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Hi, everyone, I´m new to this site, thankyou all for your welcome and sorry it´s taken so long to reply. I´m Loobyloo, english and living in Portugal since 2005. I was diagnosed as being diabetic in 2008 but since reading and researching all I can, the whole thing is still a big mystery to me. I don´t seem to ´fit the profile ´and was wondering if anyone can help. It all started on a wednesday, I was feeling a bit ´iffy´ that night and went to bed early and started to be sick. Everything got worse and by thursday night I was in intensive care and stayed there 4 days although I don´t remember anything much. Total stay in hospital - 18 days due to fever and infection. I was put on 1 injection of Lantus and 6 injections of Humalog a day. I was told to see the family doc asap and he told me I was type 2 as I was then 43 years old. After some research I wasn´t convinced so at my first analysis I asked the consultant and she said I was LADA - Yikes ! what´s that ? Where I come from, Lada is a model of car ! Anyway, my family doc who didn´t speak english had put me on aspirin and cholesterol tablets and told me I would need these for the rest of my life - omg ! I decided to change docs, and managed to find one who spoke english, and when bringing her up to speed on all that had happened to me, I was talking about LADA, and she asked how I knew what type I was. I told her I had asked the consultant and she said YOU DON´T NEED TO KNOW WHAT TYPE YOU ARE - ALL YOU NEED TO KNOW IS THAT YOU HAVE DIABETES AND WE ARE CONTROLLING IT -uuuummm- excuse me ? are you for real ? I thought it would be helpful to know whats wrong with me seeing as it´s my body and I have to deal with it day in and day out and you only see me once every 3 months ! Anyway ( sorry to go on so long ) my point is, after reading up about LADA, how it is slow onset type 1 and how everyone is thin with LADA, I am left wondering as it was certainly not slow for me and although I am not huge, I´m not thin by any standards - anyone have any suggestions ?
Have you had your c-peptide levels checked?
Have you been screened for antibodies?
Were you in DKA at the time of diagnosis?
What was your A1C at the time of diagnosis?
Are you taking insulin now?
You can develop T1 diabetes at any age, and the key tests to differentiate T1 from T2 are c-peptide and insulin antibodies.
You are correct that it absolutely is important that you know what type you are. High blood sugar levels are the manifestation of something taking place in your body; with T2 that "something" is generally insulin resistance, where the body becomes resistant to the insulin it produces. In T1, that "something" is generally (though not always) antibodies attacking the beta cells of the pancreas and rendering them unable to produce insulin. There are also people who don't fit neatly into either category, but you won't know if that applies to you until you have your c-peptide and antibodies checked.
hi, MyBustedPancreas, thankyou for your reply - Even after 3 years of this, I don´t have an answer for the top two questions - all I know is that when my hubs called the ambulance, apparently my blood sugar level was more than 600 and when I regained some kind of consiousness, I was told that my pancreas would never work again and that I would have to inject insulin for the rest of my life so get used to it. If I did have any of these tests, then I wasn´t told about it. When I left hospital, I was given a date to go back for an analysis, but I didn´t know what to expect as no-one spoke english, so I had breakfast as usual as I didn´t know any different ! I had to drive 1 1/2 hours to the hospital to be given a right telling off for eating - it was in Portuguese but you kinda get the idea that you´d done wrong ! Even now, I am prone to really bad lows without feeling anything, sometimes at night I can wake up and test and find I am 20 or just above, although thankfully that doesn´t happen as much as it used to. I can drop very quickly to 35 - 45 without knowing and for that reason, I refused to drive the hour and a half to analysis with no food, drink or insulin as I felt it was too dangerous so they have allowed me to use a clinic just 20 minutes away which is better. On the whole, my results are usually good so I must be doing something right but reading through comments throughout this site, I feel very naive still, as I really don´t know what half of it all means !
