Thursday, 23 October 2025

Hidden 'type 1.5' diabetes affects millions of adults. Here's how to spot it

From sciencefocus.com

By Prof Craig Beall

Misdiagnosis rates for this rare type of diabetes could be complicating treatment for patients 

You might be surprised to learn that there are more than two types of diabetes. We're all familiar with types 1 and 2, but you may have seen another one – type 1.5 – making headlines recently.

Type 1.5 diabetes, or latent auto-immune diabetes (LADA) to use its official name, is not a new form of diabetes, but it is somewhat rare. It’s been medically recognised as a distinct form of diabetes since 1993 and accounts for 3–12 per cent of all cases of diabetes in adults.

But as LADA shares similarities with its two, more famous, cousins, it's also trickier to identify. Hence, it's often misdiagnosed – a recent study suggests that as many as 14 per cent of people diagnosed with type 2 diabetes may actually have LADA.

Like type 1 and 2 diabetes, LADA is classed as a disorder of too much sugar, or glucose, in the blood.

When this occurs, it doesn’t matter what kind of diabetes you have – the symptoms remain the same: extreme thirst, frequent visits to the toilet, fatigue and unexplained weight loss. Diabetes UK, the leading UK charity for the disease, describe these as ‘the four Ts’: thirst, toilet, tired and thinner.

Once these symptoms appear, it's important to seek a diagnosis as soon as possible. Untreated diabetes can lead to a host of severe complications, impacting the kidneys, eyes and feet, as well as the nerve cells in your body.

But if the symptoms for these diseases are all the same, how can experts tell which kind of diabetes you really have? And how does it affect the way you treat it?

How type 1.5 diabetes compares to types 1 and 2

Diabetes, in its many forms, has ailed humans throughout history. A peculiar symptom often alerted healers in Ancient Greece, India and Egypt to the condition: the patient's urine smelled sweet. Hence the name Diabetes mellitus, taken from the Greek word ‘diabetes’, which means to pass through, and the Latin word ‘mellitus’, meaning sweet.

This aromatic side effect is caused by a build-up of glucose in the body. Glucose is meant to be broken down by a hormone called insulin, which is produced in the pancreas and converts glucose into a form that can be used as an energy source in cells.

A build-up of glucose happens when a person’s body either:

  • isn’t producing enough insulin (as is usually the case in type 1 diabetes)
  • or isn’t reacting to insulin the way it should (as in type 2 diabetes)

In either case, a lot of extra strain is put on the kidneys, which try to reabsorb the excess glucose floating around in the blood. When the kidneys can’t remove any more glucose, the excess sugar spills into the urine, offering a sign of the disease.

ADA shares a lot of similarities with these two main types of diabetes, but it has more in common with type 1 than type 2.

A doctor testing a patient's blood sugar levels using a finger prick test
Finger-prick tests provide an immediate snapshot of blood sugar levels

One of the main reasons people with type 1 diabetes don’t produce enough insulin is that their immune system attacks the cells in their pancreas that make the insulin. When a substantial number of these cells are lost, they can no longer make enough insulin to keep glucose levels in check.

The same is true in LADA – a swarm of immune cells attack the pancreas, leading to a drop in insulin production, which causes glucose levels to steadily increase. The two differ, however, when it comes to how long the disease takes to have an effect.

Type 1 diabetes takes effect rapidly, and is likely to be diagnosed in childhood or in a clinical emergency. LADA has a slower burn – hence the ‘latent’ in latent auto-immune diabetes – and doesn’t kick in until adulthood, commonly occurring in people above the age of 30.

As you age, a protective scaffold known as the peri-islet basement membrane (BM) forms around the insulin-making cells in your pancreas. Current thinking suggests that this scaffold helps to keep your immune cells from attacking your pancreas.

By the time that “autoimmunity starts in LADA, the pancreatic [cells] have already formed into larger structures and they’re better protected. They’re better able to resist the immune attack,” says Sarah Richardson, professor of cellular biomedicine at the University of Exeter.

