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.

A senior man applying a device to his finger to measure blood sugar levels.
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.

A young woman taking a tablet.
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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  • Kettlebell Sport & Fitness Basics – by Audrey Burgio

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    Professional athlete & coach Audrey Burgio covers how to get a full-body workout that will make you stronger and more flexible (there are stretches here too, and many exercises are about strength and suppleness), as well as building stability and balance. In short, more robust and with better mobility.

    Which is one of the best things about kettlebell training—unlike dumbbells and barbells, a kettlebell requires the kind of strength that one has to use when doing many routine tasks, from carrying the groceries to moving a big pan in the kitchen.

    Because it is otherwise absolutely possible to look like Arnold Schwarzenegger in the gym, and then still pull a muscle moving something at home because the angle was awkward or somesuch!

    However, making one’s body so robust does require training safely, and the clear instructions in this book will help the reader avoid injuries that might otherwise be incurred by just picking up some kettlebells and guessing.

    Bottom line: if you’d like to get strong and supple from the comfort of your own home, this book can definitely lead the way!

    Click here to check out Kettlebell Sport & Fitness Basics, and see the difference in your body!

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  • Chili Hot-Bedded Salmon

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    This one can be made in less time than it takes to order and receive a Chinese take-out! The principle is simple: it’s a bed of greens giving pride of place to a salmon fillet in a deliciously spicy marinade. So healthwise, we have greens-and-beans, healthy protein and fats, and tasty polyphenols. Experientially, we have food that tastes a lot more decadent than it is!

    You will need

    • 4 salmon fillets (if vegan, substitute firm tofu; see also how to make this no-salmon salmon)
    • 2 bok choy, washed and stems trimmed
    • 7 oz green beans, trimmed
    • 4 oz sugar snap peas
    • 4 spring onions, sliced
    • 2 tbsp chili oil*
    • 1 tbsp soy sauce
    • 1 tsp garlic paste
    • 1 tsp ginger paste
    • 1 tsp black pepper

    *this can be purchased as-is, but if you want to make your own in advance, simply take extra virgin olive oil and infuse it with [finely chopped, red] chili. This is a really good thing to do for commonly-used flavored oils, by the way—chili oil and garlic oil are must-haves in this writer’s opinion; basil oil, sage oil, and rosemary oil, are all excellent things to make and have in, too. Just know, infusing is not quick, so it’s good to do these in batch and make plenty well before you need it. For now, if you don’t have any homemade already, then store-bought is fine 🙂

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 360℉/180℃/gas mark 6

    2) Lay out 4 large squares of foil, and put the bok choy, green beans, and sugar snap peas in a little pile in the middle of each one. Put a salmon fillet on top of each (if it has skin, score the skin first, so that juices will be able to penetrate, and put it skin-side down), and then top with the spring onions.

    3) Mix the rest of the ingredients in a small bowl, and then spoon this marinade evenly over each of the fillets (alternatively, if you have occasion to marinade the fillets in advance and let them sit in the marinade in the fridge for some hours before, do so, in which case this step will already be done now, because past-you did it. Yay for past-you!)

    4) Fold up the edges of the foil, making each one an enclosed parcel, gently sealed at the top by folding it over. Put them on a baking tray and bake for about 20 minutes.

    5) Serve! If you’d like some carbs with it, we recommend our tasty versatile rice recipe.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Why You Should Diversify Your Nuts!

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    Time to go nuts for nuts!

    Nuts, in popular perception, range from “basically the healthiest food anyone can eat” to “basically high calorie salty snacks”. And, they can be either!

    Some notes, then:

    • Raw is generally better that not
    • Dry roasted is generally better than the kind with added oils
    • Added salt is neither necessary nor good

    Quick tip: if “roasted salted” are the cheapest or most convenient to buy, you can at least mitigate that by soaking them in warm water for 5 minutes, before rinsing and (if you don’t want wet nuts) drying.

    You may be wondering: who does want wet nuts? And the answer is, if for example you’re making a delicious cashew and chickpea balti, the fact you didn’t dry them before throwing them in won’t make a difference.

