No, type 1B does not = type 2. They both fit under the umbrella of type 1 diabetes as defined by the American Diabetes Association.
This articles explains nearly EVERYTHING about the differences, similarities, and distinctions between the many types of diabetes (type 1, type 2, gestational, and other disorders that result in hyperglycemia):
http://care.diabetesjournals.org/cgi/reprint/26/suppl_1/s5.pdf
Gotcha. But it is more genetically linked with Type II from what I was briefly reading in another article. Will read more. Thanks for the cite.
You've got me on a bit of a chase. Good job!! I thrive on research and a true scientist doesn't stop asking questions. So for you to say that you are interested in medicine is wonderful. If you are interested, I can send you research articles (I have subscriptions to various sources). Just give me a topic. Ha ha.
Now, lets clarify some points. There are several genetic mutations associated with beta cell function, with insulin action, as well as diseases of the exocrine and endocrine properties of the pancreas and other genetic mutations that cause Type 1 diabetes. The term idiopathic simply means something that arrises from unknown causes. Unfortunately, quite a few articles on the web are misleading in that they encorporate many forms of diabetes with "Idiopathic Type 1 diabetes" because of the general term.
Actual Idiopathic Type 1 diabetes is a rare form of diabetes most commonly seen in obese African American individuals living in large urban areas. This type of diabetes usually presents with the typical signs and symptoms of Type 1 diabetes such as diabetic ketoacidosis but its subsequent clinical course often resembles Type 2 diabetes. The natural history and pathogenesis of idiopathic Type 1 diabetes is unknown because most of these studies on these patients were done shortly after diagnosis. For the most part, these patients have been treated as if they had Type 2 diabetes with diet and/or oral agents but recent studies suggest that patients have a very variable response to diet and oral agents. They seem to have better long-term glycemic control with the use of insulin therapy. Although the pathogenesis of this disease is unknown, it may be related to lipotoxicity, glucose toxicity or transcription factors involved in fuel metabolism. (As a side note, I will also say that I am very aggressive in treatment of my Type 2 diabetics using insulin. The glycemic control and outcomes are excellent. I may just start trying to research my own patients to see if in fact this rare disease occurs in my own patient population. Nonetheless, treatment is not necessarily going to change.)
Of all of these rare types of type 1 diabetes, all together they only account for approximately 10% of the Type 1 diabetes community. Another 10% account for inhereted Type 1 diabetes. And the other 80% are autoimmune. Researching is mainly focused on the 10% inhereted because family studies are so important in identifying the internal switch that turns diabetes on, and preventing/slowing progression of disease. It is true that study of individuals with some beta cell functioning is extremely important but the with idiopathic Type 1 diabetes being so rare, it would be difficult to obtain a large study group population and I wonder if the difference in disease pathology would generate significant generalizable research.
Any way you look at it, you gave me a thought on another thesis! LOL Thanks for the spark! Keep 'em flowing!
So the verdict is out - I'm negative for GAD autoantibodies. So maybe I do have type 1B? I guess it doesn't really matter though since my C-peptide is so low(<1); so, basically I continue treatment as I normally would.
I knew I was special. Hahaha.
According to my doc, it was autoimune.
[quote user="Mad Evans"]Type 1 Diabetes Mellitus Type 1 diabetes has been subdivided into:
- Immune-mediated diabetes (Type 1A). This form of diabetes results from a cellular-mediated autoimmune destruction of the beta cells of the pancreas. Markers of the immune destruction of the beta cell include islet cell autoantibodies and other antibodies. One and usually more of these autoantibodies are present in 85 - 90% of individuals when fasting hyperglycemia is initially detected. Also, the disease has strong HLA associations.
- Idiopathic diabetes (Type 1B). Some forms of Type 1 diabetes have no known etiologies. Some of these patients have permanent insulin deficiency and are prone to ketoacidosis but have no evidence of autoimmunity. Although only a minority of patients with Type 1 diabetes fall into this category, of those who do, most are of African, Hispanic, or Asian origin. Individuals with this form of diabetes suffer from episodic ketoacidosis and exhibit varying degrees of insulin deficiency between episodes. This form of diabetes is strongly inherited, lacks immunological evidence for beta cell autoimmunity, and is not HLA associated. An absolute requirement for insulin replacement therapy in affected patients may come and go.
Source: http://www.childrenwithdiabetes.com/dictionary/t.htm
The question is... which type are you???
I'm getting my GAD antibodies tested (tells whether you are predisposed for autoimmune diabetes) and also my C-peptide levels tested (tells whether you are still producing any insulin or not) in February so I may find out soon! I'm thinking I have type 1A since I was diagnosed shortly after having a viral infection.
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Since I have had diabetes for over 15years and yet have had to deal with ketoacidosis..I'd say I'm Type 1A :)
That's some pretty interesting stuff you posted! I've never heard of T1a vs T1b!
has anyone heard about something scientists were able to make tobaco grow in the plant that could help prevent or cure type 1 diabetes?
a few years ago...god i must've been in highshool i think..so 4ish years ago...they were talking about how they thought they had found a plant that could produce insulin and that they were going to grow it in huge fields to make natural insulin for diabetes or something. nothing came of it, as to be expected.
