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new_user

GAD 250 but C-Peptide Normal

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new_user

I have just recently been diagnosed with type 1.5 due to a GAD of 250.  But my c-peptide is normal.  Weird? To be expected? 

 

My Primary Care Doc has me on 500mg of Metformin but my weight continues to drop (I am thin and getting thinner since limiting my carb intake and upping my swimming from 1 mile to 1.5 miles a day six days a week).  He suggests that I eat more carbs.  Hard to argue with those orders.  (Although I haven't yet increased my carbs mostly due to the fact that my normal diet is pretty low in carbs anyway.  As an amatuer but serious cook this low-carb diet has actually been pretty interesting to explore).  

 

A1C was 5.9 at last report. 

 

My 7:00 am glucose level varies between 105 ish and 135 --- never exceeding 175 grams of carbs per day. (Oddly the higher my carbs the lower my BGL the next morning --- mostly).

 

I don't see a LADA endocrinologist until late January but boy am I perplexed. 

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NoraWI

My c-peptide was within the normal range, too, when I was diagnosed with T1 and a high GAD65 antibody test. That's because the diagnosis came early during an initial autoimmune attack and the beta cell numbers had not declined dramatically yet. I was misdiagnosed initially (the GAD test was done almost a year later) and treated ineffectually with metformin. It is possible that I also had a long "honeymoon" period. I was also of normal weight, had lost over 30 pounds and was continuing to lose. When I consulted an endo instead of my primary, he ordered the GAD65 antibody test, which my primary had been refusing, and immediately prescribed a basal/bolus MDI insulin regimen. He told me that it was important to keep as many of my beta cells alive as possible. I also experienced the effect of *reactive hypoglycemia* when eating higher carbs. Higher carbs made my pancreas overreact and output spurts of excessive insulin that later made me go low. That is probably what is happening to you. I suggest you follow your low carb way of eating. Yes, cooking low carb does stimulate the adventure in some cooks. I hope Mike in Hawaii speaks up with his experiences in cooking. I also suggest that metformin may be the wrong medication to be taking, especially since you continue to lose weight.

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meyery2k

Diabetes has encouraged me to learn how to cook.  I used to eat starch with nearly every meal before finding out I was diabetic.  I would be happy to trade culinary adventures with you.

 

I have had some epic kitchen failures to be sure but they have been balanced with remarkable successes too. ~ Mike

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new_user

For the most part my diet (and cooking) hasn't changed much -- pasta used to be maybe a once a week thing.  (My wife misses that). Salads have always been my go-to meal of choice.  But I've had to add a lot more meat to my diet than previously.  I've also been surprised to learn how much I like collard greens.  Go figure.

 

The hard part has been baking.  Sundays I would make a loaf or two of some bread.  Various muffins were always in the freezer.  Cheese cakes aren't too bad carb wise so they've not been totally tossed on the dustbin of history.  But boy do I miss cinnamon buns.  (Well, I don't miss all the work).

 

Satisfying the pastry / cake/ bread jones is a real challenge. I've been looking at various low-carb muffin etc. recipes but I can't say they look too exciting.   Almond flour, rolled oats, here I come.  (sigh). 

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jwags

175 carbs a day for some of us is on the high side. To stop the weight loss you probably need to increase your fat intake. I walk 4 miles a day and eat about 75-100 carbs a day and my weight is stable around 112 pounds. Things like whole grains and rolled oats are high in csrbs so be careful baking with them. Use Almond flour, flaxseed or coconut flour. Type 1.5 is slow onset Type 1 and as your beta cells die off you will need insulin.

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new_user

Phew,  75 grams a day!  I know pretty much nothing about insulin therapy but I'm not yet ready to accept a diet like that.  (Not sure which state of grief "acceptance of no carbs" is but for now I'm sticking with denial.)

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meyery2k

New - I hear you.  I really do.  It has taken some out of the box thinking but I have pulled off some wins.  I have found that rather than try to "substitute" which ends up not working, I now make things based on the merits of what I am making.  For example, I was told cauliflower could replace potatoes and eagerly tried a mashed caulifolower recipe.  To me, it was a fail.  Kit then suggested what I just said about eating cauliflower because I like cauliflower (which is true).  The next go, I made mashed cauliflower and prepared it based on what I knew about cauliflower.  The result was much better.  This is likely because I got what I expected, cauliflower.

 

Recently, I made a pumpkin pie.  The recipe called for pumpkin, eggs, cream, sugar, and the various spices.  Obviously I couldn't use the sugar so I used Splenda and got the taste just right.  For the crust I used almond flour, butter, and Splenda mixed and pressed into the pie plate.

 

Baked as needed.  Made a whipped topping with Heavy Whipping Cream, vanilla, Splenda, and a wee bit of bourbon.

 

My non-diabetic son came over and demolished my pie :(  I commented that it was low carb and no sugar and he said he had no idea.  He really liked it.  When my daughter and her friends come over they eat all my stuff and I have to yell at them lol...

 

I have also processed macadamia nuts and made a great pie crust

 

Kit has this wonderful mousse that I have also used as a pie filling.  I took this to a potluck and was asked many times for the recipe.

 

 

Crust
Preheat oven to 350 degrees
1C chopped nuts (mac nuts, walnuts, pecans, almonds, whatever).  You can also do the graham cracker crust or flour based pastry.  I am diabetic so I can't really eat those so I make a nut based crust.
4T (1/2 stick) non-salted butter, melted.
Sweetener to taste.
In a bowl, mix nuts, butter and sweetener. I taste test since I use Splenda.  Once you have the flavor down, line a 9x13 pan evenly with your crust mix.  Bake for about 8-12 minutes or until golden.  Cool in fridge so it doesn't melt the mousse you are making.
 
