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October 29, 2004

Diagnosis and Symptoms

Question from Washington, USA:

Does pre-diabetes commonly precede type 1 diabetes in older patients? My doctor has said that because of my age, 20 years old, and the fact that I have been diagnosed with impaired glucose tolerance (an OGTT was performed), I am developing type 2. However, I am not overweight at 4 feet 10 inches, 106 pounds. I do not have high blood pressure or other symptoms of syndrome X and I have no family history. I do, however, have a heavy family history of thyroid failure. I've been trying to come to grips with this situation, but now, I have begun to suffer 'lows' and I am questioning what was said to me. After reading through previous Ask the Diabetes Team questions on this site and others, I am under the impression that this doesn't happen in the progression of type 2. Should I ask for an antibody test, and if so, how much do they cost, or can they be gotten for free somehow? Please advise as I am unable to see an endocrinologist.

Answer:

Some patients present with a late-onset form of type 1 diabetes that looks like type 2 diabetes at first. This is referred to as LADA (late-onset autoimmune diabetes of adulthood). The difference between LADA and type 2 diabetes is that beta cell function falls off appreciatively within months to years of diagnosis. The antibody test is helpful for predicting a late-onset form of type 1 diabetes if it is positive. On the other hand, there is no therapy specific for LADA at this time. The things under your control are to chose a healthy lifestyle and get good medical follow-up care. The antibody test is not cheap and it is not usually available for free.

JTL