Replies to This Discussion

Permalink Reply by LiL MaMa on January 12, 2011 at 5:31am

That's what I was wondering..thanks for your reply!

Permalink Reply by April on January 11, 2011 at 3:24pm

Hi, there...I am so interested in your post. I tested negative for antibodies last month, but my Endo says I am diabetic and "insulin deficient" but not insulin resistant. But because of no GAD antibodies, she is considering me a type 2 for now. I do not know whether she tested me for the islet antibodies, too. I will see her at the end of Feb and I have a bunch of questions to ask her.

My A1C was 5.3 in Dec which was great....and I've been controlling my BG really well with diet (very low carb intake) and my Endo put me on onglyza....but I am just not sure how well the oral med is working. For example, I had a turkey chili for dinner the other night and a salad. I decided to splurge and have some dark chocolate for dessert. My BG was fine (high 90's at 1 hr and at 2 hours....but I woke up at 3 a.m. and just decided to do a random check: 155!!!!!! And I checked twice....it wasn't just a fluke. So what is going on?????/

I meet with the dietician tomorrow a.m. I have all my meter readings downloaded since 11-23-10. I have examples of menu and workout schedules. Basically, I don't feel I can eat more than about 25 carbs per meal and that is only at night. Otherwise, I stick to about 15.

So, I just had a small packed of fresh popped popcorn with 1 oz of hard cheese to add some fat and protein. I'm going to test at 3o mins, 1 hr, 90 mins and 2 hrs...I'm just really curious to see what the heck the Onglyza is doing for me. I may add a bit of fruit on top of it....half of an apple. The popcorn had 14 carbs...then the 1/2 apple....

Oh, I meant to tell you, I have Hashimoto's as well and my Dad and his sister were both adult onset autoimmune diabetics....

I wish I could do a better job of answering your question....

Best WIshes

April

Permalink Reply by LiL MaMa on January 12, 2011 at 5:34am

Sounds like your numbers are great! If I eat over 10 g carbs my blood sugar is about 200 but then again I am not taking any meds. You may have the very early stages of LADA, my numbers used to be much much better than they are now but have progressively gotten worse pretty quickly over this past year. You should get checked for antibodies and watch for worsening blood sugar. Let me know what you find out!

Permalink Reply by April on January 12, 2011 at 7:49pm

I had to go on meds....I just couldn't sustain eating what I had to eat eat. The final straw was eating half of a bell pepper (it was a yellow one) and shooting up over 200. By that time I had had eliminated all fruit, all breads, rice, pasta, any processed food of course, red veggies, all potatoes, tomatoes. I was down to lettuce, broccoli, eggs, lean meat, cheese, nuts..well, you get the picture. I exercised like crazy and my BG was staying okay, but I was losing weight fast (not from DKA...just not enough calories) and I was not very happy.

In any event, I am extremely vigilant about testing. Daily. And now I have the software for my meter and can view the trends, which I don't plan to be too anal about...but will look at monthly. VERY helpful....Thanks so much for sharing your story....I'm seeing the Endo again on 2/15 so at that point I'm going to get copies of all my labs, see how often I should be tested for antibodies. Also will ask about MODY etc.. In the meantime, I just need to relax about it a little. After worrying for about 8 weeks, it's time to chill a little! So, it is the status quo between now and the next endo appt unless my numbers change a whole a lot all of a sudden!

Permalink Reply by LiL MaMa on January 13, 2011 at 7:31am

Wow okay so you do sound a lot like me! I am basically doing and am where you were before going on meds, Barely eating, very low carb, exercising constantly and anything I eat sends me to 200. What meds did they put you on? Is it helping at all? Keep me updated!

Permalink Reply by April on January 13, 2011 at 8:33pm

OMG...yes...day and NIGHT. I am on Onglyza....which is a newer version of Januvia. There are apparently 3 ways that oral meds lower BG: 1) stimulate insulin production from remaining beta cells; 2) decrease insulin resistance; and 3) reduce the liver's output of glucose.

It seems like all of the meds hit 2 of the 3 of these methods! Onglyza and Januvia stimulate insulin production and reduce the liver's glucose output.

Yes...I have seen a HUGE difference. I got pretty used to eating low carb...so I haven't gone back to huge pasta dinners (LOL)..but my intake has surely increased.

Yesterday, I met with the dietician at the Endo's practice. The only thing she fussed at was that I was not eating enough carbs...I took in a print out of all my BG readings for 6 weeks and after lunch and dinner....my BG isn't going up at all after lunch or dinner....and she says it should go up at least 15-20 points! So, I need to eat some more carbs...So, a bit more brown rice, fruit, low carb bread (my favorite is from Trader Joe) and even a bit of forbidden stuff...like a sugar free pudding with 12 g carbs or something! Whoa! Tonite I had a Walker Shorbread cookie with a cup of warm 2% milk (I'm about to go to bed)...what a treat!....Of course, I just walked 4 miles at 7 pm...and my BG was only 79 when I got home....so a carb or two is in order!

