Can Type 2 Diabetes Turn Into Type 1?

You may be familiar with the different types of diabetes.

There is gestational diabetes, which is the type of diabetes that occurs during pregnancy.

Type 1 diabetes used to be referred to as insulin dependent diabetes.

Type 2 diabetes used to be called non insulin dependent diabetes.

This begs the question: could non insulin dependency turn into insulin dependency?

Can type 2 diabetes turn into type 1 diabetes? Let’s discuss it.

Can type 2 diabetes turn into type 1?

The short answer is no. Type 1 diabetes and type 2 diabetes are two distinct health conditions. They each have different causes. One cannot transform into the other over time.

However, someone with a type 2 diabetes diagnosis can get a diagnosis of type 1 diabetes later on in life. It is important to note that this is a separate diagnosis, though.

Type 2 diabetes mellitus is the most common type of diabetes. This is one reason a doctor may think you have type 2 diabetes, even though it is type 1. It is less common that a person develops type 1 diabetes in adulthood, but it can still happen!

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Misdiagnosis

It is possible to be incorrectly diagnosed with type 2 diabetes when it is, in reality, type 1 diabetes of adulthood. This can happen if the patient has risk factors for type 2 diabetes, such as being overweight or having a sedentary (inactive) lifestyle.

Although it is less common, type 1 diabetes can develop during adulthood. Someone with type 2 diabetes who later gets a diagnosis of type 1 diabetes has not had a change in their type of diabetes. It is more likely that they were misdiagnosed with type 2 diabetes, to begin with.

Diagnosis of diabetes occurs through testing blood glucose levels. However, these tests do not determine which type of diabetes it is.

There is a blood test to check for antibodies that attack the beta cells of the pancreas.

If this is positive, it is more likely that the patient had type 1 diabetes all along. In fact, 90 percent of patients with type 1 diabetes have these antibodies.

Another test for diabetes is a C peptide test. It measures how much insulin the pancreas is producing. If C peptide levels are low, this indicates that type 1 diabetes may be present.

LADA

A patient could have lots of the symptoms of type 2 diabetes but actually have LADA.

LADA is more closely related to type 1 diabetes. It stands for latent autoimmune diabetes in adults.

Researchers believe that somewhere between four and 14 percent of patients diagnosed with type 2 diabetes have LADA.

This is because many doctors don’t even know about LADA. Physicians often assume a person has type 2 diabetes if they are an adult with diabetic symptoms.

Both LADA and type 2 diabetes develop in adulthood.

The symptoms of LADA mimic the symptoms of type 2 diabetes.

These include the following:

  • Excessive thirst

  • Blurry vision

  • High blood sugar

  • Insulin resistance

When they suspect diabetes, doctors don’t usually run the tests for LADA. At first, a patient with LADA’s pancreas will produce some insulin. At first, treatments for type 2 diabetes will typically work well on someone with LADA.

These include the following:

  • Changes to the diet

  • Physical activity

  • Oral diabetes drugs

There continues to be quite a bit of uncertainty around LADA and how it works. Researchers don’t know too much about it.

However, they do know of certain genes that could play a role. Your doctor may not even realize that you have LADA until you aren’t responding well to exercise, nutritional changes, and type 2 diabetes medications.

It’s essential to make sure that what you have is actually diabetes and not another condition that presents similarly, such as cystic fibrosis, Celiac disease, or pancreatic cancer.

Difference between type 1 and type 2 diabetes

So, what’s the difference between type 1 and type 2 diabetes?

Type 1 diabetes is an autoimmune disease. It has also been called juvenile diabetes or neonatal diabetes, since it is diagnosed at an earlier age.

This means that the immune system is attacking your own body. The islet cells in the pancreas become wholly destroyed. The islet cells are where insulin production happens. This is why in type 1 diabetes, the body doesn’t produce any insulin at all.

Type 2 diabetes patients, on the other hand, have insulin producing cells that work. The body is resistant to that insulin being made, though. The body doesn’t efficiently use insulin.

Type 2 diabetes is much more common than type 1. Type 1 diabetes is usually present in childhood. Whereas, type 2 diabetes is more common in adults, specifically those who are overweight or obese.

This being said, it’s important not to rely on age to determine which type of diabetes is present. One of the reasons for this is that obesity is prevalent among children nowadays. Type 2 diabetes, though thought of as an adult condition, can happen even in childhood.

