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angelsbridges

LADA blood sugars

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angelsbridges

Was anyone here dx prediabetic before getting a dx of LADA?

Did you have symptoms as a prediabetic? If so, what?

What were your numbers like?

What tests did your doctor order to find out?

 

 

 

I have all the symptoms of type II - but I am slender and healthy. My cholesterol was a little high, but is fine now, and my bad cholesterol (HDL) isn't high. I have no high BP or other issues. My pancreas seems to work overtime on some occasions, and not others. I see a doctor tomorrow and want to discuss LADA, but want to go in knowing a little more if possible.

 

Thanks!

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mazea

I was diagnosed with Type 1 last year,( LADA) as I was diagnosed at 30, didn't go into ketoacidosis, had a HBAC1 of 20 on diagnosis and still had some insulin production bur a low c petptide.

I had symptoms up to 6 years before being diagnosed with LADA. The symptoms I had 6 years before being diagnosed were having accidents with not being able to hold on for the bathroom to pee especially after meals, having had dizzy spells like hypos, feeling sick if I missed a meal. I also had a borderline fasting test 2 years before I was diagnosed, but the doctor didn't say anything about it.

If you have LADA, I don't recommend doing a fasting test, they will not pick it up like other diabetes as basal insulin will often be good and it will not pick up post meal blood sugar readings. The best test is probably a blood glucose test meter 2 hours after meals I think or a c peptide test. At later stages a HBAC1 will pick up the LADA as is probably a good idea too.

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angelsbridges

What would one need to watch for if doing the bg test meter two hours after eating?

 

Sometimes I am lower than pre-prandial 2 hours after, and sometimes I'm between 100-150, depending on the day.

 

My fasting tests are in the prediabetic range, as was my OGTT (although I had a reactive hypo episode). The symptoms of Type II and LADA seem so similar, but I know the pancreas doesn't act the same. No matter how hard I try, I can't seem to find what to watch for if trying to determine LADA or Type II.

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mazea

There was a graph on some teenagers and their blood sugars after meals. I recall the teenagers blood sugars normally go up to about 180 or 216(12mmol) at about 50 minutes after a meal. But 2 hours after a meal, your blood sugars should normally drop to under 7(126).

 

My husband is prediabetic type 2(controlled by diet not medication) and his blood sugars (for eating under 75g carbs) are always under 7mmol (126) at 2 hours after a meal. So your blood sugars should be better than my husbands.

 

LADA or type 2 can be determined with a C Peptide test. If C peptide is low, it will indicate Type 1 or Lada. I have low c peptide, therefore LADA. If the C peptide is high it indicates type 2. Antibodies test will also show LADA, but some people like me had a negative antibody test.

 

I was underweight at diagnosis, another indicator of lada.

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angelsbridges

They typically are under 120 two hours later. I've only had it higher than that three times since I started testing a month ago.

 

The dietitian mentioned LADA to me, but she didn't tell me anything other than that. She was very confused though at how I would be prediabetic for type II.

 

Would an A1C help with this at all? Is there another test I can ask for to rule out 1.5? Sorry to ask so many questions!

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mazea

That's ok.

I think a c peptide test, which shows the level of insulin production would be good for you to get. It's always good idea to have a HBAC1 if you are prediabetic (LADA or type 2) Keep a record of your HBAC1 so you can monitor the progress of the diabetes.

 

My husbands HBAC1 was borderline and he has type 2 prediabetes. If your HBAC1 is borderline, it could be good to go count and limit your carbohydrate intake per meal. Don't eat whole pizzas and get slight kidney damage like I did.

 

High readings occasionally could just mean you ate a lot of carbs for that meal.

 

How old are you?

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angelsbridges

what is HBAC1? Would my clinic do that test, or is it one I have to purchase elsewhere?

*edit* Nevermind, it's an A1C, right?

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angelsbridges

Thank you for your help.

 

I'm starting to think this has been going on for two years now, so I'm sort of worried and want to figure it out as soon as I can. In the last two years, I've had two bouts of weight loss, and it was a struggle to gain weight after each one (until this last year, and it took a while, but I gained about 35 pounds and now am at a healthy weight). Hopefully a new doctor will help me figure it out!

 

Thanks again! :)

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mazea

You could also get an antibody test for the diabetes type 1 antibodies. If it is positive it will rule out type 2. If you are older than 25 with positive antibodies, LADA is likely.

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angelsbridges

Hopefully the doctor I see tomorrow will know more about it than my last doctor. Hearing people's stories about ending up in the hospital before they know what's going on really scares me.

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lilituc

I was diagnosed as prediabetic at first - it does refer to Type 2. The problem is that not much seems to be known about the development of Type 1, so they don't really have a name for what happens before diagnosis. I stayed at prediabetic levels (most of the time) for about six months before I was diagnosed diabetic (Type 2, which ended up being wrong).

