your lifestyle can have on such, and how to change your habits.
The second part of the book is rather larger, and addresses changing foundational habits, nutrition habits, weight loss/maintenance, healthy activity habits, and specifically addressing heart-harmful habits (especially drinking, smoking, and the like).
She then follows up with a section of recipes, references, and other useful informational appendices.
The writing style throughout is super simple and clear, even when giving detailed clinical information. This isn’t a dusty old doctor who loves the sound of their own jargon, this is good heart health rendered as easy and accessible as possible to all.
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Hazelnuts vs Almonds – Which is Healthier?
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Our Verdict
When comparing hazelnuts to almonds, we picked the almonds.
Why?
It’s closer than you might think! But we say almonds do come out on top.
In terms of macronutrients, almonds have notably more protein, while hazelnuts have notably more fat (healthy fats, though). Almonds are also higher in both carbs and fiber. Looking at Glycemic Index, hazelnuts’ GI is low and almonds’ GI is zero. We could call the macros category a tie, but ultimately if we need to prioritize any of these things, it’s protein and fiber, so we’ll call this a nominal win for almonds.
When it comes to vitamins, hazelnuts have more of vitamins B1, B5, B6, B9 C, and K. Meanwhile, almonds have more of vitamins B2, B3, E, and choline. So, a moderate win for hazelnuts.
In the category of minerals, almonds retake the lead with more calcium, magnesium, phosphorus, potassium, selenium, and zinc, while hazelnuts boast more copper and manganese. A clear win for almonds.
Adding up the categories, this makes for a marginal win for almonds. Of course, both of these nuts are very healthy (assuming you are not allergic), and best is to enjoy both if possible.
Want to learn more?
You might like to read:
Take care!
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Fatty Acids For The Eyes & Brain: The Good And The Bad
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Good For The Eyes; Good For The Brain
We’ve written before about omega-3 fatty acids, covering the basics and some lesser-known things:
What Omega-3 Fatty Acids Really Do For Us
…and while we discussed its well-established benefits against cognitive decline (which is to be expected, because omega-3 is good against inflammation, and a large part of age-related neurodegeneration is heavily related to neuroinflammation), there’s a part of the brain we didn’t talk about in that article: the eyes.
We did, however, talk in another article about supplements that benefit the eyes and [the rest of the] brain, and the important links between the two, to the point that an examination of the levels of lutein in the retina can inform clinicians about the levels of lutein in the brain as a whole, and strongly predict Alzheimer’s disease (because Alzheimer’s patients have significantly less lutein), here:
Now, let’s tie these two ideas together
In a recent (June 2024) meta-analysis of high-quality observational studies from the US and around the world, involving nearly a quarter of a million people over 40 (n=241,151), researchers found that a higher intake of omega-3 is significantly linked to a lower risk of macular degeneration.
To put it in numbers, the highest intake of omega-3s was associated with an 18% reduced risk of early stage macular degeneration.
They also looked at a breakdown of what kinds of omega-3, and found that taking a blend DHA and EPA worked best of all, although of people who only took one kind, DHA was the best “single type” option.
You can read the paper in full, here:
Association between fatty acid intake and age-related macular degeneration: a meta-analysis
A word about trans-fatty acids (TFAs)
It was another feature of the same study that, while looking at fatty acids in general, they also found that higher consumption of trans-fatty acids was associated with a higher risk of advanced age-related macular degeneration.
Specifically, the highest intake of TFAs was associated with a more than 2x increased risk.
There are two main dietary sources of trans-fatty acids:
- Processed foods that were made with TFAs; these have now been banned in a lot of places, but only quite recently, and the ban is on the processing, not the sale, so if you buy processed foods that contain ingredients that were processed before 2021 (not uncommon, given the long life of many processed foods), the chances of them having TFAs is higher.
- Most animal products. Most notably from mammals and their milk, so beef, pork, lamb, milk, cheese, and yes even yogurt. Poultry and fish technically do also contain TFAs in most cases, but the levels are much lower.
Back to the omega-3 fatty acids…
If you’re wondering where to get good quality omega-3, well, we listed some of the best dietary sources in our main omega-3 article (linked at the top of today’s).
However, if you want to supplement, here’s an example product on Amazon that’s high in DHA and EPA, following the science of what we shared today 😎
Take care!
