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Permalink Reply by Libby on March 19, 2008 at 12:01pm

I was diagnosed as pre-diabetic. My C-peptide was normal. Turns out I was very, very early LADA. (Latent Autoimmune Diabetes in Adults- a variation of Type 1) Ask to have the diabetes antibody panel of tests. Don't just have the GAD antibody test- I was negative for that one. If you have to eat really low carb you probably have no first phase insulin release. This is the common progression for Type 1 ANDType 2. However, if you are early Type 1 you would be better off trying small amounts of insulin before eating so that you could have a more balanced diet. If you respond well to a couple of units of insulin you are probably Type 1 since this would show that you are insulin sensitive, not resistant. Ask your doctor about the antibody tests and about trying insulin to confirm the diagnosis. I took an article about LADA to my doctor- she had never heard of it- and she was willing to do a bit more testing. I now use 2 units 2-3 times a day, eat relatively low-carb and exercise frequently and manage to keep my BG normal. The hope is that if you do this during the honeymoon phase (C peptide showing that you still have some insulin production) you can maintain your beta cells for longer, or even forever. Good luck and please feel free to ask more questions.

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Permalink Reply by Lili on March 20, 2008 at 12:58pm

I had a similar presentation and turned out to have LADA, which is a form of Type 1. My first c-peptide also appeared normal, but over the course of two years dropped.

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Permalink Reply by Julie on March 20, 2008 at 1:57pm

I agree with the above. My guess is that you're actually a Type 1 (or at least well on your way.) I find it terrifying that Libby's Dr. didn't even know what LADA was! You make a reference to your family Dr. If you haven't already, I advise seeing an endocrinologist ASAP. If you are LADA (aka type 1 for old people:), the faster you find out and start treatment, via inijections or a pump, the better off you’ll be. I also developed type 1 as an adult. I’m 34, thin, and have a pretty healthy, natural diet.

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Permalink Reply by Libby on March 20, 2008 at 8:52pm

My primary care person is a nurse practitioner. She hadn't heard of LADA but she brought herself up to speed pretty fast. Ironically, she referred me to an endocrinologist who looked at my glucose tolerance test: 96 fasting, 174 at 90 minutes and 111 at 2 hours and told me I was completely normal, not even pre-diabetic. He prescribed precose and when I asked him about insulin, this same endo said, and I quote: "there isn't any insulin fast enough to prevent post meal high BG". My nurse practitioner referred me to another endo who did put me on insulin, but who thinks I am very weird, she called me "extremist" for trying to maintain normal blood sugars. I am very grateful to my NP since she was the one who ordered all the tests. She didn't know it was LADA but she DID know that there was something seriously wrong with a thin, fit and healthy person having an A1C of 7.2. A lot of GPs would have just told me to come back in 6 months, but she really stayed on top of the situation. She saved my life already once when she caught an atypical melanoma very early- the surgeon was sure it was nothing- so I am pretty loyal to her.

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Permalink Reply by Lili on March 20, 2008 at 9:01pm

"there isn't any insulin fast enough to prevent post meal high BG"

Sure, that was true...in 1995. It sounds like your endo and the first endo I saw (who insisted I was a typical Type 2, and told me to eat more carbs and do less exercise to treat my problem) could be buddies. I took Novolog at meals for almost six months before starting a basal insulin, and it sure did control my postprandial bg while I was still making a little insulin. As long as the Novolog was somewhat matched to the food, I didn't have lows.

I've been called an extremist too, of course.

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Permalink Reply by Linda Gauvin-Miller on March 20, 2008 at 9:10pm

Why would this doctor not come forth with the truth? Obviously he indeed suspect something was off, for him to prescribe Precose. My sugars are also doing strange things and my GP also denies anything being off...(I too am thin, and "older"). Why do they respond that way!

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Permalink Reply by drrps3 on March 20, 2008 at 2:01pm

I had the exact same stats as you, but I was 33. It was a rapid onset for me, same diagnosis and now 11 years later, my diagnosis should have really been LADA or Type I back then. My suggestion to you is to start a low dose insulin (forget the pills, which your doc may prescribe) to prolong your insulin production (i.e. honeymoon phase). I started with pills, but my fasting were getting higher. The endo didn't want me on insulin, but I happen to have a biology background and was close with my primary physician so I sort of insisted. I have been on insulin about 10 years now. While I'm not jumping up and down about it, for me the insulin therapy is much more liberating and has helped me maintain some of my own insulin function. You just get used to it. Anyway, 11years later I am doing fine. No complications. A1C's stay fairly normal. I do have highs and lows from time to time, but I believe that is the nature of the disease and have to be monitored and corrected as soon as possible. You just have to stay on top of the disease, and you will do fine. Good luck!

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Permalink Reply by Jenny on March 20, 2008 at 2:44pm

If you are having to eat 6-10 grams a meal to get normal blood sugars and are not overweigth, you probably don't have Type 2.

LADA is most likely. Do you have any other autoimmune issues or are they in your family? Thyroid? Rheumatoid Arthritis, Lupus, etc?

I would urge you to find a doctor who is willing to work with you to figure out what is going on. You may very well need insulin. I did the very low carb thing for years, but I never could get really normal blood sugars, and when I realized that most Type 2s were eating 20 more grams per meal than I was and getting much better numbers, I finally started figuring out that maybe something else was going on.

It was.

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Permalink Reply by Laura Strudwick on March 20, 2008 at 6:07pm

I'm just going to add myself to the list --- I was diagnosed with Type 2 originally and would have ended up in the hospital with ketoacidosis if I didn't happen to get an appointment changed (I was supposed to meet with the diabetes educator 4 weeks after my diagnosis, but there was a cancellation the next day -- thank god!). My doctor even said "You're obviously type 2 so there's no need to test!" (I am not overweight either). They basically caught me in a rapid deterioration state -- my A1c was low enough that I looked like type 2, but by the time I went in to the med center i was walking around with a blood glucose of 450.

It was lucky for me, but I think this is common assumption that if you're older it must be type 2.

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