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EeyoreButterfly
There was a graph on some teenagers and their blood sugars after meals. I recall the teenagers blood sugars normally go up to about 180 or 216(12mmol) at about 50 minutes after a meal. But 2 hours after a meal, your blood sugars should normally drop to under 7(126).

 

My husband is prediabetic type 2(controlled by diet not medication) and his blood sugars (for eating under 75g carbs) are always under 7mmol (126) at 2 hours after a meal. So your blood sugars should be better than my husbands.

 

LADA or type 2 can be determined with a C Peptide test. If C peptide is low, it will indicate Type 1 or Lada. I have low c peptide, therefore LADA. If the C peptide is high it indicates type 2. Antibodies test will also show LADA, but some people like me had a negative antibody test.

 

I was underweight at diagnosis, another indicator of lada.

 

 

That's really interested. I have started testing at the one and two hour mark because I realized I was totally missing the spikes. For instance, I tested today 1 hour after lunch and was at 205, at the two hour mark I was 115. That happens to me frequently.

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angelsbridges

I don't test at the one hour mark :(

 

Only at the two hour. If I get a Rx tomorrow, I will probably test more often than I am.

 

I've been hanging around 115 at the 2/3 hour mark today.

 

Maybe it is type II. I just wish I could get a difinitive answer.

 

Could mono have triggered something? I keep reading about people getting sick and then starting symptoms of diabetes.

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mortis505

From diabetesnet.com

 

 

Type 1.5 is one of several names now applied to those who are diagnosed with diabetes as adults, but who do not immediately require insulin for treatment, are often not overweight, and have little or no resistance to insulin. When special lab tests are done, they are found to have antibodies, especially GAD65 antibodies, that attack their beta cells.

 

About 15% to 20% of people diagnosed as "Type 2" actually have this type. They are often diagnosed as Type 2 because they are older and will initially respond to diabetes medications because they have adequate insulin production. The treatment the person is first put on may be diet, exercise, and standard Type 2 medications.

 

Since insulin resistance is minimal or non-existent, medications designed to reduce insulin resistance such as Avandia and Actos are not effective. Other meds that stimulate the pancreas to produce insulin, slow digestion of carbs, or reduce excess glucose production by the liver are often effective in controlling the blood sugar for a few years.

 

As insulin production falls, insulin becomes necessary to maintain control. One clue that people have Type 1.5 rather than Type 2 is their appearance, which is more likely though not always slender and physically fit. They often do not have other signs of Type 2 diabetes, such as the Syndrome X cluster of high TGs, low HDL or high blood pressure. Luckily, in these early stages, diabetes treatment is not significantly different for slow-onset Type 1s compared to truly insulin-resistant Type 2s. The only exception is that drugs designed to increase insulin sensitivity like the glitazones do not work because insulin sensitivity is normal.

 

One major benefit to this type is that when their blood sugars are controlled, people with Type 1.5 usually do not have the high risk for heart problems more often found with the high cholesterol and blood pressure seen in true Type 2 diabetes.

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dbc
Maybe it is type II. I just wish I could get a difinitive answer.

 

Could mono have triggered something? I keep reading about people getting sick and then starting symptoms of diabetes.

 

I was misdiagnosed T2 & 6 months later T1 after GAD antibody tests. Absolutely no symptoms at all (picked up by an alert GP during a routine physical exam). First 18 months controlled bs by diet change, then metformin, now MDI/metformin/diet/exercise.

 

Don't stress (at least not too much :) ) Seems to me you're doing all the right things for now. Diabetes progression is normally a slow business, so you have time on your side, especially as you are already aware of things. I understand the frustration at not knowing the details, but knowing/not knowing the details is secondary to actively dealing with the D, which you are already doing. The detail will be filled in later.

 

As regards what caused/triggered it: As many theories as there are people, I think :confused: ! In my case pretty much everyone agrees it was probably stress - about 5 years worth of work & personal stuff :eek: Can also be the stress of an illness. . .

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Subby
That's really interested. I have started testing at the one and two hour mark because I realized I was totally missing the spikes. For instance, I tested today 1 hour after lunch and was at 205, at the two hour mark I was 115. That happens to me frequently.

 

A spike at the one hour mark is typical for non-diabetics, followed by a rapid descent back to normal levels. Check out this graph of a study of non-diabetics:

 

The meal is eaten at 7:30 (solid black line)

The average BG is the blue line.

The standard deviation (the range of results) are the two brown lines.

 

Blood sugar trend in non-diabetics

 

This is from the bloodsigar101 site which you can google: it's in the second item down on the left - "What is a normal blood sugar?"

 

When you take a 2 hour test, it is checking that you did indeed return from this initial spike, or how far you did, the importance being that's when you can test and be confident it's an indication things have not returned to normal. The one hour test, while it can inform on the dimensions of that spike, is "during the initial battle" so to speak - you primarily want to see the aftermath!

 

That's doesn't negate the use of 1 hour testing, and 2, 3 even 4 hour, to get a picture of your trends rather than just a single figure that doesn't inform of what direction things are going. And, for foods that do cause a longer spike, but your BG returns downwards a little later.

