Am I slowly developing T1?

This is a bit long but please bare with me. I’m 39F (130lbs), diagnosed in the last year with celiac disease. I do a moderate work out almost every day. About 6 years ago a regular blood test showed my A1C at 6.0. My doc told me to watch what I eat and so on even though I already was. Since then my A1C has averaged between 5.3 and 5.6 (I was also pregnant 3 years ago with no issues). After I was diagnosed celiac in July of last year my diet changed. I went for about a month without eating anything during the day except for some rice cakes and a boost and then I would eat a big meal of white rice and chicken. During this time I got two yeast infections and I even noticed a blurry spot in my vision on two occasions (my blood sugar was clearly spiking in retrospect but I wasn’t testing at this point). My gastroenterologist sent me for a BMP and my fasting BS was 101. I freaked out of course and started working out again and eating around 130 carbs a day and my FBG normalized (85-90). I ended up seeing an endrocrinologist and on two separate occasions my c-peptide was .72 and .69 with 82FBG. My A1Cs were 5.1 and 5.2. I tested negative for all five antibodies. She even gave me a 2 hour 75grams glucose OGTT and I brought my meters with me. On all three of my meters I never went above 134 and I tested at one hour, 1 1/2 hour and 2 hours. I was back to 84 on my blood test and 124ish on my meters at 2 hours. I actually ended up going home and working out and went low around three hours (in the sixties). I’m convinced I have super slow developing LADA. Why else would my A1C have been at 6.0 six years ago. I’m currently maintaining a low carb diet (130 grams a day, under 40 grams per meal) and I test regularly and have never seen a number over 120 except a few times but it was under 140. Does anyone have any ideas? Do you think I have LADA? What are the chances of me having lada with no antibodies?

Was this done from a blood draw, or in office with meter or desktop machines common in dr offices?

In office A1C machines are not as accurate as labs.
A1C is not actually reading average BG, and can be falsely high/low if your red blood cells live longer or shorter than normal. (My A1C test was low when my RBC was low due to chemo, so was not correlated with average BG).

Your current A1C does not indicate sign of LADA.

Testing your BG just after high carb meals is easy way to log/track if you are showing signs of diabetes.

The A1C was a blood draw and also I had reoccurring yeast infections then as well. Also I do regularly check my post meal numbers (never seen over 130 ish and that is rare usually the highest I will see is 120 1 hour after a meal) but the most carbs I eat in a meal are 40 grams because I’m scared to eat more. Should start experimenting?

We can all be very different. And there are some people that don’t have antibodies, but don’t make insulin and they don’t know why. There also seems to be some unidentified forms of diabetes.

But honestly, your blood work is not pointing to a problem with LADA that I can see. That is just me and I am not a doctor. Although I am usually someone that likes to warn people about LADA really easily. There can be margins of error in A1c tests. There can be variability on meters and some are definitely more accurate than others. There can also be fluctuations in blood sugars. A 105 fasting level is not a big deal. 30 years way before I had the first signs of diabetes my fasting blood sugar was always between 100-103. Plus there is always a margin of error. And “normal” people drop to the 60’s all the time. When you are sick or not well blood sugar levels can also trend higher.

So to have the “first” alert 6 years ago, but pretty much normal since then would not seem to be a sign of LADA. As an LADA you slowly lose the ability to make insulin. Even very slow onset, you slowly get worse. Lifestyle changes work at first because you still make insulin, but that slowly changes. I would expect you would see some higher numbers after you eat or higher numbers staying higher for longer than the 2 hour “normal” mark.

Right now it looks like your meter(s) might be off. Are they all the same brand? Contour Brand is usually known for being the most accurate.

I remember in my 20’s (way before diabetes) we started getting in fresh juices and I would guzzle carrot juice, tangerine and watermelon juice and the doctor did yearly blood work. All of a sudden my triglycerides were sky high. The doctor was not concerned. But right about that time I ran across a book where a hiker was eating a lot of trail mix with dried fruits and all of a sudden they tested high in triglycerides, they stopped eating so much dried fruits and dropped to normal levels. Sure enough, I laid off so much juice and I returned to normal by the next test.

Sometimes we have specific food problems that set off issues. White rice and chicken is severely lacking in nutrients. It could be the lack of nutrients that caused some issues. But constant white rice and rice cakes are also pure sugar, hence yeast infections, which in itself can cause all sorts of issues. Some people have huge issues with keeping yeast under control for years. And yeast they now know, gets more stubborn each time you get it. You do not want to mess with a constant yeast problem.

I would try adding some carbs back, but smartly. Start with healthy foods, like more veggies. Lots of people have issues with rice, so maybe not rice.

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Thank you for taking the time to respond. My meters are all different, one is accu-check, one is reli-on and one is one touch. I read that the post pradial reading after an ogtt might be significantly higher with capillary blood vs veinous blood so that my be why my meters were so off in that situation. When I have used my meters during a blood draw for FBG they seem to match the blood results pretty accurately. Just curious, do you think that your FBG numbers of 101-103 could have been super early signs of diabetes or no?
I think I will start adding a few more carbs in and see what happens. Thank you again.

Your blood tests are good, Did the doctor tell you there is nothing wrong? I would believe the doctor, if he did. Did he also say there are reasons that there can be an isolated 6%, A mild pancreatitis. Even thrush can throw out your BG. It may even be a lab error?
You had a pregnancy after the 6% without the common short term gestational diabetes. I think it would have shown up there, if there was an issue.

I’d relax a bit in my diet, if you aren’t enjoying low carb, Some normal people choose that way. 150g the old what people normally ate, may suit you better
Carbohydrate Consumption (NHANES):
1971–1974: 42% (∼250 g for 2450 kcal/d)
1999–2000: 49% (∼330 g for 2600 kcal/d)

1971–1974: 45% (∼150 g for 1550 kcal/d)
1999–2000: 52% (∼230 g for 1900 kcal/d)

Your BG strips have a 10% error for the most part. A BG of 100, could be reading between 90 and 110.
Take averages and trends.
normal blood glucose is under 140, 2 hours after a meal.

When you are ready, throw away the meter and just have an A1c in your blood tests. Other than reassuring yourself, I see that there is no need to home test in your case.

No, the 100-103 was a consistent fasting number for at least 30 years before the first signs of changes and was done at a lab every year. At home too for years every 3-6 months I would take a variety of readings as I had a meter just because I thought it was a good idea. I was always in normal ranges. I am actually the one that caught the first fluctuations and went to the doctor when I started waking up to 112-120 fasting levels for several days in a row. At first I was told it was just a fluctuation and as the numbers kept raising. I was misdiagnosed as a type 2 for over 8 years.

So I am avid about warning people about being a type 1 instead of type 2. But initially while change of diet works, your numbers slowly keep going up. One of the signs of type 1 versus type 2 is needing insulin within 3 years and while that 3 year mark can vary depending how soon it is caught, the numbers steadily do go up because you are lacking production of insulin which keeps declining. Pregnancy usually brings out an issue if there is one because it stresses the pancreas.

And who knows, celiac disease is common with type 1’s. But except really for the one oddity which can be a fluke everything looks great. Just test off and on, add healthy carbs and see how you do. It might have just been one of those “things” that just happens for no apparent reason.

Being alert and occasional testing BGs is not going to hurt you. Nor is eating lower carb, which is healthy for everybody. Don’t worry about it. The numbers you see may just be normal for YOU. And if you do develop T1 LADA, then you will certainly notice the difference sooner. Just don’t obsess about it.

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