LADA diagnosis questioned

[LAC1965]

I’ve been diagnosed as LADA, despite a lack of GAD, Islet cell or insulin antibodies. I do have low fasting c-peptide and insulin levels. But my typical pattern is very high postprandial blood glucose, followed by the over secretion of insulin and reactive hypoglycemia. My fasting glucose is always normal. Does this sound like LADA or is it more consistent with Type 2 insulin resistance? Based upon what I’ve been reading, I’m starting to question the LADA diagnosis. I was just curious as to whether anyone with a LADA diagnosis has a pattern similar to what I’ve described.

Thanks,

Liz

[angelsbridges]

How high are your postprandial numbers?

They've only tested my fasting and did a 5 hour OGTT, which resulted in reactive hypoglycemia. I'm seeing an endo in June to do more tests to see if I could be LADA, since I don't fit the "typical" bill for started type II. My fasting is usually always fine, but after I eat (depending on what it is, it will spike around 150-160 an hour after, then if it's bad, it stays at 140-150 until a few hours after).

[LAC1965]

My postprandial glucose on an OGTT is really high, around
300. I stay elevated for about 3-4 hours before experiencing a very rapid decline (into the 50s).

Good luck with the testing. If you are LADA perhaps you’ll be given a fast acting insulin to reduce the postprandial spikes. I use a Novolog FlexPen but it’s been very hard for me to know how much to use per meal since my needs seem to vary day by day.

[EeyoreButterfly]

LAC: I believe I have seen other people with LADA state that is how they started out: High postprandials with normal fastings.

I would think that a low C-Peptide would be indicative of LADA. If it was type 2 you should have a normal or higher than normal C-Peptide since it takes more insulin to do the same job.

[lorilei]

now you might be the first person incorrectly diagnosed lada ( I had been hoping it was me, but that was not my fate)..seems strange to hear when a large number of docs seem to immediately toss a type 2 label our way..nice to know another doc may be on the ball

[EeyoreButterfly]

Meant to add that from what I understand it is perfectly possible to have negative antibody tests and s till have LADA. Basically, if you are positive you definitely have some form of Type 1 and if you are negative you may still have some form of Type 1 but with no antibodies.

[Ohana]

Wow, am I glad this thread came up...

I am almost exactly like you LAC... except I only crash in a reactive hypo a couple times a month.

I have absolutely normal fastings. But after a meal I can range from 110's to the high 200's. I use a Humalog pen, but it is also hard for me to judge because some days I need more than others.

I also have negative antibodies and a low/normal C-peptide, yet my Dr. is insistent that I am LADA (he says slow onset type one, but whatever.. same difference) ;)

He said what eyeore B said...you can still have LADA with neg. antibodies. and the antibodies may show up later...

So, sorry, I know that probably isn't what you wanted to hear, but your story sounds familiar. Hang in there. Only time will tell for sure I guess.

[LAC1965]

Okay. This sounds reasonable. I do get frustrated because it is so difficult for me to regulate my blood sugar w/the insulin pen. Sounds very similar to your experience. Thanks to all who replied. It helps me to put this in perspective.

[mazea]

I also started out with high post prandial and normal fasting readings. 2 years before getting diabetes, my fasting was borderline, but I was having symptoms of diabetes and including going to the bathroom a lot after meals and having accidents indicating high post prandials. I suspect when I was younger I had hypos. My c peptide is low at around 1. My endo diagnosed me with type 1 honeymoon, but I think I have type 1.5 Your scenario sounds familiar to mine. My antibodies were negative. My dad also had type 1.5.

[Ategeler]

Your labs sound more like LADA than Type 2 to me given your Cpeptide was low not high. High would show more insulin resistance. I am also LADA with fairly low fastings but high postprandial numbers. Glad to hear that your doctor is aware of the Type 1.5 Diagnosis as mine will only refer to me as Slow Onset Type 1. It is the same thing but for some reason she doesn't like to use that term...Go figure.

[lorilei]

Your labs sound more like LADA than Type 2 to me given your Cpeptide was low not high. High would show more insulin resistance. I am also LADA with fairly low fastings but high postprandial numbers. Glad to hear that your doctor is aware of the Type 1.5 Diagnosis as mine will only refer to me as Slow Onset Type 1. It is the same thing but for some reason she doesn't like to use that term...Go figure.

My fastings were the last to go, but go they did..I'm thinking that the insistence on dx as Slow Onset Type 1 may be related to an icd9 code which is insurance terminology...i'll ask my doc the next time so we can solve this mystery once and for all...

ironically there are at least 8 codes for diabetes mellitus, but no slow onset listed in my computer for work in healthcare..

[lorilei]

I’ve been diagnosed as LADA, despite a lack of GAD, Islet cell or insulin antibodies. I do have low fasting c-peptide and insulin levels. But my typical pattern is very high postprandial blood glucose, followed by the over secretion of insulin and reactive hypoglycemia. My fasting glucose is always normal. Does this sound like LADA or is it more consistent with Type 2 insulin resistance? Based upon what I’ve been reading, I’m starting to question the LADA diagnosis. I was just curious as to whether anyone with a LADA diagnosis has a pattern similar to what I’ve described.

Thanks,

Liz


sorry i missed that line...i agree with ategler above...high cpeptide is oversecretion of insulin often correlated with developing type 2...vs type 1 where we deplete from the get go