8oz cream cheese
 2 cups heavy whipping cream
 
1/4 cup unsweetened cocoa powder (optional)  If you want chocolate mousse.  You can also use a small amount of lemon extract or lemon juice for lemon.
 
1tsp vanilla
 
Sweetener to taste (I have diabetes so I use Splenda).  Usually about 6 packets.
If you can, use a metal bowl.  Freeze bowl and mixer paddles for about 10 minutes before making.
So cream cheese and vanilla in bowl and mix until the cream cheese smooths out a bit.  Add cocoa and sweetener and mix on low until all dry ingredients have been incorporated.  Add heavy whipping cream and continue mixing until its mixed together.  Then kick the mixer up to its highest setting and basically keep mixing until the entire thing gets stiff.  You can turn the bowl upside down and have none of it move.
Spread mixture over the crust you made.  This will make enough mousse to spread generously over a 9x13 pan.
I sprinkled some cocoa powder on top.  We also have a store that sells Hawaiian Cacao nibs (this is the nuts that chocolate is made from) so I spread some on top too.
Serve and enjoy.  You could make whipped topping but you don't really need to. 
WARNING - Even though this is sugar free it is definitely not low calorie ;)

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Kit

Phew,  75 grams a day!  I know pretty much nothing about insulin therapy but I'm not yet ready to accept a diet like that.  (Not sure which state of grief "acceptance of no carbs" is but for now I'm sticking with denial.)

 

I rarely go over 30g of carbs a day.  It seems utterly impossible at first, but as you go it gets a lot easier.

 

That said, as a T1.5, you are going to have more wiggle room using insulin therapy than many of us T2s as we're dealing with insulin resistance.  Still, from what many T1s have said here, limiting your daily carbs, and becoming aware of how they affect you, will make the job a lot easier.

 

I do a asian inspired dish.  Instead of rice or rice noodles, I use zucchini noodles.  They work perfectly.  I just toss them into the pan for the last 3-5 minutes of cooking.  Instead of using sicky sweet pre bottled sauces or the powdered mixes full of starches, I season with chopped garlic, ginger, sesame oil, soy sauce, and whatever else I might have that sounds good.

 

For Christmas dessert this year I'm making a ginger spice cake using almond and flax meals instead of regular flour.  I plan on topping it with I guess you might call it a hard sauce, but is basically butter, a Tbsp of bourbon, and sweetener (I'm thinking of using Davinci SF caramel syrup).  Basically with butter at room temp, cream the butter, alcohol, and sweetener until mixed well and then pop back into the fridge.  My early tests show that this should work.  Bring back to room temp before serving.  Oh and will likely be some whipped cream too.  :D

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SweetAndBendy

By the sound of it you were diagnosed early and still have much/most of your own insulin production still, but with time it will go down as more beta cells are destroyed by the autoimmune reaction going on, and you will eventually need to take insulin regardless of what type of food you eat, the process is just a lot slower in Type 1.5/LADA than in Type 1 which is a big contributing factor as to why many with 1.5/LADA are first misdiagnosed as Type 2 as many doctors don't bother to check for GAD-65 antibodies (so applause to your doctor for having that checked on you) but just assume that an adult with higher A1c and/or higher blood glucose levels have type 2. 

 

I'm type 1 and for me the onset was pretty fast. I can't remember much, but think it was just a month or two of feeling "off" before the symptoms were very clear and rapidly got worse and couldn't be waved off any longer by me or my parents, so I went to get checked and was diagnosed on the spot with type 1 based on my rapid onset of symptoms and high glucose reading (then confirmed by positive GAD antibodies and low C-peptide) and would probably have gotten DKA had I waited like a day or so longer. 

 

My husband has type 1 as well since a year now (Diaversary on January 1st), and his onset was similar to mine but we caught him earlier, always more than one glucose meter around the house when there's a diabetic living there, and both him and I could see the signs in him.  

 

Diet wise you might want to increase fat and protein intake to compensate for all the exercise and not lose as much weight. And enjoy the carbs while you can do it without having to calculate the size of the universe first :lol: 

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new_user

thanks for these ideas. 

 

One of my real challenges is that since my diagnosis and carb-watching (just 2 months) my weight has been dropping like a stone. From a relatively thin 167 I'm now at 154.  (I'm 5'11 and looking pretty gaunt).

 

I'm not sure how many more avocados, nuts, peanut butter, yoghurt, and steaks I can eat.  I seem to be grazing all day long on high fat/low carb but still can't get enough calories in me to maintain.   

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Bar&In

thanks for these ideas. 

 

One of my real challenges is that since my diagnosis and carb-watching (just 2 months) my weight has been dropping like a stone. From a relatively thin 167 I'm now at 154.  (I'm 5'11 and looking pretty gaunt).

 

I'm not sure how many more avocados, nuts, peanut butter, yoghurt, and steaks I can eat.  I seem to be grazing all day long on high fat/low carb but still can't get enough calories in me to maintain.

 

I'm 6'2" 183. Aside from yogurt (no go for me) the foods you mentioned are staples in my diet but try adding heavy whipping cream as well, packed with cals. I use it in my morning protein shake daily, gives it a milkshake consistency as well and tastes great.

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NoraWI

You should be started on insulin. As soon as you are, your weight loss will taper off. I know that your c-peptide is still in the normal range. But I'm sure that your beta cells are being stressed. You should start on insulin to rest and protect them. Let us know how your appointment with the endo goes.

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