Type 1 diabetes and type 2 diabetes are different conditions. They have separate mechanisms.

A patient with type 1 diabetes will likely need to take insulin shots for the remainder of their life.

Insulin dependency

People with type 1 diabetes are dependent on insulin. This is why type 1 diabetes has sometimes been called insulin dependent diabetes.

It is vital for someone with type 1 diabetes to keep a close eye on their blood sugar levels to ensure they don’t get hyperglycemia or hypoglycemia.

Even though close monitoring and insulin therapy can help maintain low blood sugar levels, it’s still possible to develop high blood sugar.

When this happens, you may need more insulin or seek emergency medical care.

If you have type 2 diabetes, you may still need insulin. This may be the case if other treatments aren’t helping to control your blood sugar levels.

If you have any contraindications to medication, then you may need insulin with type 2 diabetes.

If type 2 diabetes becomes progressive to the point where your pancreas can no longer produce insulin, then you may also need insulin treatment through medication.

What is latent autoimmune diabetes in adults (LADA)?

LADA stands for latent autoimmune diabetes in adults. Some people refer to LADA as adult type 1 diabetes. This is because LADA is an autoimmune condition.

Just like in type 1 diabetes mellitus, in LADA, the pancreatic islet cells are destroyed. In LADA, this happens more slowly than in type 1 diabetes. It can take several months or even a few years.

Some people call LADA type 1.5 diabetes because it lies somewhere between type 1 and type 2. Diabetes can happen along a spectrum.

LADA develops in adulthood. It has a slower onset than type 1 diabetes. It usually develops in people who have not had weight gain or have other metabolic issues (like high blood pressure or high cholesterol).

Patients with LADA also produce antibodies that work against the islet cells of the pancreas.

The symptoms of LADA

  • Increased thirst

  • Frequent urination

  • Blurry vision

  • High blood sugar

  • High sugar levels in the urine

  • Dry skin

  • Fatigue

  • Frequent infections

Treatment for LADA

  • Improving the diet

  • Exercise

  • Weight loss

  • Taking medications for diabetes

  • Insulin replacement therapy

  • Monitoring levels of hemoglobin a1c

LADA vs. diabetes

People with type 2 diabetes might never need insulin. They can also potentially reverse their diabetes with dietary changes and by losing weight.

However, people with LADA cannot do this. If you have been diagnosed with LADA, this means that you will eventually need to take insulin to stay healthy.

Conclusion

All of this information is a long way of saying that type 2 diabetes cannot turn into type 1 diabetes.

It’s more likely that the patient was misdiagnosed with type 2 diabetes, to begin with, and had type 1 diabetes all along.

Type 1 and type 2 diabetes each have different causes. It’s possible that what may seem like type 2 diabetes is LADA.

If you have prediabetes, speak to your doctor before it developing diabetes.

If you have been diagnosed with type 2 diabetes and suspect a misdiagnosis, talk to your health care provider. They can test for type 1 diabetes.

No matter which type of diabetes you may have, it is important to monitor your condition closely with your doctor.

Type 2 diabetes can put you at higher risk of diabetes complications such as kidney disease, heart disease, or diabetic ketoacidosis, which can be severe.

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Sources

  1. Brahmkshatriya, PP; Mehta, AA; Saboo, BD & Goyal, RK. (2012). Characteristics and prevalence of latent autoimmune diabetes in adults (LADA). Hindawi. 2012 (1), 1. https://pubmed.ncbi.nlm.nih.gov/22577577/
  2. Laugesen, E; Ostergaard, JA & Leslie, DG. (2015). Latent autoimmune diabetes of the adult: current knowledge and uncertainty. Diabetic Medicine. 32 (7), 843-52. https://pubmed.ncbi.nlm.nih.gov/25601320/
  3. Nambam, B; Aggarwal, S & Jain, A. (2010). Latent autoimmune diabetes in adults: A heterogeneous clinical entity. World Journal of Diabetes. 1 (4), 111-5. https://pubmed.ncbi.nlm.nih.gov/21537436/
  4. Unger, J. (2010). Latent autoimmune diabetes in adults. American Family Physician. 81 (7), 843-7. https://pubmed.ncbi.nlm.nih.gov/20353141/

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