Am I inching towards being Type 1.5 LADA?

Type 1 and LADA
1

I am a Type2 diabetic on oral medication, ethnicity - Asian Indian. Age - 36 yrs, been diabetic for past six years.

I have been monitoring my blood glucose levels. Fasting levels are in 120's regularly - 129, 123, 131, 128, 126, 122, etc.

HbA1C - 7.1 %.
I have also got the C-Peptide test and the value is - 3.54 ng/ml (normal range 1.1 - 4.4 ng/ml).

Looks like I am inching close to being a Type1, what do you say? What kind of steps do I need to take?

Please help me with tips and suggestions?

Thanks,
Sai

2

sai, here's a blog that I think really explains it
http://www.tudiabetes.org/profiles/blogs/positive-autoantibody-tests-indicate-type-1-autoimmune-diabetes

and another thoughtful post
http://www.tudiabetes.org/profiles/blogs/a-field-guide-to-identifying

3

Thanks Marie. I will read through.

4

C-peptide seems normal, and a lot of T2s end up on insulin eventually. How's your diet/weight? Do you eat fairly low carb? Looks like your current oral meds aren't cutting it.

5

Sai, you might want to consider going on insulin (maybe discuss with your doctor). this will not make you a type 1 or a type 1.5, you would still be a type2. if you decide to try it, just know it's not because you "failed" to adhere to whatever treatment plan you're on now. there are plenty of members here who are type2 on insulin, they have a group here
http://www.tudiabetes.org/group/insulin_dependent_type2

please join the group if you like, whether you start insulin or not. let us know how you're doing!

6

It doesn't work that way, Sai. If you are Type 2, you are always Type 2; if you are Type 1, you are always Type 1. The confusion you might have about this is that many of us were misdiagnosed as Type 2, then found out we were Type 1, adult onset.

Your C-peptide is normal which indicates type 2. The only way to determine type for sure is by Antibody testing.

Many type 2's do need insulin eventually, but that doesn't mean they "become type 1's". Your numbers aren't terrible, and perhaps you could inch them a bit lower by closer attention to insulin dosing and diet improvements. But if they are inching up on a slow but steady rise, yes, it might be much better for you to go on insulin. Insulin is being used sooner with type 2's now; it's a very effective method of treating high blood sugar compared to pills.

7

None of your test results suggest any marked movement towards insulin deficiency. And as others have mentioned, T2 does not just progress to T1. I suspect a major reason that you are still struggling with blood sugar control is that you are probably eating a high carb diet. In this recent post you suggested a good diabetic diet as:

1. Diet rich in millets - ragi, jowar, etc
2. Lots of beans, chick peas, rajma dal
3. Preparations of lentils (or dal) - toor dal, moong dal, urad dal
4. More roti's or bread rich in grains, less of rice
5. Rice could include basmati, hand-pounded types of rice
6. Condiments like - cinnamon (dalchini), little bit of cloves, etc
7. Biscuits (diabetic friendly) - oats, ragi, hi-fiber, nutrigrain varieties.

I would really try to limit your carbs more.

8

Based on your c-pep, looks like your pancreas is okay. It's classic T2 insulin resistance.

I'm T2 also, and am a very strong advocate of T2's using insulin therapy. Indeed, I feel the health care industry should support pumps and CGMs for any diabetic that wants it, and is willing to learn and implement the steps to successful treatment with this technology.

Short of the "cyborg" solution (of which I am a happy blend of man and machine :-)), Multiple Daily Injections, with a daily long-acting like Lantus to take pressure of that tired pancreas so it stays healthy as long as possible, is the minimum treatment for any T2, starting with initial DX.

The reason medicine doesn't advocate this is because of the patients, not doctors. Most people will avoid going on routine injections if at all possible. I know -- I was like that way too long. I regret it. I wish I had started on insulin from day one (DX'd 15 years ago).

After getting past that psychological barrier, I found that MDI really wasn't that big a deal, and I felt so much better, energetic, mentally sharp as a finely honed Japanese sword (from Highlander), etc. etc., that there was no contest -- I'm on insulin for life until this thing is cured.

Now, it's even become a fun game, driving my A1c down. Got it from 11->6.3 in 3 months. Next stop under 6; after that, under 5.5.

With a pump and a CGM, it's a breeze.

And here's the biggie from one T2 to another: No more being controlled by this condition, having to remember to eat at certain times, don't forget that snack, oh, I can't have that large popcorn at the movies, ever, and on and on and on.

I have near non-diabetic blood sugars these day, and if I want to indulge in something now and then, on the spur of the moment, I can. I just push a few buttons on my "cellphone" (that's what strangers think the Omnipod PDM is most of time), and I'm good to go to shove that popcorn in my gaping maw.

We have another new member, T1, struggling with this same issue of control. I just can't put in to words how liberating, exciting, happiness-inducing it is to get in the driver's seat with this condition and run the show, instead of being a marionette on strings being pulled by Demon Diabetes.

You will never achieve this on pills, without going on a near carb-free diet. But then, if you don't want to do that, well, puppet, strings, you get the idea.

Finally, you can always go to your doc, give insulin therapy a try, and if it doesn't work for you, go back to oral meds/diet/exercise/restriction. The only thing you risk giving insulin a try is hypoglycemia, but that's managable.

9

I have met my doctor (Endocrinologist) and he has checked all my reports. He has clearly stated that I am Type-2 and because of long history of family (being diabetic) and due to excess stress, I have got T2D. I hope he is correct and he was re-assuring that with good exercise and diet control, my numbers would come down.

10

One significant difference I found was that when I got tested for Fasting and Post-Prandial sugars, the fasting was in the range of 90's instead of the 120's that was shown in my Accu-Check meter. What does this mean? Are digital meters not accurate enough for testing at home? Please share your views.

11

My c peptide was 3.5 as well and I was labeled type 2 diabetic at only 22 years old and 100 pounds. Within a year my c peptide was less than 1 and I was placed on insulin. It can happen slowly if you are LADA.

12

Thanks for the info LiL MaMa......