Hahahaha. Yeah, this one doesn't look all too promising either... all it seems to do is decrease immune function, which may be beneficial in reducing your risk of developing type 1 if you are undiagnosed but doesn't seem like it would do much to "cure" the disease.
http://www.reuters.com/article/scienceNews/idUSTRE52I04720090319
Wow, that's really interesting. No pump for a few days? That definitely seems like type 1B then, unless you are still in a 'honeymoon phase'? Is it also possible you were active through out the entire day (I guess in this case you would wake up high, though)? Personally if I have any kind of activity, e.g., doing the laundry, cooking a meal (just pacing to and from the fridge, for example) I will go low if I have any basal running.
Yeah, that's what I thought, too. But since my C peptide is low, that means my pancreas isn't producing much insulin at all and I'm out of the honeymoon phase. It could be just because I'm so thin and don't require much insulin (I literally cannot put any fat on my body, it's extremely frustrating). And I'm usually not too active... I may go skateboarding about once a week but other than that I'm usually sitting at school, sitting at work, or sitting doing homework assignements, etc. Lots of sitting.
So insulin sensitivity changes from person to person.. I guess that could explain your extremely low basal? But what about when you weren't wearing your pump for a couple days? I guess in this case the insulin you took at meal times was also enough to cover your basal glucose release (have you seen the sphere model of insulin injection?).
Also, am I to understand type 1B is only essentially different in the cause (no sign of auto-immune), based on rmeadowsaprn post of how type 1B stop producing insulin due to beta-cell exhaustion past a certain point? Thanks.
Sorry if I am boring everybody to death, but basically I'm just trying to figure this all out for myself (and instead of writing on paper and feeling like I'm doing more schoolwork, might as well document it here, eh?).
I read this paper: http://www.ibms.org/index.cfm?method=science.clinical_chemistry&subpage=clinical_chemistry_reclassifying_diabetes
I found some interesting stuff about a novel type of 1b diabetes. I may have something similar to this group of 11 patients studied in Japan:
To summarise, the Japanese researchers identified 11 patients with unusually rapid onset and severe type 1 diabetes (ß-cell destruction) but no evidence of an autoimmune process to explain the destruction. The unusual presentation included evidence of pancreatic exocrine damage. They believe they have identified a novel subtype of type 1B diabetes characterised by near normal HbA1c and raised pancreatic enzymes at the time of diagnosis. The suggestion is that the beta-cell destruction and resulting insulin deficiency in this subtype of diabetes is caused by a virus infection of pancreatic exocrine tissue. This work provides more evidence of the heterogenity of diabetes.
What's most interesting to me is that last statement. It seems like researchers have been working so hard to fit type 1 diabetes into this neatly organized box - all involving the same symptoms, pathophysiologies, and laboratory markers. But, my guess is that destruction of the beta cells can occur in a variety of different ways. It may be an autoimmune reaction to a specific virus, or it may be an autoimmune reaction to a different virus (hell, some of us may have even had an autoimmune reaction to an immunization that ended up going bad and destroying our pancreatic beta cells). Who knows, I heard from a friend that her friend was actually diagnosed while in Costa Rica after getting a parasitic infection. Supposedly (the doctors think), the parasite made it's way from the gut into the pancreatic duct and ate up all of his pancreatic beta cells. Scary. I hope that's not what happened to me, hahaha.
Yeah, that could be it. It does seem like I subconsciously give myself about a unit extra per meal/snack of rapid insulin when I'm not wearing my pump. And, from the sphere hypothesis, that would basically cover my already low need for insulin basally.
Yes, there are a few types of "type 1B" that researchers are beginning to learn about. But, you're right, basically the only difference is the cause.
Ahhh this is confusing! Alyssa, I agree with you. But I'm almost positive I have Type 1A + whatever else there is in the unknown realm of diabetes...
[quote user="Batts"]
a few years ago...god i must've been in highshool i think..so 4ish years ago...they were talking about how they thought they had found a plant that could produce insulin and that they were going to grow it in huge fields to make natural insulin for diabetes or something. nothing came of it, as to be expected.
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True, again with the false hopes... we could make a post about that... yet again no, it could be just depressing for some. Or we could mock all of those false hopes because they are so annoying... :S
[quote user="Cesar"]
True, again with the false hopes... we could make a post about that... yet again no, it could be just depressing for some. Or we could mock all of those false hopes because they are so annoying... :S
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i was doing some research and found this study done in 2004 where scientists cured diabetic mice by injecting something in their stomach. and it was succesful.
They cured it in humans by injecting stem cells into the pancreas down in Brazil.
http://www.timesonline.co.uk/tol/life_and_style/health/article1637528.ece
The procedure is risky though, and it involves a lot of immunosuppresive drugs. So it's still not considered a safe and viable "cure" at this point.
exactly. while they have been known to "cure"(we have yet to hear if it was permanent)..it would mean WORSE medication to keep it working. So it may be a cure..but it's more replacing one medical condition with another medical condition.
I'd rather keep taking needles, than have to down keno-type anti-rejection drugs everyday for the rest of my life..