I don't know how insurance works for you in Portugal but in the States I think it's important to have that diagnosis and know what type you are for insurance purposes as well as treatment. It seems to me that insurance companies are more hesitant to cover certain things for Type 2 patients than they are for Type 1 patients even if the treatment would benefit either way.
I have come across doctors that tend to only tell you what THEY think you need to know..which is usually bare minimum. It makes me angry because how can we make fully informed decisions on our own medical care if we don't have all the information?
Good for you for asking questions! Keep asking questions and pushing for answers. It's your body and your health and you have a right to know.
Hi, smileandnod, thankyou for your reply. As far as I understand, Portugal has some kind of agreement with England, so that treatment is covered in the same way as if you were in your native country and it works both ways, so thats good. I think the docs opinions come from the days when Portugal was ruled by dictatorship ( not so long ago ) heres a useless bit of info for you - where we live in central Portugal, they didn´t have cars here until 1970 !!! we still see donkeys and carts from time to time and it´s all very quaint. I digress - getting back to the big D, getting the medication I need is no problem - its getting an appointment with the doc to ask for the meds is the thing. You can only make an appointment on a certain two days in any one month, and for the whole of the area, there are only 15 appointments to be had per day so if you are not queued up outside the surgery at 5 in the morning,they open at 8, then you don´t stand a chance !!! Then you have to go back in anther 4 weeks and try again. Please don´t get me wrong, I don´t mean to sound like I´m moaning, it´s just frustrating when you don´t fully understand how it all works because even if you are one of the lucky ones who gets an appointment, invariably the surgery will phone you on your special day,to tell you that the doc hasn´t turned up for work so you are cancelled - but they don´t give you another appointment - no, you have to wait till the last friday of the month and go through the whole process again - crazy or what ?
Hi Loobyloo: I just wrote a blog about many of the issues you raise (link here). In my opinion, I would say you had rapid onset Type 1 diabetes, based on what you write. LADA is slow onset Type 1 diabetes--you had very rapid onset. And not all Type 1s/LADAs are thin, not at all! Type 1 diabetes can be diagnosed at any age (Dr. Kenneth Moritsugu, former acting U.S. Surgeon General, was diagnosed with Type 1 diabetes at age 49). I think it is important to know what type you are to immediately get the correct treatment, and also to get tested for other autoimmune diseases commonly associated with Type 1 autoimmune diabetes (the most common are Hasimoto's Disease and celiac disease). I am glad you found TuDiabetes, and be your own best advocate for you health!
hi, Melitta, thanks for your reply and the link - it will take me some time to sift through it all as I don´t have a clue what half of it means but it all sounds very positive and I have a lot of learning to do. one thing I remember being told in the hospital was that if I was very happy / excited / laughing a lot then it would affect my glucose level and I would get a false reading. It was almost as if they were telling me it was all doom and gloom but I´m not like that - me and hubs love our life and we are always laughing even with all our problems - he has been disabled for 40 years and spent 32 of them in a wheelchair but when we came to Portugal, he made up his mind to get out of it and has done really well despite many setbacks. We are like a pair of bookends holding each other up !
Wonderful attitude, Loobyloo and it sounds like you have a great marriage too! I agree with Melitta, as I read your post I thought "Adult Type 1, rapid onset", rather than LADA which is slow onset. And your doctor is.....well, I think you are smart enough to know what he is and, like many of us, do your own homework. Yes, there is a lot to learn, but you'll get there,poco a poco as we say in Spanish (little by little) especially with such a positive attitude and the recognition that your doctor doesn't know everything!
By the way, I'm LADA/Type 1 and I was diagnosed at age 58!
Hi Loobyloo: I would be glad to help you with any part of the information in my blog that you don't understand. At your own pace, of course! It all can be so overwhelming. Sounds like you and your husband are having a wonderful time in Portugal, in spite of the setbacks! Ah, Portugal, I was there in 2009, simply wonderful.....
If a person that spent over 5 years in med school is going to give you the diagnosis of being diabetic but can not give you a hint of which type is a moron! Find another doctor and get a 2nd opinion.
