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Question:

From Canada:

I am 23 years old and was diagnosed with Type 2 diabetes 2 years ago. However, I was wondering if I would eventually become Type 1. I discussed this with my family doctor and requested a test be done of the presence of autoantibodies to islet cells which I understand to be the only way to know for sure. My doctor apparently has not heard of this test and insisted I was Type 2 because I'm not insulin dependent. Is there a name for this test? I'm from Canada and my doctor was wondering if this was a test only done in the United States? Knowing for sure what to expect in the future would take a lot of pressure off my mind.

Answer:

Whether you have Type 1 diabetes (which is an autoimmune disorder), or Type 2 (which has unknown causes or causes), is usually decided on clinical grounds: age at onset, weight at onset, and need for insulin to avoid severe hyperglycemia and ketoacidosis. However, there also are several other less-well-understood varieties of diabetes, one called "slowly evolving Type 1 diabetes," and another, "Type 1.5 diabetes," that clearly show that the standard definitions are inadequate.

Testing for antibodies is being done in a few commercial laboratories in the USA (and presumably elsewhere), but the testing methods are really not very well worked out, and therefore many endocrinologists still view the concepts as investigational and best done in a medical research setting. Also, HLA testing can be done, and combined with testing for ICA's and other antibodies to help analyze the situation better.

By the way, Type 2 diabetes does not become Type 1; perhaps some of the cases that seem to be this way really are cases of slowly-evolving Type 1 diabetes.

You can review previous questions and answers about the Causes and Prevention of diabetes for more information.

WWQ

Original posting 8 Feb 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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