The onset of LADA is therefore more similar to type 2, which usually rears its head during adulthood. It’s because of this similarity that up to 14 per cent of people diagnosed with type 2 diabetes are actually misdiagnosed cases of LADA.

Why misdiagnosis matters

The first line of treatment for type 2 diabetes is a medication called metformin. Given in tablet form, metformin works in two ways. Not only does it stop the liver from too much glucose, but it also increases the body’s sensitivity to insulin.

There isn’t, however, a definite, agreed-upon way of managing LADA yet. Metformin can be prescribed, as can insulin replacement therapy. If a person is misdiagnosed with type 2 diabetes when they really have LADA, they could be put on a course of metformin when they really need insulin.

The longer a person takes the wrong medication, the higher their glucose levels can climb. Over the longer term, high glucose levels increase the risk of heart disease and stroke, eye problems (retinopathy), foot problems (which can range from a higher risk of infection and ulcers to a loss of sensation), kidney disease (nephropathy) and nerve disease (neuropathy).

A 2018 study published in Diabetic Medicine found that people with LADA were more prone to developing severe neuropathy than people with type 2 diabetes.

LADA can also cause damage to small blood vessels, known as microvascular disease. A 2020 study found that implementing strict glucose control from the time a person was diagnosed with LADA could significantly reduce the later risk of microvascular disease.

Cutting down rates of misdiagnosis is therefore crucial for people with LADA, and thankfully there are a few key ways to tell it apart from type 1 and type 2 diabetes.

The first and most important thing doctors can do to differentiate the disease is to check for antibodies. These falsely tell immune cells to attack the insulin-producing cells in the pancreas. The presence of at least one antibody indicates autoimmune diabetes. If antibody levels are high, LADA may progress more quickly.

The same is true if multiple antibodies are found. In this case, insulin injections should be the first course of treatment, giving immediate and better control over glucose levels.

Doctors can also directly check a person’s insulin production. This is done by measuring a protein in their blood, called c-peptide, that’s made during pancreatic insulin production. Higher levels of c-peptide can be treated with metformin tablets, and very low or undetectable levels mean that insulin should be started immediately. In LADA, C-peptide levels decline with time – the current recommendation is to get them checked every six months.

A person’s body type can also be an indicator of LADA. If someone developed an increase in the ‘four Ts’ – thirst, toilet trips, tired and thinner – but had relatively low fat levels or body weight, they’re generally more likely to have LADA than type 2 diabetes. People with LADA also typically have better cholesterol, which can be used to narrow down a diagnosis.

Once the correct diagnosis has been made, LADA can be treated appropriately. It’s getting to this place, with the help of a medical professional, that’s critical.

https://www.sciencefocus.com/the-human-body/how-to-recognise-lada

Wednesday, 22 October 2025

Vegan Diet May Help People With Type 1 Diabetes Cut Insulin Costs by 27%

From technologynetworks.com

A low-fat vegan diet that doesn’t limit calories or carbohydrates could help people with type 1 diabetes reduce insulin use and insulin costs, according to new research by the Physicians Committee for Responsible Medicine published in BMC Nutrition.


Insulin is a hormone that helps move glucose (sugar) from the blood into muscle and liver cells to be used as energy. People with type 1 diabetes must take insulin because their body doesn’t produce enough. Some people with type 1 diabetes may need to take additional insulin, because they have insulin resistance, a condition in which cells don’t respond well to insulin and glucose remains in the blood. Insulin resistance is strongly influenced by dietary fat, which can inhibit glucose from entering the cells.

                                                                                               Credit: Sweet Life / Unsplash

The new research, which is a secondary analysis of a 2024 Physicians Committee study, compared the effect of a low-fat vegan diet to a portion-controlled diet on insulin use and insulin costs in people with type 1 diabetes. The analysis found that the total dose of insulin decreased by 28%, or 12.1 units, per day in the vegan group, compared to no significant change in the portion-controlled group. The reductions in insulin use in the vegan group likely reflect improved insulin sensitivity, or how well the body responds to insulin. Total insulin costs decreased by 27%, or $1.08 per day, in the vegan group, compared to no significant change in the portion-controlled group.


