Lance Bass diagnosed with Type 1.5 diabetes

A few years ago, Bass was diagnosed with Type 2 diabetes. However, despite his efforts to eat right, exercise, and take medication, he had difficulty managing his symptoms. After multiple medications, three different doctors, and over four years, Bass discovered he had been misdiagnosed.

Instead of having Type 2 diabetes, Bass has a lesser-known condition called Type 1.5 diabetes, or latent autoimmune diabetes in adults (LADA). This condition occurs when the pancreas stops making insulin, typically because an autoimmune process is damaging the organ's cells.

"[W]hen I was first diagnosed, I had a difficult time getting my glucose levels under control even though I made adjustments to my diet, my medications and my workout routine," Bass said. "Things just weren't adding up."

"You just feel like there's something wrong with you. How am I broken? Why can no one can figure this out?" Bass said. "… The fact we realized it was this 1.5 just changed everything. And I know there are millions of people going through this with their doctor where their doctor just didn't realize."

Since his diagnosis, Bass has been raising awareness of Type 1.5 on social media. He is also an ambassador for Dexcom, which manufactures continuous glucose monitors.

According to Bass, it was only when he started using a continuous glucose monitor that doctors were able to see that his blood sugar readings weren't typical for Type 2 diabetes and diagnosed him with Type 1.5.

What is Type 1.5 diabetes?

Like Type 1 diabetes, Type 1.5 is an autoimmune disease, but the condition develops more slowly, and people with the condition may not need to use insulin right away. The American Diabetes Association considers the condition to be a subset of Type 1 diabetes since they are both autoimmune in nature.

"[This] destruction of beta cells [in the pancreas] occurs very slowly over many years," said Saleh Adi, a pediatric endocrinologist and VP of medical affairs at Willow Laboratories. "This results in a gradual loss of insulin secretion and an increase in blood glucose levels. Patients with LADA remain asymptomatic for years until there is significant loss of beta cells, or there is an increase in insulin resistance."

Because the condition develops gradually and is typically diagnosed in adults, Type 1.5 diabetes is sometimes misdiagnosed as Type 2 diabetes. Between 4% and 12% of people who have been diagnosed with Type 2 diabetes may actually have Type 1.5 diabetes instead.

According to Adi, certain clinical clues may indicate that a patient has Type 1.5 diabetes instead of Type 2:

• The patient has another autoimmune condition or a close family member with an autoimmune condition.
• The patient's blood glucose level does not improve while on medication for Type 2 diabetes.
• The patient does not have other signs of Type 2 diabetes, such as being overweight or having insulin resistance.

To be diagnosed with Type 1.5 diabetes, the presence of at least one pancreatic autoantibody needs to be identified. Low levels of C-peptide, which is used as a surrogate for insulin levels in the blood, may also suggest that a patient has Type 1.5 diabetes instead of Type 2.

Currently, there is no way to prevent Type 1.5 diabetes, but symptoms can be treated. Initially, the condition may be managed with lifestyle changes, such as maintaining a healthy weight and eating a healthy diet, but over time, patients will need to use insulin as their bodies lose the ability to make their own.

Earlier treatment with insulin may also slow the loss of beta cells in the pancreas and make it easier for patients to manage their symptoms. "Current evidence is that early initiation of insulin therapy can slow down beta cell loss, making it easier to manage diabetes without a high risk of hypoglycemia," Adi said.

Overall, limited awareness of Type 1.5 diabetes and unclear diagnostic criteria have made it difficult to get a full understanding of the condition. More research on Type 1.5 diabetes, especially in non-European populations, is needed to determine how many people have the condition and the best way to diagnosis and treat it.

"Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce diabetes distress," The Conversation wrote. "If you're experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you've already received, monitor your symptoms and chat with your doctor." (Reed, Axios, 10/21; Burch/Ball, The Conversation, 8/26; Radcliffe, Healthline, 8/8; McGorry, Fox News, 8/14)

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