Hello everyone. This is my first post and iam hoping 
Someone can help me sort some of this out.
My Enzo says I have high insulin levels. Then
She says I have type 1. Arent the two in contradiction
Of each other? Im not on insulin. But Was diagnosed
With pancreatic insufficiency. I'm no dr. But she is making no
Sense. No other symptoms like thirst or etc.  Might Feel low around 70
Could this be early lada stage? Thanks for your help

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well, in what world, ha! a continual 80 - 90 range for a type 1 diabetic is nearly impossible to achieve w/out constant lows and corrections, i.e., lows. we are manually having to manage our blood sugars and inject insulin, which in no way even absorbs the same way one's pancreas would and does deliver insulin. Most of us aim for 70 - 130, 80 - 120, and we try to have a blood sugar of 140 or below 2 hours after meals, some try for tighter control, it depends on the 'lows'. But I can pretty much guarantee you, it's very tough and takes a huge amount of work and a lot of correction shots.

LADA is just type 1 diabetes. There's no such diagnosis, really, as LADA, it's just type 1 diabetes. Many children have a slow onset, still produce insulin, just like an adult may have, the autoimmune attack can happen very rapidly (DKA) or a gradual process. If you test positive for the antibodies and have a low cpeptide, indicating you're producing very little insulin, you many have caught it early, it's called a honeymoon stage". Initially some still produce insulin and their fasting numbers aren't effected yet..,that's the last phase to go. Most are put on a small dose of insulin (basal, bolus or both) to preserve any remaining beta cells they may still have. Orals typically don't work. Thyroid issues (autoimmune) often do go hand in hand with type 1 diabetes...

Good luck!

There actually is a diagnosis of LADA, Type1Gal, (Latent Autoimmune Diagnosis in Adults), though you are absolutely right that it is Type 1. The difference is most notable at onset, which is much slower than "regular"type 1. Today, I just tell people I'm Type 1, because for all intents and purposes my management is the same today as any other Type 1. But 5 years ago, being diagnosed as LADA would have been very useful for me. Instead I was misdiagnosed Type 2, because of my age (58) and because I didn't meet the usual picture of sudden onset/DKA, etc. If people had known about the possibility of a slower onset version of Type 1 that typically happens to people in adulthood or older, I would not have been misdiagnosed. And yes, oral meds worked for me for 15 months with very good blood sugars. Generally LADAs can go anywhere from a couple months to 4 years without needing insulin, much longer than a typical Type 1 honeymoon, although you are correct, many people believe LADAs should be started earlier on insulin to preserve beta cells.

well, not really. i'm referring to a diagnosis code, none exists for LADA, it's just type 1 diabetes. Nor for 1.5 diabetes, none exists (my Endos laugh at that). LADA is more for the patient, to help him/her understand. But, my Endo (none of them) has never used that term on me, just type 1 diabetes. What we forget is there are many children who present in the same way, catch it early, do not present DKA, have a very long honeymoon, go off a basal - bolus insulin after initial diagnosis, etc..it's the same disease. Just like adults can present in DKA with a very rapid onset or a very slow onset. It makes no difference. If it's confirmed it's a positive autoimmune disease, it's the same thing whether one's 5, 12, or 80 years old.

No, you are right, there is no diagnosis code for LADA, but it is an important distinction for the reasons I explained above.According to John Walsh in Using Insulin, LADA's are approximately 15% of all Diabetics more than even "traditional type 1's"who make up 10%. Many of us would have had a lot easier time of it if more people knew about LADA.

Children can present in the exact same way...I would imagine if they too were given orals initially, when their type 1 was caught early, it may work too....most just start low carbing anyway, early in the diagnosis which can help a bit while the destruction takes place. We've read many stories on here where young children needed very little insulin, once starting out..because they too have some beta cells left, some pancreas function..same as you. It's just a term used, for some reason, because many medical providers are ignorant to diabetes, especially type 1, and don't even realize adults can get type 1.

I'm not sure why I'm bothering, Type 1, because you don't seem particularly open to hearing information that disagrees with your preconceptions, but it may be of great value to someone else who is struggling with a diagnosis. In general onset is more rapid the younger a person is, and less rapid the older. There are, of course, exceptions to this general principal. I don't believe there are many Type 1 children who are treated with oral meds (nor should they be), and there are also not a lot of pediatric endos that advocate low carb for their children patients. To quote John Walsh that most of us on here look upon as an expert: "Correct diagnosis of LADA is important because insulin treatment will be required much sooner than in Type 2 diabetes. If LADA is suspected, a GAD65 antibody test should be done." and "Adults diagnosed with diabetes at an age considered "too old"for the onset of Type 1 and who do not immediately require insulin for treatment are often told they have type 2 diabetes. For many, this is a misdiagnosis. Their diabetes is actually a slow form of Type 1 diabetes referred to as Type 1.5 or LADA. People with LADA number over 2 million people in the U.S. or double the million or so people with"(classic) Type 1 diabetes.

