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August 26, 1999

Diagnosis and Symptoms

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Question from Houston, Texas USA:

I am a 38 year old female. I was diagnosed with type 1 diabetes one month ago. I had all the classic symptoms such as constant hunger, thirst, and urination. My weight went from 114 to 101. After a glucose screening, my blood sugar was 571. I was very dehydrated and admitted to the hospital for two days.

How common is it for a woman my age to get type 1 diabetes? I was diagnosed with hypothyroidism one year ago. At that time I was given an anti-nuclear antibody test. It was negative. Does this mean anything in relation to my diabetes?

Also, I have been taking three shots a day of insulin (R and NPH). I am now in the honeymoon phase taking only 2 units of R and 6 units of NPH. What are my chances of an extended honeymoon? Could I be a type 1B?

Answer:

From: DTeam Staff

Beginning from your last question: yes, you could be Type 1B. even though that type of classification of Type 1 diabetes doesn’t exactly fit with epidemiological and clinical findings. Type 1A is the most common form, early onset, male predominant, and Type 1B tends to be late onset, female predominant, with associated autoimmune endocrinopathies. As we ascertain more and more newly type 1 diabetic patients trough the diabetes registries all over the world, and we are better able to identify prediabetes in the background population by immune markers and genetic determinants, we see that the incidence (i.e. the risk) of type 1 autoimmune diabetes is higher than expected in “older” age groups (that is, older than 20-25 years) and there are proper studies carried out in Europe (IDA, Insulin Dependent of the Adults, sponsored by the EU) and in the USA to register all older cases of clinical diabetes and to ascertain through follow up which are truly late onset type 1 (so-called LADA) and which are early onset Type 2.

Finally, to answer your other question, the honeymoon phase is generally longer in LADA than in children.

MS