C-peptide

Hello, I have diabetes, most likely LADA. I have not yet tested positive for antibodies yet. However, I do have Hashimoto’s Thyroiditis. I developed diabetes 9 years ago. 6 years ago my C-peptide was 0.7, then 3 years ago 0.8, and a week ago my Fasting C-peptide dropped to 0.6, with a fasting insulin of 2, at this time my fasting blood glucose was 92. My after meal sugars rise up to 250 sometimes, then go down relatively fast. Sometimes I will get hypoglycemia. So far, my fasting glucose is in the 90’s. My metabolic panel otherwise is fine. Has anyone else experienced anything similar to this. My endocrinologist has given me a CGM to watch my blood sugar. So, I see it rising rapidly after any carb meal. I am currently on no medication and my last A1C was only 5.1. Any feedback is welcome….

Thanks, Jackie

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Hello Jackie, welcome to the site. I have T1 and have had for 48 years. In some ways T1 is easier to diagnose and have than LADA T2, MODY or Gestational diabetes. For us it is fairly clear cut.

I have to say that we make a practice of never giving medical advice or opinions on our site. I am not an expert on LADA ( we have commenters who are), but it is not me. Even if it were me, I would not give an opinion because I am not kind of doctor and besides even if were and I saw the labs etc, I still would be doing it without benefit of a history or observation.

Still I suggest you find and stick with a endocrinologist who will see you over time. The A1C you state seems exceptional so I suspect most GP’s would dismiss your suspicion. That does not make it real or not. But only looking at your case over time will give you the answer. Well looking overtime and a really top notch endo.

I hope you find your answer.

rick

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It sounds like you are on the right track. My symptoms are similar to yours and after over 30+ years at Joslin, they still try, unsuccessfully, to “type me”. I do not tolerate any slow-acting insulins such as Lantus or Levemir as they give me nightly hypoglycemia regardless of how small a dose I take. I can eat pretty much anything as long as I carb count and adjust with fast-acting Humalog as required to keep me fairly close to flatline BG’s by pre-bolusing and then following up with an additional shot 1 1/2 to 2 hours later depending on what I eat. This keeps my BG’s pretty much flatlined especially if I tend toward a low carb/high fat diet. Virtually any carb drives my BG into the 200-300 range if I don’t counteract with fast acting insulin. White carbs such as bread, pasta, pizza, linger in my body for about 3 days, sugar spikes and is out of my system within hours. My A1C is in the 5,7 range. Lower than that my endo complains even without lows and higher I am not a happy camper.

We are all different and some of us way different than most diabetics. Your CGM should be your best friend and salvation. Keep us posted and welcome to our community. We look forward to hearing about your experience to your proper control solution.

If I were to guess it appears you have lost first phase insulin release so you get the rapid rise after carbs. You still seem to have good second phase release and good response to insulin since your 250 comes down relatively fast. Is this big rise after carbs new? If so did you have Covid?

Below is some info on losing first phase release. The only thing which can mimic first phase release is afrezza. It may also help getting your liver back in-sync to prevent the lows but you will need to watch and learn with your CGM.

Is reduced first-phase insulin release the earliest detectable abnormality in individuals destined to develop type 2 diabetes? - PubMed.