    Now, let’s do a quick run-down; we don’t usually do “listicles” but it seemed a good format here, so we’ve picked a top 5 for nutritional potency:

    Almonds

    We may have a bias. We accept it. But almonds are also one of the healthiest nuts around, and generally considered by most popular metrics the healthiest.

    Not only are they high in protein, healthy fat, fiber, vitamins, and minerals, but they’re even a natural prebiotic that increases the populations of healthy gut bacteria, while simultaneously keeping down the populations of gut pathogens—what more can we ask of a nut?

    Read more: Prebiotic effects of almonds and almond skins on intestinal microbiota in healthy adult humans

    Pistachios

    Not only are these super tasty and fun to eat (and mindful eating is all but guaranteed, as shelling them by hand slows us down and makes us more likely to eat them one at a time rather than by the handful), but also they contain lots of nutrients and are lower in calories than most nuts, so they’re a great option for anyone who’d like to eat more nuts but is doing a calorie-controlled diet and doesn’t want to have half a day’s calories in a tiny dish of nuts.

    See: Effects of Pistachio Consumption in a Behavioral Weight Loss Intervention on Weight Change, Cardiometabolic Factors, and Dietary Intake

    Walnuts

    Popularly associated with brain health (perhaps easy to remember because of their appearance), they really are good for the brain:

    Check it out: Beneficial Effects of Walnuts on Cognition and Brain Health

    Cashews

    A personal favorite of this writer for their versatility in cooking, food prep, or just as a snack, they also do wonders for metabolic health:

    Learn more: The Effect of Cashew Nut on Cardiovascular Risk Factors and Blood Pressure: A Systematic Review and Meta-analysis

    Brazil nuts

    The most exciting thing about these nuts is that they’re an incredibly potent source of selenium, which is important not just for hair/skin/nails as popularly marketed, but also for thyroid hormone production and DNA synthesis.

    But don’t eat too many, because selenium is definitely one of those “you can have too much of a good thing” nutrients, and selenium poisoning can make your hair (however beautiful and shiny it got because of the selenium) fall out if you take too much.

    Know the numbers: Brazil nuts and selenium—health benefits and risks

    Bottom line on nuts:

    • Nuts are a great and healthful part of almost anyone’s diet
      • Obviously, if you have a nut allergy, then we’re sorry; this one won’t have helped you so much
    • Almonds are one of the most healthful nuts out there
    • Brazil nuts are incredibly potent, to the point where moderation is recommended
    • A handful of mixed nuts per day is a very respectable option—when it comes to food and health, diversity is almost always good!

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  • Planning Festivities Your Body Won’t Regret

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    The Festive Dilemma

    For many, Christmas is approaching. Other holidays abound too, and even for the non-observant, it’d be hard to escape seasonal jollities entirely.

    So, what’s the plan?

    1. Eat, drink, and be merry, and have New Year’s Resolutions for the first few days of January before collapsing in a heap?
    2. Approach the Yuletide with Spartan abstemiousness and miss all the fun while simultaneously annoying your relatives?

    Let’s try to find a third approach instead…

    What’s festive and healthy?

    We’re doing this article this week, because many people will be shopping already, making plans, and so forth. So here are some things to bear in mind:

    Make your own mindful choices

    Coca-Cola company really did a number on Christmas, but it doesn’t mean their product is truly integral to the season. Same goes for many other things that flood the stores around this time of year. So much sugary confectionary! But remember, they’re not the boss of you. If you wouldn’t buy it ordinarily, why are you buying it now? Do you actually even want it?

    If you really do, then you do you, but mindful choices will invariably be healthier than “because there were three additional aisles of confectionary now so I stopped and looked and picked some things”.

    Pick your battles

    If you’re having a big family gathering, likely there will be occasions with few healthy options available. But you can decide what’s most important for you to avoid, perhaps picking a theme, e.g:

    • No alcohol this year, or
    • No processed sugary foods, or
    • Eat/drink whatever, but practice intermittent fasting

    Some resources:

    Fight inflammation

    This is a big one so it deserves its own category. In the season of sugar and alcohol and fatty meat, inflammation can be a big problem to come around and bite us in the behind. We’ve written on this previously:

    Keep Inflammation At Bay

    Positive dieting

    In other words, less of a focus on what to exclude, and more of a focus on what to include in your diet. Fruity drinks and sweets are common at this time of year, but you know what’s also fruity? Fruit!

