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March 28, 2001

Diagnosis and Symptoms

Question from Los Angeles, California, USA:

My mother and one sibling have both had type 1 diabetes for years, and at 30 years of age, I was diagnosed with type 2. Previously, I developed Grave's disease and polycystic ovary syndrome in my late teens. It seems like insulin resistance has direct links to type 2, Graves and PCOS. After several months of treatment with oral agents, my endocrinologist placed me on insulin because I had been max'ed out on three medications, still had high blood glucose levels and hope to become pregnant in the not too distant future. Considering my family history, I wonder what risk, if any, there is that I could eventually become completely insulin dependent (type 1)? Does type 2 diabetes ever develop into type 1?

Answer:

Polycystic Ovary Syndrome (PCOS) is associated with insulin resistance. This can be a forerunner of type�2 diabetes. However, there are a number of adults who are diagnosed with type2 diabetes originally which turns out to be a Late-onset Autoimmune Diabetes of Adulthood (LADA) These patients have positive antibodies. A history of Graves’ Disease fits this, as Graves’ disease is another autoimmune disease. Finally, your insulin secretory reserve can be evaluated and followed. This falls over time in individuals with true type�1 diabetes. The fact that you are already on three medications suggests you may have a form of LADA.

JTL