The 2024 study found that a vegan diet also led to an average weight loss of 11 pounds, improved insulin sensitivity and glycaemic control, and improved cholesterol levels and kidney function in people with type 1 diabetes.


The new research comes as insulin prices in the United States continue to rise. Spending on insulin in the United States tripled in the past 10 years, reaching $22.3 billion in 2022, due to the increased usage and higher price of insulin, according to the American Diabetes Association. The inflation-adjusted cost of insulin increased by 24% from 2017 to 2022.


“As insulin prices continue to rise, people with type 1 diabetes should consider a low-fat vegan diet, which can help improve their insulin sensitivity and reduce the amount of insulin they need, potentially saving them hundreds of dollars a year,” says Hana Kahleova, MD, PhD, the lead author of the study and director of clinical research at the Physicians Committee for Responsible Medicine.


https://www.technologynetworks.com/tn/news/vegan-diet-may-help-people-with-type-1-diabetes-cut-insulin-costs-by-27-405910

Monday, 20 October 2025

7-Day Diabetes Meal Plan for Healthy Aging, Created by a Dietitian

From eatingwell.com

This meal plan is full of fibre, protein, calcium and vitamin D for healthy muscles, bones and blood sugar levels

ABOUT THIS PLAN

  • This 7-day plan is set at 1,800 calories, with modifications for 1,500 and 2,000 calories.
  • Each day provides at least 80 grams of protein and 30 grams of fibre to support healthy aging, balanced blood sugars, cardiovascular health, digestion and more. 
  • This plan prioritizes key nutrients for healthy aging, including protein, fibre, calcium and vitamin D.

Almost 15% of U.S. adults have diabetes, yet learning how to manage it may feel overwhelming.

 That’s why we created this meal plan. Each meal and snack meets our diabetes-appropriate nutrition guidelines designed to support healthy blood sugar levels and prevent heart disease. Since diabetes rates are higher among older adults, we also made sure to focus on key nutrients for promoting muscle mass, heart health and bone density as you age—protein, calcium, vitamin D and fibre. In fact, each day provides at least 80 grams of protein and 30 grams of fibre. Even if you haven’t hit 60 yet, it’s never too early to start prioritizing these nutrients so you can age with grace.

Meal Plan at a Glance
Breakfast/ A.M. SnackLunch/ P.M. SnackDinner/ Evening Snack
French toast & berries/ Mixed nutsTuna rice bowl/ Cocoa chia puddingSweet chili salmon bowl
Vanilla-cranberry overnight oats/ Yogurt parfaitChickpea salad lunch box/ Cocoa chia puddingBalsamic chicken with arugula salad/ Crunchy chickpeas
Vanilla-cranberry overnight oats/ EdamameChickpea salad lunch box/ Cocoa chia puddingMojo chicken with veggies/ Crunchy chickpeas
Vanilla-cranberry overnight oats/ Mixed nutsChickpea salad/ EdamameCreamy pesto shrimp & gnocchi/ Yogurt parfait
Yogurt parfait/ Mixed nutsChickpea salad/ Cottage cheese snack jarSpicy chicken & cabbage stir-fry/ Apple & nut butter
Yogurt parfait/ EdamameChicken & feta wrap/ Cottage cheese snack jarChicken with rice & green beans/ Apple & nut butter
Yogurt parfait/ EdamameChicken & feta wrap/ Cottage cheese snack jarHigh-protein pasta with peas/ Yogurt parfait

Day 1 

Air-fryer French toast sticks on a white plate, drizzled with maple syrup, with a small bowl of raspberries next to it
Air-Fryer French Toast Sticks.