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The Inflammation Spectrum – by Dr. Will Cole
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We’ve previously reviewed Dr. Cole’s other book “Gut Feelings”, and now he’s back, this time to tackle inflammation.
The focus here is on understanding what things trigger inflammation in your body—personally yours, not someone else’s—by something close to the usual elimination process yes, but he offers a way of sliding into it gently instead of simply quitting all the things and gradually adding everything back in.
The next step he takes the reader through is eating not just to avoid triggering inflammation, but to actively combat it. From there, it should be possible for the reader to build an anti-inflammatory cookbook, that’s not only one’s own personal repertoire of cooking, but also specifically tailored to one’s own personal responses to different ingredients.
The style of this book is very pop-science, helpful, walking-the-reader-by-the-hand through the processes involved. Dr. Cole wants to make everything as easy as possible.
Bottom line: if your diet could use an anti-inflammatory revamp, this is a top-tier guidebook for doing just that.
Click here to check out The Inflammation Spectrum, find your food triggers and reset your system!
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Podiatrists Debunk 11 Feet Myths
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Podiatrists Dr. Sarah Haller and Dr. Brad Schaeffer put us on a better path:
Don’t get wrong-footed
We’ll not keep the 11 myths a mystery; they are…
- “You have warts because your feet are dirty.”
False! Warts are caused by a virus, not dirt. Viruses can be picked up from surfaces like yoga mats, pools, gyms, and showers. - “Bunions are caused by wearing heels.”
False! Bunions are genetic deformities where the bone behind the big toe shifts. Heels might worsen them but don’t cause them. - “Cutting the sides of my toenail will prevent an ingrown toenail.”
False! Toenails should be cut straight across. Cutting the sides can make ingrown toenails worse. - “Pedicures gave me toenail fungus.”
Partially true! You can get fungus from many places, but safe, sterile pedicures are generally fine. - “Only athletes get athlete’s foot.”
False! Athlete’s foot is a fungal infection caused by warm, moist environments. Anyone can get it, not just athletes. - “My feet are fine because I trained them to walk in stilettos.”
False! You can get used to stilettos, but they aren’t healthy long-term. They shorten the Achilles tendon and put pressure on the foot. - “You can’t do anything for a broken toe.”
False! Broken toes can be treated and should be checked by a doctor. They may need to be set for proper healing. - “It’s normal for your feet to hurt from standing all day.”
False! Foot pain isn’t normal and can be prevented with proper footwear, support, and compression socks. - “All inserts are the same.”
False! Everyone’s feet are different. Some may benefit from over-the-counter insoles, but others need custom orthotics. - “Sprained ankles are no big deal.”
False! Sprains can damage ligaments and lead to instability or arthritis if untreated. Proper stabilization is essential. - “If I can walk after an injury, I don’t need to see a doctor.”
False! You can still have serious injuries like fractures even if you can walk. Always get checked after an injury.
For more on each of these, enjoy:
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Want to learn more?
You might also like to read:
Steps For Keeping Your Feet A Healthy Foundation
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- “You have warts because your feet are dirty.”
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How To Escape From A Despairing Mood
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When we are in a despairing mood, that’s when it can feel hardest to actually implement anything we know about getting out of one. That’s why sometimes, the simplest solutions are the best:
Imagination Is Key
Despairing moods occur when it’s hard to envision a better life. Imagination is the power to envision alternatives, such as new jobs, relationships, or lifestyle, but sadness can cloud our ability to imagine solutions like changing careers, moving house, or starting fresh. With enough imagination, most problems can be worked around—and new opportunities can always be found.
Importantly: we are not bound by our past or present circumstances; we have the freedom and flexibility to choose new paths. That doesn’t mean it’ll always be a walk in the park, but “this too shall pass”.
You may be thinking: “sometimes the hardship does pass, but can last many years”, and that is true. All the more reason to check if there’s a freer lane you can slip into to speed ahead. Even if there isn’t, the mere act of imagining such lanes is already respite from the hardships—and having envisioned such will make it much easier for you to recognise when opportunities for change do come along.
To foster imagination, we are advised to expose ourselves to different narratives, preparing ourselves for alternative ways of living. Thus, we can reframe life’s challenges as intellectual puzzles, urging us to rebuild creatively and find new solutions!
For more on all this, enjoy:
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Want to learn more?
You might also like to read:
Behavioral Activation Against Depression & Anxiety
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