Back on Insulin again...........and positive auto antibodies

So, my new Endo put me on Jardiance back in March. I was able to transition off the MDI of insulin and was doing SO well. My average glucoses ran in the 140’s.

Then, things started creeping up again!!! I have no earthly idea why. At first, the Jardiance actually worked better for me than the insulin and that’s why I was so happy about it. I just can’t figure out what caused this decline except possibly a stomach bug that I had about a month ago and allergies affecting one of my ears.

I was just so happy to be off the MDI of insulin and to see good blood sugars from the Jardiance.

I also have a positive auto antibody that they can’t seem to explain. I feel like nothing I do has a positive effect and feel very helpless about this and depressed.

Has this up and down cycle affected anyone else with type 2? I am at a loss for an explanation.

I have an appointment with my Endo’s NP in a few weeks. I hope this one is good and listens.

Thanks for listening…

If you have positive antibodies, that’s a strong sign of being a type 1. A C-Peptide test would also be helpful to know how much insulin you are still making. Honestly, running an average of 140 is not normal for a healthy person, it’s just considered acceptable for a diabetic but It means that something isn’t right with your system.

A C-Peptide if low or low normal is a sign of being a type 1 as you aren’t making enough insulin. If high or high normal it’s a sign of being a type 2 as you make extra insulin to make up for being insulin resistant.

LADA/type 1 takes years to progress, you make enough insulin for a while and that allows diet changes or medications to work for a while, until they don’t because you stopped making “enough”. But it can take many years to completely stop.

A type 1 ends up needing insulin, there is no getting around that. The antibodies attack our beta cells that make insulin and kills them off. Insulin is a learning curve that can be more difficult when you are in what we consider the “Honeymoon” phase as your pancreas is erratic in what insulin it makes.

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You didn’t say which auto antibody you have tested positive for. There are 4 (possibly more) antibody types that indicate Type 1 diabetes. To my knowledge there are no confirmed Type 2 antibodies. The antibodies found frequently but not always in type 1 diabetes are,

  • Islet cell cytoplasmic autoantibodies (ICA)
  • Glutamic acid decarboxylase autoantibodies (GADA)
  • Insulinoma-associated-2 autoantibodies (IA-2A)
  • Insulin autoantibodies (IAA)

If you have tested positive for any of these antibodies it is a strong indication of type 1 diabetes.

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You are a type 1 not type 2, antibodies proved that. Be thankful you are back on insulin and will not go into dka as I did when your insulin production completely stops.

Also average of 140’s is not good.

By the way, I was a late in life type one but dka happened pretty rapidly.

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I used to have both Gad and islet antibodies but now I only have Gad,

I have a positive insulin auto antibody (IAA). But, I still have insulin, so it’s not type 1. I am also overweight. It could possibly be a slow forming LADA. My c peptide dropped in one year, it dropped from 4, which was high, down to 2, which is still normal from what I’ve read. I’ll ask for them to do another one.

I am feeling better today about having to go back on insulin. I guess I had to have my little pity party for a day or two.

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This isn’t confusing at all, so we’re having a hard time understanding why your doctor is confused.

Simply put, the existence of the antibodies equals Type 1 diabetes. That’s the very definition of Type 1.
It doesn’t matter that you were misdiagnosed as Type 2. Lots of adults are, since antibody testing isn’t the norm. It doesn’t matter what your weight is. In fact, Type 1s are statistically heavier than our non-diabetics counterparts. Especially in the middle-aged group. Seniors of all demographics tend to catch up to us. The deathly skinny stereotype is mostly only consistent with children pre-diagnosis or those still in metabolic distress. It doesn’t matter that you still produce insulin, in fact, it’s expected that you still produce insulin in the early days/years. Type 1 diabetes doesn’t happen overnight, but rather is a slow process while your immune system attacks the beta cells.

LADA is still Type 1, it’s just like a subdivision of it. Half of Type 1s are diagnosed as children, and the other half as adults. LADA is just a term used to describe the later onset of Type 1, usually accompanied by a very long honeymoon period where you still produce insulin.

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Jean3 is IAA positive. Positive IAA can’t be used to determine Type 1 if a person has already used exogenous insulin, so in Jean3s case the positive result has no implications.

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@Melitta I didn’t know anything about it so I went looking and I think you just have to be off insulin for a week? But I don’t know when she did the test and if she was back on insulin yet. And not completely sure whether that’s right. Here is the link I saw that at.

Insulin Autoantibodies (IAA) » Pathology Laboratories » College of Medicine » University of Florida.

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I am a LADA Type 1 diabetic, diagnosed in my mid fifties in the UK. Confirmed through C Peptide test. I am also overweight and no matter the diet have difficulty losing weight. Carb counting helps etc but generally only allows for small changes and not steadily. Some months ago I was referred to a weight loss clinic where after a full assessment was allowed to try Ozempic. Strictly speaking this is off label use of the drug as it is not recommended for T1 diabetics. In Ontario, to use this for weight loss you must be classed as a T2 diabetic as it is not recommended for T1’s. The government here, as I am covered through the Ontario seniors plan, has cracked down and now will not cover the Ozempic unless you are T2. I have lost nearly eight kilos since starting the Ozempic and both I and the clinic are ecstatic. It looked as though I was going to have to stop the drug because without the subsidy from the government it was over 900 dollars a month for the 4ml pen. Even with insurance, still covered through husbands work plan, it would have cost 180 a month. The solution? Fancy paperwork by the clinic, because they have never done a c peptide test in Ontario they “ascertained” I was a T2. My original diagnosis was in the UK. So just a warning to T1’s in Ontario who have a doctor prescribing ozempic for weight loss, if you’re on the ODB you’re going have to start covering the cost yourself or through private insurance.

I had already been on insulin when they did the auto antibody test. I don’t know if he ordered the test because I was getting red itchy spots at the injection site of Levemir or because my sugars were a little wonky.

Now, I am suspecting that I have some allergy to the insulin. I’ve had hives a few times and the other night after I took my Tresiba, I started itching. Luckily, I had been on some allergy medications for a few days, so I didn’t break out in hives! I’ll have to ask my doc about it in a few weeks.

@jean63 Some people definitely have allergies to insulin. It usually works to switch the brands if that’s the case.

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