Only worry about the Onglyza is that I've heard it doesn't preserve the beta cells like insulin, so I want to talk to the endo about that when I see her in Feb....

But the difference from a quality of life perspective is HUGE!!!!

Take care!

Anni

Permalink Reply by Brian (bsc) on January 14, 2011 at 5:35am

One of my most favorite diabetes researchers is Ralph Defronzo. He won the ADA Banting award in 2008 and has been a vocal critic of ADA/EASD approach of stepwise oral medications and instead has suggested another protocol, immediate triple medication. More than a decade ago, he advocated a "triumvirate" of defects in diabetes as you indicate, but now he suggests that there are actually "eight." He has done extensive work on beta cell dysfunction and looked at how various medications preserve beta cells. After his lecture in 2008, the ADA gave him a grant to either "put up or shut up." The first results are coming in from his trial and the results look good.

He discusses that work in This presentation from December. He has a great discussion of how different oral medications impact all the three primary and total of eight defects. Of particular note is his assessment of how various drugs preserve beta cells. His conclusion, Byetta and Victoza are far superior (over Januvia and Onglyza) for preserving beta cells. His reasoning is that that Januvia and Onglyza reduce the inhibitor of GLP-1, while Byetta and Victoza directly increase GLP-1 and he has charts showing the dramatically different insulin response and preservation properties.

I know you have had luck with Onglyza, but it is something for you to think about.

Permalink Reply by Jean on February 1, 2011 at 5:18pm

My Endo just prescribed Victoza for me for Type 1.5 paired with Metformin. Can you tell me more about the side effects or warnings?

Permalink Reply by Brian (bsc) on February 2, 2011 at 6:28am

There is a group here on Victoza. In the scope of things Victoza appears to have only a few mild side effects and the warnings appear to be for rare suspected conditions. The most common side effect is nausea, which many people find dissappears quickly. Starting at a small dose (0.6 mcg) and then moving up when you feel fine (after 1-2 weeks) seems to be the most common approach. There are rare side effects, basically an allergic reaction and pancreatitis. Both are basically highly notible effects. Pancreatitis is suspected to occur in people already at risk (i.e. having had chronic pancreatitits before).

There are warnings about pregnant and breastfeeding women. And there is a warning the Victoza was found in one study to cause thyroid cancer in mice, but actually it turns out people are not mice. Still if you have a history of thyroid cancer, it is suggested you not take it.

Now as to side effects, Victoza is supposed to slow digestion and make you feel full. There is a groundswell of reports that Victoza helps Type 1s in this way. It is futher suggested by people like DeFronzo that Victoza, even though it pushes the pancreas to secrete more insulin when you eat, it actually appears to preserve beta cell function.

So that is it. If you have more questions, I'd urge you to join the Victoza group and ask away.

Permalink Reply by LiL MaMa on January 14, 2011 at 3:51pm

Wow..thanks for the reply I am just basically a diabetic robot at this point revolving everything around my diabetes UGH!!!! So this gives me hope, especially since my dr is refusing insulin at this point. Maybe he would give me an oral.

Permalink Reply by rachel on January 12, 2011 at 9:06am

Hi there! I was diagnosed with LADA after having my baby, and my "gestational diabetes" didn't go away. I had a relatively good c-peptide, but below normal, and it was the presence of antibodies that confirmed the diagnosis for them. I went to a research conference this past weekend and they are working on halting diabetes onset by treating with "vaccines" that induce immune tolerance. They are starting to look at people with decent c-peptides, but clearly "high risk" for developing full autoimmune diabetes. The define "high risk" as having antibodies to at least 2 of the 4 antibodies that are typical in diabetics.

What that means to me is that for many of us, the immune attack can be against a variety of things, and we will not consistently have antibodies to everything. Therefore, you may not have islet antibodies, but you might have GAD or insulin antibodies... The most important measure though is your c-peptide, and your increasing blood sugars. They all sound like Type 1 or LADA, and an A1C of 6.1 is great, but post meal spikes are not good for your health even if the average overall blood sugar is okay.

Best of luck!

Permalink Reply by momto3 on January 12, 2011 at 8:14pm

I am in the same situation as you. My c peptide levels have gone down in the last eight months and have tested negative for antibodies. I am doing the low carb thing and walk at least two miles a day to keep my bg down. I spike after meals into the low 200's but will come down in a couple of hours. My fasting levels are in the 90's. My endo is not sure what I am because I am thin and don't fit the type 2 profile.

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