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Man diagnosed with rare Type 1.5 diabetes


NORMAN, Okla. — We’ve all heard of Type 1 and Type 2 diabetes. Type 1, is when the body isn’t producing insulin; it’s typically diagnosed before the age of 20.

Type 2, usually diagnosed later in life, is when the cells don’t respond properly to insulin or there isn’t enough insulin being produced. But, a 35-year-old man fell in between and has now has actually been diagnosed with Type 1.5 diabetes.

This all came to light when Nathan Mobley, who is slender and active with a healthy diet, started experiencing extreme thirst and couldn’t stay awake.

“I was sluggish at work. It was hard to pay attention at times. I was very tired. I would never take naps on the weekends, but I would. I felt completely exhausted,” Mobley explains.

Type 1.5 is also known as LADA. It stands for Latent Autoimmune Diabetes in Adults. People who have it show both signs of Type 1 and Type 2, but they’re often misdiagnosed as Type 2.

At first Mobley’s doctor thought he had Type 2; then Type 1. Then came the diagnosis from the Harold Hamm Diabetes Center at OU. It was Type 1.5. The body’s immune system actually destroys or damages the insulin producing cells.

“But it does this in a way that’s on a timetable that’s much more drawn out and more gradual than usual than Type 1 diabetes,” says Dr. James Lane, a physician at the Harold Hamm Diabetes Center.

He immediately put Mobley on a diabetic diet and he lost several pounds. He is battling this unusual disease with exercise, nutrition, and oral medication.

In the early stages of LADA patients typically don’t need insulin but require it in later year to keep this little known, but dangerous, condition under control.

Additional information below is from the http://forecast.diabetes.org/ website, an affiliate of the American Diabetes Association:

Surprise Finding
Doctors stumbled upon the LADA phenomenon quite by accident back in the 1970s. They were testing a way of identifying proteins called auto­antibodies in the blood of people with type 1. The presence of these proteins is evidence of an attack by one’s own immune system. The new test was successful and confirmed for the first time that type 1 is an autoimmune disease in which the body’s immune system kills off the beta cells in the pancreas, the makers of insulin.

As part of their study, the researchers also looked for the same autoantibodies in the general population and in people with type 2 diabetes (which is not an autoimmune disease). The proteins were virtually absent in the general population, but they showed up, to the scientists’ surprise, in about 10 percent of people diagnosed with type 2. This suggested that there was a subcategory of people who could now be diagnosed as having LADA instead, even though there was no obvious difference in their symptoms from those of people with type 2.

While not everyone has settled on calling the condition LADA (some prefer “type 1.5”), or even whether it’s distinct from type 1, researchers are working on a set of criteria for its diagnosis: 1) the presence of auto­antibodies in the blood, 2) adult age at onset, and 3) no need for insulin treatment in the first six months after diagnosis. This definition would distinguish LADA from type 1—because people diagnosed with type 1 typically need to start insulin immediately—and from type 2, because of the presence of autoantibodies in the blood. There is still some controversy about whether these are the best criteria for diagnosing LADA. But “the general concept is very well accepted,” says Jerry Palmer, MD, a professor at the University of Washington in Seattle.

The debate over LADA has led some doctors to move away from the idea that the various types of diabetes are truly separate entities. “We think there is a continuum in diabetes overall,” says Suat Simsek, MD, a professor at VU University Medical Center in the Netherlands. Autoantibodies and their effect on beta cell health may be the key to defining the relationships among type 1, type 2, and LADA. Scientists have discovered several different types of auto­antibodies related to diabetes. People with type 1 have higher levels and more types of these proteins than do those with LADA, which may be the reason beta cells are destroyed faster in type 1 than in LADA. In type 2 diabetes, autoantibodies are generally absent and, as a consequence, beta cell decline is the slowest.