Jason Donnelly

Breakfast (403 Calories) 

Morning Snack (199 Calories) 

  • ¼ cup unsalted dry-roasted mixed nuts 

Lunch (394 calories) 

Afternoon Snack (222 Calories) 

Dinner (604 Calories) 

Daily totals: 1,822 calories, 88 g fat, 93 g protein, 168 g carbohydrates, 34 g fibre, 1,724 mg sodium

To make it 1,500 calories: Omit morning snack and omit avocado from dinner.

To make it 2,000 calories: Add ¼ cup hummus with 1 cup cucumbers as an evening snack. 

Day 2

A lunchbox containing raspberries crackers and a chickpea salad with tomatoes and cucumbers
Easy Chickpea Salad Lunch Box.

Ali Redmond

Breakfast (422 Calories) 

Morning Snack (125 Calories) 

  • ½ cup low-fat plain strained (Greek-style) yogurt
  • ½ cup fresh blueberries

Lunch (422 calories) 

Afternoon Snack (222 Calories) 

Dinner (485 Calories) 

Evening Snack (100 Calories) 


Daily totals: 1,776 calories, 81 g fat, 90 g protein, 190 g carbohydrates, 44 g fibre, 1,399 mg sodium

To make it 1,500 calories: Omit blueberries from morning snack and omit afternoon snack. 

To make it 2,000 calories: Increase morning snack to 1 cup low-fat plain strained (Greek-style) yogurt with 1 cup blueberries and add ½ cup low-fat plain strained (Greek-style) yogurt and ¼ cup cucumbers to evening snack to make a savoury yogurt bowl.

Day 3

Recipe image of Sheet-Pan Mojo Chicken with Green Beans & Red Potatoes
Sheet-Pan Mojo Chicken with Green Beans & Potatoes.

Photographer: Jake Sternquist, Food Stylist: Shannon Goforth, Prop Stylist: Breanna Ghazali.

Breakfast (422 Calories) 

Morning Snack (129 Calories) 

  • 1 cup edamame, in pods (microwaved from frozen) 

Lunch (505 calories) 

Afternoon Snack (222 Calories) 

Dinner (413 Calories) 

Evening Snack (100 Calories) 


Daily totals: 1,790 calories, 85 g fat, 94 g protein, 181 g carbohydrates, 49 g fibre, 1,422 mg sodium

To make it 1,500 calories: Omit yogurt from lunch and omit afternoon snack. 

To make it 2,000 calories: Add ⅓ avocado to dinner and add ½ cup low-fat plain strained (Greek-style) yogurt and ¼ cup cucumbers to evening snack to make a savoury yogurt bowl.

Day 4

a recipe photo of Creamy Pesto Shrimp with Gnocchi & Peas
Creamy Pesto Shrimp with Gnocchi & Peas.

Photographer: Greg DuPree, Prop stylist: Shell Royster, Food stylist: Emily Hall

Breakfast (422 Calories) 

Morning Snack (199 Calories) 

  • ¼ cup unsalted dry-roasted mixed nuts 

Lunch (422 calories) 

Afternoon Snack (129 Calories) 

  • 1 cup edamame, in pods (microwaved from frozen) 

Dinner (409 Calories) 

Evening Snack (250 Calories) 

  • 1 cup low-fat plain strained (Greek-style) yogurt
  • 1 cup blueberries 


Daily totals: 1,830 calories, 86 g fat, 87 g protein, 192 g carbohydrates, 37 g fibre, 1,222 mg sodium

To make it 1,500 calories: Omit morning and afternoon snacks. 

To make it 2,000 calories: Add ¼ cup hummus with 1 cup cucumbers to afternoon snack.

Day 5

Recipe image of Everything Bagel Cottage Cheese Snack Jar with Bell Peppers and Chickpeas
Everything Bagel Cottage Cheese Snack Jar with Bell Peppers and Chickpeas.