 

But, the one hour is special, quite a bit of spiking is expected.

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angelsbridges

well, the doc I saw didn't even know what LADA/Type 1.5 was.

 

She ordered some autoimmune tests (I think RA and Lupus?). She said she didn't feel comfortable ordering labs about something she had no clue what it was, and to talk to the endo in June.

 

She also mentioned seeing a urologist because of how much I urinate. Meep.

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mazea

I would find another one as he hasn't ordered an antibody to insulin test yet. It's a basic test that should be done for all diabetics that might be type 1. I had a test for antibodies when I was diagnosed.

 

I wouldn't worry about your doc not knowing about LADA. Some are so behind in there diabetes knowledge and it is common that this happens.

 

Interestingly, they are discovering new antibodies all the time. Discovery of new antibody that helps detect type 1 diabetes

 

If I were you, I would go to a new doctor and request a cpeptide test, an insulin antibody test, and a HBAC1.

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Ategeler

So sorry I missed this post before seeing the doc. However, a positive GAD 65 Antibody Test would be Type 1.5 not Type 2. Or C-peptide can give them indicators as well. An HBA1C won't really differentiate. It is the antibodies/cpeptide that are telltale b/w Type 1 vs.Type 2.

 

An endocrinologist would have a much better understanding of the specific tests associated with diabetes.

 

Type 1.5 is not recognized in the medical arena as much as 1 and 2. Sorry your doctor couldn't be more helpful.

 

I went through a similar experience, although I was labeled gestational diabetic. The perinatologist kept saying it was more Type 2 while my Endocrinoligist did the antibody test and found Type 1.5. It can be frustrating trying to get a clear cut answer! Hang in there!

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angelsbridges

she ordered a c-reactive protein test and a test for RA, and both came back negative.

 

I'm slightly irritated because I have a history of depression issues, but have been completely depression free for almost two years (something very big happened in my life, and for some reason, everything in my head just clicked, and I haven't had any depression since then). But of course the doctor looked in the file and brought it up, and asked if I was seeing anyone and taking medication, I told her no, that I've been great, and I saw a psychiatrist almost 2 years ago that told me I was either in depression remission, or was "cured" of it. She said that was weird and she didn't buy it. So she told me to see a therapist and psychiatrist because she doesn't think they'd just "let me stop going". Why the heck would I see one if I'm fine? I don't get doctors sometimes...I think she's just trying to blame something instead of finding the real reason why I'm freaking sick all the time.

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Ategeler

I don't think that either one of those tests designates autoimmune diabetes.

 

It is unfortunate when doctor's don't take their patient's concerns more seriously. Maybe you should seek a second opinion?

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angelsbridges

Sadly enough, she was a second opinion. I went to her because she was a.) younger, and b.) sent quite a few referrals to the dietitian I saw for diabetes/prediabetes.

 

I don't know what to do at this point other than wait for the endo in June. This doc also gave me the impression that I shouldn't be testing. She also said there was nothing in my 5 hour OGTT that would indicate anything diabetes-related...and actually stated that my fbs that initially gave me the diagnosis of prediabetes could have been a fluke, since the fbs on my OGTT was normal range.

 

She also didn't understand what use a 5 hour OGTT was and said she only orders two hour ones.

 

These were my results for OGTT -in parenthesis I put what my meter read, if it was different.

GLUCOSE, FASTING 88 (same)

GLUCOSE, 1 HOUR 186 (245)

GLUCOSE, 2 HOUR 135 (167)

GLUCOSE, 3 HOUR 103 (I didn't test this hour)

GLUCOSE, 4 HOUR 68 (70)

GLUCOSE, 5 HOUR 77 (65)

 

So who knows. All I know is that I'm tired of feeling like this, and if it's related to diabetes at all, I want to know so I can fix it and feel better and get rid of all the little problems.

 

She also told me to start doing Kegler exercises, which is apparently for urinary incontinence -while I told her I don't have any "leakage" (as she put it), I just pee every hour/half hour, I can hold it longer if I haven't eaten, but once it gets after breakfast, it starts, and gets worse after lunch and dinner.

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mazea

No offence, but if I were you I would get a third opinion and be assertive about asking for the GAD antibody test. While doctors sometimes don't know much about diabetes, you are the person in the end that is ultimately responsible for your health. And keep reading of your blood glucose monitor 2 hours after meals.

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angelsbridges

The problem is finding a doctor who KNOWS what a GAD antibody test is. The only person I have run into at the clinic that knows what LADA is is the dietitian.

 

Maybe I'll have to send her another message and ask if she knows docs who specifically deal with LADA, although I doubt there are any outside of the endo.

 

My first doctor made me...mad? I guess, and didn't listen. But this one listened, and then made me feel like **** by insinuating that there is no problem, and then told me to go see a therapist. I don't know if I can handle a third doctor doing anything on the same lines, I might just give up on health care! Haha.

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