    And it can be festive, too! Berries are great, and those tiny orange-like fruits that may be called clementines or tangerines or satsumas or, as Aldi would have it, “easy peelers”. Apple and cinnamon are also a great combination that both bring sweetness without needing added sugar.

    And as for mains? Make your salads that bit fancier, get plenty of greens with your main, have hearty soups and strews with lentils and beams!

    See also: Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)

    Your gut will thank us later!

    Get moving!

    That doesn’t mean you have to beat the New Year rush to the gym (unless you want to!). But it could mean, for example, more time in your walking shoes (or dancing shoes! With a nod to today’s sponsor) and less time in the armchair.

    See also: The doctor who wants us to exercise less; move more

    Lastly…

    Remember it’s supposed to be fun! And being healthy can be a lot more fun than suffering because of unfortunate choices that we come to regret.

    Take care!

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  • Morning Routines That Just FLOW

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    Morning Routines That Just FLOW

    “If the hardest thing you have to do in your day is eat a frog, eat that frog first!”, they say.

    And, broadly speaking, it is indeed good to get anything stressful out of the way early, so that we can relax afterwards. But…

    • Are we truly best at frog-eating when blurry-eyed and sleepy?
    • Is there a spoonful of sugar that could make the medicine go down better?
    • What do we need to turn eating the frog into an enjoyable activity?

    Flow

    “Flow” is a concept brought to public consciousness by psychologist Mihaly Csikszentmihalyi, and it refers to a state in which we feel good about what we’re doing, and just keep doing, at a peak performance level.

    Writer’s note: as a writer, for example…

    Sometimes I do not want to write, I pace to and fro near my computer, going on side-quests like getting a coffee or gazing out of the window into my garden. But once I get going, suddenly, something magical happens and before I know it, I have to trim my writing down because I’ve written too much. That magical window of effortless productivity was a state of flow.

    Good morning!

    What is a good morning, to you? Build that into your morning! Set parameters around it so you don’t get carried away timewise and find yourself in the afternoon (unless that would work for you!), but first thing in the morning is the time to light up each part of your brain with appropriate neurotransmitters.

    Getting the brain juices flowing

    Cortisol

    When we wake up, we (unless we have some neurochemical imbalance, such as untreated depression) get a spike of cortisol. Cortisol is much-maligned and feared, and indeed it can be very much deleterious to the health in cases of chronic stress. But a little spike now and again is actually beneficial for us.

    Quick Tip: if you want to artificially stimulate (or enhance) a morning cortisol spike, a cold shower is the way to go. Or even just a face-plunge into a bowl of ice-water (put ice in it, give it a couple of minutes to chill the water, then put your face in for a count of 30 seconds, or less if you can’t hold your breath that long).

    Serotonin

    Serotonin is generally thought of as “the happy chemical”, and it’s stimulated by blue/white light, and also by seeing greenery.

    Quick tip: to artificially stimulate (or enhance) a morning serotonin boost, your best friend is sunlight. Even sun through a partly-clouded sky will tend to outperform artificial lighting, including artificial sunlight lighting. Try to get sun between 08:30 and 09:00, if you can. Best of all, do it in your garden or nearby park, as the greenery will be an extra boost!

    Dopamine

    Generally thought of as “the reward chemical”, but it’s also critical for a lot of kinds of brainwork, including language processing and problem-solving.