If it has no other purpose, the term is of critical importance for the very reason you state: giving people the understanding that people like me who are diagnosed in middle age and manage on oral meds may not be Type 2.

i don't believe this is true at all, age has nothing to do with the onset, whether it's rapid or not. I know just as many adults who have been DKA as children, or had a long honeymoon..has nothing to do with age, really. I guess you're not understanding my point, which is...why does there have to be a distinction between a child and adult getting type 1, they don't use a different Dx for a child when he/she may present 'slow onset', not DKA, long honeymoon, it's still just type 1. The LADA just puts more confusion into the mix. I'm not saying it's not true, of course it is, it is latent..but it's just type 1. there's not a latent onset termed used for a child who may present in the same way when diagnosed, they just simply say type 1. that's my point.

MANY children have the same slow progression too and have a honeymoon stage.

That term LADA is a 'new term' used to maybe describe the process but why isn't it then used for a child who presents in the same way say as YOU? Mary Tyler Moore was in her 30's, she wasn't DKA, they found it after she miscarried but she wasn't diagnosed or termed LADA, just type 1. If someone asks, I just say I have what MTM has, type 1.

Taking insulin early on may preserve basal function in the long run which is what you want. A short vacation from insulin may just give you more problems down the road.

Maurie

I started insulin 5 months after my formal diagnosis (by which time I was very symptomatic), when it became apparent that the sulfs were not going to work, and I STILL have measurable C-peptide after 18 years. I don't know if it was from going on insulin, but let me tell you it makes control easier! Even though my insulin production has definitely deteriorated over the years, and it's harder now than it used to be, nevertheless, I'm glad I came along before all those T2 drugs -- it would have been agony to have had to try them all before being allowed to go on insulin.

I was diagnosed as a T2 in 2005. I found Bernstein soon afterwards, starting on his diet in 2006. I could never attain his goals. My fasting numbers were chronically elevated, not dangerous but high enough that they clearly were not normal (120-140 mg/dl). And I couldn't eat more than 10-15g of carbs with any hope of being under 140 mg/dl at 2 hrs. My A1c was in the 6-6.5% range, all perfectly fine with most doctors, not with Bernstein.

I tried all the medications, eventually trying several triple medication regimes, none of the medications made any noticible difference. I never had much success in getting the right tests. I was granted a c-peptide, it showed I had low insulin. After years of asking, I got a GAD, it was negative. At that point, my endo at the time refused further discussion.

I made my own decision to start insulin. I started early, before I destroyed my remaining beta cell function. I'm glad I did. Today, using MDI I have good control. All that really matters is that you get appropriate treatment. I could go through life wondering why am I this way? Why did it happen? But at some point it really doesn't matter.

Today, even on insulin, I still eat very low carb. But if I am 140 mg/dl 2 hrs after a meal, I consider that great. At this point, I only correct if I am over 180 mg/dl 2 hrs after my meal.

also, many t1's do low carb and advocate for Dr. Bernstein, many (most) do not..i do low carb (only about 40grams/day). i don't know why really cause I need to gain weight. i find no diffence if I eat more carbs and take more insulin (and taking MORE insulin has NOT caused me to gain 1 pound, not one..it's a myth that insulin causes weight gain too, we ALL need, use and have insulin in our bodies, one way or the other), but i just (still) need to get the 'dosing' correct. Which I have not mastered yet, hoping a pump will help. Example, I had a terrible weekend, 'low carbing', same food I eat everyday, corrections all weekend. Right now I'm at a nice 85...after 2 days of corrections (for NO reason)..but, I have to eat again, breathe, move, be active..so, it ain't gonna stay there.

I'm soooo sorry to come across as a smart-ass, or whatever. I just read Bernstein's book, and he is of course a life-long juvenile Type 1, and says that he and his patients maintain 80-90 with diet (admittedly harsh) and minimal insulin. He doesn't really go into the LADA issues, except for one paragraph in the new edition. Since I've been able to stay under 100 most of the time with just strict diet I'm hoping for the best, but frankly expecting the worst from everything I'm reading. I see that you are struggling, and I again apologize for seeming flip about this. This is all new, and I obviously have a lot to learn, while trying to come to terms with the possibility (probability I think) of having diabetes at age 67.

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