It is important to know because they will determine your therapy. Therapy for a T1 or T2 or T 1.5 lada is very different. Then individually it can be more tweaking that has to be done. This is not a cookie cutter disease.
BECOME YOUR OWN HEALTH ADVOCATE!!! I can not stress this enough. Start doing your own learning and research about diabetes. Don't depend on a doctor even if they are a "good doctor or ENDO". They will take you seriously if they see you are taking your condition seriously. Are you seeing and ENDO or a general practioner? There is a big difference..See an ENDO if you are not. To be honest with you there are some doctors that don't know what they are doing and are grasping at straws. I had a friend that was diagnosed wrong because they simply looked at her age, weight and ethnicity. They did pay any attention what her body was doing till it was almost too late. When they started treating for LADA then her symptoms started to relax.
Without knowing what Type you may be leaning toward....YOU ARE A GUINEA PIG EXPERIMENT.
Hi, Christalyn, thanks for your reply, I think I am VERY behind the times - whats an ENDO ? I am under the diabetic unit of a hospital an hour and a half away, but my G.P. is 20 mins drive away, she´s the one who said I don´t need to know what type I am, but.............. her husband is diabetic and in a poor state waiting for a kidney transplant. She runs a diabetic kind of session for her patients - I was given an appointment for that but I had to wait nearly 2 hours to be seen and I really don´t relish the thought of that type of control ! At the hospital, I am being treated for LADA and I feel that I´m doing ok. My Ac1 thingy is usually around 6.2 - 6.5 and cholesterol level is around 160 ish. I have been told that the expected levels in Portugal are somewhat different to America but I don´t know what they are or why -I certainly do have many more questions to ask !
Loobyloo, I'm very sorry that it's so difficult for you to get good health care where you are. That's distressing! Whatever type of diabetes you have, you have a chronic illness that you can manage if you understand it. Only you can be an expert about your health care, what goes on with your body, what works and what doesn't. You have an absolute right to every single bit of information about your health and you shouldn't settle for one iota less!
How is your blood glucose? Are you able to test frequently? Do you know how to figure out how much insulin you need at different times of the day--especially mealtime boluses? Do you know how to adjust your insulin when you exercise? What do you do when you have a hypo? Are you taking any medications other than insulin? You mentioned that you were on something for cholesterol. Have you had blood tests to see what your cholesterol levels are since you've been taking that medication? Have you been tested for underactive thyroid (Hashimoto's disease)?
I ask about the cholesterol because elevated cholesterol can be a result of low thyroid. When the thyroid level is increased, the cholesterol usually returns to normal. Taking statins and other drugs for cholesterol isn't helpful, particularly if it's your thyroid that's caused the problem in the first place.
You might see if you can get a copy of Dr. Bernstein's Diabetes Solution. Regardless of what type of diabetes you have, Dr. B gives a very good, thorough description of what diabetes is, how it works and what you need to focus on to achieve and maintain normal blood glucose levels. He knows what he's talking about, having been a T1 diabetic since he was about 12 years old. He's 77 now--very unusual for a T1--and attributes his longevity to what he's learned about diabetes and how he managed his own health care, which was contrary to the medical advice he received for years.
Another place to learn more about diabetes--in addition to the wonderful discussions here--is Jenny Ruhl's website, Blood Sugar 101. Jenny provides a huge amount of information about diabetes, treatment, drugs, low carbohydrate diet, and ways to manage, all based on medical reports which she references extensively.
You sound like you're in good spirits, and that's a huge advantage. Keep asking questions! The folks here are an incredible source of information, insight and support.
I guess this is one of the downsides of moving to a non English speaking paradise.
Same here in Canada if you are older then 12 with diabetes = type 2 automatically.
They will put you on oral pills and these will insure that your pancreas will die completely then they will put you on tonnes of insulin.
Read the blood sugar 101 site very good one and ask more questions.