    Quick Tip: to artificially stimulate* a dopamine surge to get you going, do something that you and/or your body finds rewarding. Examples include:

    • Exercise, especially in a vigorous burst
    • A good breakfast, a nice coffee, whatever feels right to you
    • An app that has motivational bells and whistles, a streak for you to complete, etc

    Note: another very enjoyable activity might come to mind that doesn’t even require you getting out of bed. Be aware, however, gentleman-readers specifically, that if you complete that activity, you’ll get a prolactin spike that will wipe out the dopamine you just worked up (because prolactin is antagonistic to dopamine). So that one’s probably better for a lazy morning when you can go back to sleep, than a day when you want to get up and go! Ladies, this is less of a worry for us as the physiology an orgasm driven by estrogen+progesterone rather than testosterone is different; there will not usually be a prolactin spike following the spike of dopamine; our orgasm-related dopamine spike is followed by a wave of oxytocin instead (“the cuddle chemical”), which is much more pleasant than prolactin.

    *there’s no “(or enhance)” for this one; you won’t get dopamine from doing nothing, that’s just not how “the reward chemical” works

    Flow-building in a stack

    When you’ve just woken up and are in a blurry morning haze, that’s not the time to be figuring out “what should I be doing next?”, so instead:

    • Work out the things you want to incorporate into your morning routine
    • Put them in the order that will be easiest to perform—some things will go a lot better after others!
    • Remember to also include things that are simply necessary—morning bathroom ablutions, for example

    The goal here is to have a this-and-this-and-this-and-this list of items that you can go through without any deviations, and get in the habit of “after item 1 I automatically do item 2, after which I automatically do item 3, after which…”

    Implement this, and your mornings will become practically automated, but in a joyous, life-enhancing way that sets you up in good order for whatever you want/need to do!

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  • Long COVID is real—here’s how patients can get treatment and support

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    What you need to know

    • There is still no single, FDA-approved treatment for long COVID, but doctors can help patients manage individual symptoms.
    • Long COVID patients may be eligible for government benefits that can ease financial burdens.
    • Getting reinfected with COVID-19 can worsen existing long COVID symptoms, but patients can take steps to stay protected.

    On March 15—Long COVID Awareness Day—patients shared their stories and demanded more funding for long COVID research. Nearly one in five U.S. adults who contract COVID-19 suffer from long COVID, and up to 5.8 million children have the disease.

    Anyone who contracts COVID-19 is at risk of developing long-term illness. Long COVID has been deemed by some a “mass-disabling event,” as its symptoms can significantly disrupt patients’ lives.

    Fortunately, there’s hope. New treatment options are in development, and there are resources available that may ease the physical, mental, and financial burdens that long COVID patients face.

    Read on to learn more about resources for long COVID patients and how you can support the long COVID patients in your life.


    What is long COVID, and who is at risk?

    Long COVID is a cluster of symptoms that can occur after a COVID-19 infection and last for weeks, months, or years, potentially affecting almost every organ. Symptoms range from mild to debilitating and may include fatigue, chest pain, brain fog, dizziness, abdominal pain, joint pain, and changes in taste or smell.

    Anyone who gets infected with COVID-19 is at risk of developing long COVID, but some groups are at greater risk, including unvaccinated people, women, people over 40, and people who face health inequities.

    What types of support are available for long COVID patients?

    Currently, there is still no single, FDA-approved treatment for long COVID, but doctors can help patients manage individual symptoms. Some options for long COVID treatment include therapies to improve lung function and retrain your sense of smell, as well as medications for pain and blood pressure regulation. Staying up to date on COVID-19 vaccines may also improve symptoms and reduce inflammation.

    Long COVID patients are eligible for disability benefits under the Americans with Disabilities Act. The Pandemic Legal Assistance Network provides pro bono support for long COVID patients applying for these benefits.

    Long COVID patients may also be eligible for other forms of government assistance, such as Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid, and rental and utility assistance programs.

    How can friends and family of long COVID patients provide support?

    Getting reinfected with COVID-19 can worsen existing long COVID symptoms. Wearing a high-quality, well-fitting mask will reduce your risk of contracting COVID-19 and spreading it to long COVID patients and others. At indoor gatherings, improving ventilation by opening doors and windows, using high-efficiency particulate air (HEPA) filters, and building your own Corsi-Rosenthal box can also reduce the spread of the COVID-19 virus.

    Long COVID patients may also benefit from emotional and financial support as they manage symptoms, navigate barriers to treatment, and go through the months-long process of applying for and receiving disability benefits.

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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