[Brian23]

Dr. thinks I may be LADA. I recently got some lab work done and was wondering if anyone could help with the results and what it may mean.
HbA1c : 6.9
BUN : 25
Creatinine :1.0
Bun/creatinine Ratio : 25.0
Proinsulin : 9.6 pmol/L
Insulin : 1.5 uU/mL
Proinsulin as %: 96
GAD-65 : less than 1
C-peptide,serum : 0.9

Can anyone sort this out for me?

[Funnygrl]

With an a1c of 6.9% and no meds, it seems like you're doing okay. The lack of antibodies is suggestive of type 2, however, with your lower c-peptide, it's still possible to be LADA.

In other words, your labs are inconclusive.

[BlueSky]

Originally Posted by Brian23

Dr. thinks I may be LADA. ...
HbA1c : 6.9 ...
Insulin : 1.5 uU/mL ...
GAD-65 : less than 1
C-peptide,serum : 0.9

Mmmm .... It looks like T1.5 to me too. If those high blood sugars were being caused by insulin resistance, the insulin and c-peptide levels would be higher. So T2 seems unlikely. And 20% of T1/1.5s test negative for the GAD antibodies, anyway. If it was T1, your HBA1c would be higher by now. So T1.5 (or LADA) seems most likely. In which case you would probably do quite well on a small dose of insulin.

[Brian23]

So are any of my #'s out of wack? Can I do anything to slowdown the process? Should i consider any oral meds or herbal/supplements?

[Funnygrl]

Originally Posted by Brian23

So are any of my #'s out of wack? Can I do anything to slowdown the process? Should i consider any oral meds or herbal/supplements?

You consider insulin. You don't appear to have a resistance issue, and 6.9% isn't fantastic control or anything.

[Brian23]

I got the flu or something on christmas day and my BG#'s stayed 200-300 for 3 days. I went to the Dr. and he put me on Lantus. I am currently taking 6-8 units of lantus a day and my fasting #'s are from 85-120. My post pradial #'s are normally 100-160 but sometimes when i eat too many carbs i get 250's-300's. Today for instance I had 2 blueberry pancakes, 3 eggs, 4 strips of Bacon and 16oz. orange juice. 2hrs later 250 mg/dl and 1hr after that (and 10 min walking) 142 mg/dl. When should i look to start a basal bolus? Dr. told me not to worry about a bolus until my A1c goes over 7.0

[Bunkins]

I'd try to reduce my carbs and see what that does for ya, along with exercise everyday.. If ya eat like that, and numbers getting around 180-200 I'd personally want to be on a bolus ( OJ is bad stuff for BG numbers ). Even though it came down to a 140 within 3 hrs, I'd want to be lower.. But if watching your carbs can delay the need then thats what I would focus on.. Even then I'd want to on a bolus, just incase things got out of hand and you end up in trouble... Dont know how much my opinion is worth, I'm not really all that educated on T-1.5, just from what your saying, thats what I would do..

[BlueSky]

Originally Posted by Brian23

... When should i look to start a basal bolus? Dr. told me not to worry about a bolus until my A1c goes over 7.0

IMO, pre-meal bolusing is the logical place to start insulin treatment. After meals is when you need supplemental insulin the most. It sounds like your beta cells are still producing enough of the stuff between meals. Anyway, looking forward, is there any good reason to delay pre-meal bolusing? I know doctors hang back with getting patients to treat intensively, but I really can't see the point in waiting for your control to get worse. It just means that you will get increasingly frustrated as control becomes more difficult. Bolusing now would improve your control immediately and it would give you more flexibilty in when/what you eat. Sounds to me like a compelling reason to act now rather than later.

[ladytaz]

I'm with BlueSky!! Why put off the inevitable, and have the frustration with control, probably sooner than later? You're already giving yourself a shot every day .... what's the diff? I don't understand why docs take that attitude!

And Lord have mercy, if I'd eaten that meal, even WITH a bolus of like 8u, I'd still have a BG of 250 (more like 300!) two hours later! (pancakes are the devil, in my world! LOL)