Photographer: Jen Causey, Food Stylist: Chelsea Zimmer, Prop Stylist: Claire Spollen

Breakfast (381 Calories) 

Morning Snack (199 Calories) 

  • ¼ cup unsalted dry-roasted mixed nuts 

Lunch (422 calories) 

Afternoon Snack (195 Calories) 

Dinner (392 Calories) 

Evening Snack (190 Calories) 

  • 1 medium apple
  • 1 Tbsp. natural peanut butter


Daily totals: 1,779 calories, 81 g fat, 93 g protein, 173 g carbohydrates, 34 g fibre, 1,406 mg sodium

To make it 1,500 calories: Omit walnuts from breakfast and omit evening snack . 

To make it 2,000 calories: Add 1 Tbsp. chia seeds to breakfast, add ½ cup blueberries to morning snack, and add 1 cup edamame, in pods (microwaved from frozen) to dinner.

Day 6 

a recipe photo of the Chicken, Spinach & Feta Wrap
Chicken, Spinach & Feta Wrap.

Photographer: Grant Webster, Food Stylist: Addelyn Evans, Prop Stylist: Gabe Greco

Breakfast (381 Calories) 

Morning Snack (129 Calories) 

  • 1 cup edamame, in pods (microwaved from frozen) 

Lunch (457 calories) 

Afternoon Snack (195 Calories) 

Dinner (459 Calories) 

Evening Snack (190 Calories) 

  • 1 medium apple
  • 1 Tbsp. natural peanut butter 


Daily totals: 1,810 calories, 78 g fat, 124 g protein, 160 g carbohydrates, 36 g fibre, 1,547 mg sodium

To make it 1,500 calories: Omit morning and evening snacks. 

To make it 2,000 calories: Add 1 Tbsp. chia seeds to breakfast, add ½ cup blueberries to morning snack, and add ⅓ avocado to lunch wrap.

Day 7 

Recipe image of High-Protein Pasta with Peas
High-Protein Pasta with Peas.

Photographer: Morgan Hunt Glaze, Prop Stylist: Claire Spollen, Food Stylist: Chelsea Zimmer

Breakfast (381 Calories) 

Morning Snack (129 Calories) 

  • 1 cup edamame, in pods (microwaved from frozen)  

Lunch (457 calories) 

Afternoon Snack (195 Calories) 

Dinner (414 Calories) 

Evening Snack (250 Calories) 

  • 1 cup low-fat plain strained (Greek-style) yogurt
  • 1 cup blueberries 


Daily totals: 1,825 calories, 71 g fat, 119 g protein, 181 g carbohydrates, 35 g fibre, 1,369 mg sodium

To make it 1,500 calories: Omit morning and afternoon snacks. 

To make it 2,000 calories: Add 1 Tbsp. chia seeds to breakfast and add ⅓ avocado to lunch wrap.

Prep-Ahead Tips

Other Tips for Healthy Aging

Besides eating a well-rounded diet with plenty of fruits, veggies, whole grains, lean proteins and healthy fats, there are a few other lifestyle changes you can make for healthy aging. For one, try to stay active through a mix of aerobic activity, muscle-strengthening and balance work. This promotes heart healthmetabolic health and helps prevent falls. It also helps combat age-related losses in muscle mass and bone density.

Also, don’t underestimate the importance of a good night’s sleep. This is when your body and brain slow down to rest and recover from the wear-and-tear of the day. Studies show that not getting enough quality sleep is linked with higher rates of depression, dementia, falls and cognitive decline. Other things that support healthy aging include keeping up with regular check-ups with your health care providers, minimizing your alcohol intake, quitting smoking, regularly socializing and keeping your mind active through reading, writing or games.

How We Create Meal Plans

Registered dietitians thoughtfully create EatingWell’s meal plans to be easy-to-follow and delicious. Each meal plan meets specific parameters depending on the health condition and/or lifestyle goal it is targeting and is analysed for accuracy using the nutrition database, ESHA Food Processor. As nutritional needs differ from person to person, we encourage you to use these plans as inspiration and adjust as you see fit.


https://www.eatingwell.com/7-day-healthy-aging-meal-plan-for-diabetes-11830086