There are over two types of diabetes

Dear Dr. Roach: Last year, at 57, I was diagnosed with Type 1 LADA diabetes. Initially I was put on insulin to get my blood sugar within the normal range. Then I was just on metformin until the “honeymoon period” was over. I now am back on insulin. I walk anywhere between 3 and 8 miles about three times a day. My blood pressure is excellent. I initially lost about 18 pounds after diagnosis, so my weight is good.

When looking at Google, it says my life expectancy has been cut by 20 years! Yikes, I JUST retired and if I go by their gauge, I’ll be passing around age 68! Is this based on someone who has had diabetes for many years? The doctor said I was very healthy and that’s why nothing was “destroyed.” My vision was off for about a month but no permanent damage was done. — M.W.

Most people are familiar with Type 1 diabetes. It is caused by an autoimmune destruction of the insulin-making cells in the pancreas. People also know about Type 2 diabetes; it’s caused by resistance to insulin. But there are other subtypes of diabetes, including latent autoimmune diabetes in adults (LADA). It has some characteristics of both Type 1 and Type 2 diabetes, but the autoimmune nature and the usual progression to insulin need makes most experts feel it is closer to Type 1 than to Type 2.

The change in life expectancy from diabetes relates to how long you have had diabetes and how well controlled it has been. With outstanding diabetes control, the effect on overall mortality is modest. In one model, the reduction in life expectancy is less than a year.

For new-onset autoimmune diabetes (both Type 1 and LADA), early and aggressive blood sugar control with insulin may reduce the amount of autoimmune damage and improve long-term prognosis.