The singer Lance Bass has shared a surprising update to his diabetes diagnosis: He doesn’t have the type of the disease he originally thought he had.
Bass disclosed a “plot twist” about his diagnosis in an Instagram Reel, sharing that he has a condition known as type 1.5 diabetes, which can develop in adulthood and shares some symptoms with both type 1 and type 2 diabetes.
“As many of you know, I was diagnosed with type 2 diabetes a few years back,” Bass said in the post. “But when 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.”
“But I recently discovered that I was misdiagnosed,” Bass continued in the post. “I actually have type 1.5, also known as LADA, or latent autoimmune diabetes of adults.”
What Is Type 1.5 Diabetes, or Latent Autoimmune Diabetes of Adults (LADA)?
Like type 1 diabetes, type 1.5 diabetes happens when the pancreas stops making the hormone insulin, which the body needs to effectively convert the sugars in our diet into energy. Per Mayo Clinic, this typically happens because an autoimmune process damages cells in the pancreas. But unlike type 1, which comes on quickly and requires insulin treatment right away, type 1.5 develops very slowly and can often be managed without insulin for a period of time when the pancreas hasn’t completely stopped making this hormone.
“LADA, sometimes referred to as type 1.5 diabetes, is autoimmune diabetes that develops later in life, usually in adults over the age of 30, and progresses more slowly, at least in the first few years of the condition,” says M. Regina Castro, MD, an endocrinologist and a professor at Mayo Clinic in Rochester, Minnesota.
“Most patients may be managed without insulin early on, at least during the first six months after diagnosis,” Dr. Castro says. “But ultimately as the disease progresses, all individuals with LADA will require insulin therapy.”
How Is Type 1.5 Diabetes Diagnosed?
- Frequent thirst
- Frequent urination
- Blurry vision
- Loss of weight even when appetite goes up
- Frequent infections
- Weakness and fatigue
- Dry, itchy skin
- Tingling in your hands or feet
One key difference with type 1.5 diabetes is that it often develops in people who are at a normal weight, while type 2 diabetes is associated with obesity. “Unlike people with type 2 diabetes, those with LADA are generally not overweight, are often lean, and do not respond well to oral agents commonly used in type 2 diabetes,” Castro says.
“So, if you are an adult over the age of 30 newly diagnosed with diabetes, lean and physically active and without a strong family history of type 2 diabetes, and your blood sugars are not improving or reaching goals despite adherence to recommended treatment, you should ask your doctor to test you for autoimmune diabetes,” Castro adds. This is a simple blood test that looks for antibodies that form when the body attacks the insulin-making cells in the pancreas.
How Is Type 1.5 Diabetes Treated?
Unlike type 2 diabetes, which can sometimes improve with lifestyle changes, type 1.5 diabetes can continue to progress even when you get plenty of exercise, eat well, and maintain a healthy weight, says Jason Gaglia, MD, an endocrinologist at the Joslin Diabetes Center in Boston and an assistant professor at Harvard Medical School.
“If someone is overweight or obese, weight loss could be helpful, and if someone is sedentary, increasing activity could be helpful,” Dr. Gaglia says. But this will only go so far in managing symptoms, and insulin will eventually be needed.
“Over time, as the amount of insulin the body makes continues to decrease, these efforts are usually not enough,” Gaglia says. “This can lead to frustration, as the patient is ‘doing everything right,’ but the blood sugars are still higher than they would like. This is why it is important to correctly make this diagnosis.”
Type 1.5 diabetes typically doesn’t respond to medications used in type 2 diabetes, Castro says.
As the disease progresses, people with type 1.5 diabetes will take insulin to manage their blood sugar levels, similar to treatment for type 1 diabetes. As with type 1 diabetes, there’s currently no cure for type 1.5 diabetes, Castro says.
Can You Prevent Type 1.5 Diabetes?
There’s currently no clear way to prevent type 1.5 diabetes, because it’s an autoimmune condition and its triggers aren’t clearly understood, Castro says.
People might, however, be able slow the progression of damage in the pancreas that leads them to require insulin, Gaglia says.
“As diabetes is an imbalance between the amount of insulin the body can make and the amount that the body needs, one could take steps to try and decrease the amount of insulin the body needs,” Gaglia says. “This could include keeping weight in the normal range, eating a healthy diet, and staying active.”
The Bottom Line
If you get a type 2 diabetes diagnosis but your symptoms don’t improve with medication or lifestyle changes that are typically used to manage this condition, you should ask your doctor to test you for type 1.5 diabetes.
“It is not unusual to be misdiagnosed, so people need to keep an open mind and determine if it makes sense to check for LADA,” Gaglia says.