Diagnosis Perhaps in Limbo?

Hello Everyone,

Let me first thank you all for such a welcoming response, wow! I never knew there was a Facebook for diabetics, ha! There are some really cool people on here and it makes me realize that I’m not alone. I live in an outskirt of Tampa Bay where the population is a bit older. Being a 31 year old, recently diagnosed diabetic, this has been a bit overwhelming. I know many other diabetics around town, but I’m literally half their age. This was eye opening.

Backround - Given my age and weight at diagnosis (27.5 BMI), along with my mildly high bloodpressure (139/89), high triglycerides (321) and low HDL (33), my doctor assumed me to be type 2. I generally think he is correct, but this the last couple of days have brought me to question this just a bit.

I recognize that this is a controversial topic and I certainly do not wish to generate a debate on this as it can get quite heated (and I like you guys!), but I am considering the experimental procedure of duodenal switch for T2 diabetics. That’s a different conversation for a different day, right? I have been asked to be sure that my diabetes is not autoimmune driven and I hadn’t heard of Type 1.5 (LADA) before this week. Given my relative young age and the fact that I was slightly overweight (certainly not obese), I now question whether I have markers for the T 1.5. I have requested a C-Peptide and GAD65 test from my doctor, but have not received the script yet.

Given my metabolic issues at diagnosis (considerably better now with exercise), I tend to believe I was an unlucky young T2, but it isn’t a slam dunk of a diagnosis to me. I have responded fairly well to meformin and glipizide (although I’m trying to drop the glipizide).

The message boards I have read seem to indicate that most T1’s or T 1.5’s do not have the cholesterol, bloodpressure, triglyceride problem that I did (do?). Can those of you with LADA describe to me your metabolic indicators in addition to your diagnosis trigger?

Thanks a million!

Oh yeah, I’m a business school graduate from the University of South Florida. They are playing Kansas tonight…GO BULLS!

My blood pressure is slightly high and I have LADA. My C-peptide is still normal and I am negative for GAD antibodies. However, I’m positive for islet cell antibodies so make sure you have the whole diabetes antibody panel done. Are you responding to meds or did you not start yet? Your A1C was very high and that might indicate 1.5 so I do think it is worth asking for the tests. If you have LADA you want to start on insulin right away. I was diagnosed because of the high blood pressure and tiredness. My doctor ordered a bunch of tests and my A1C was 7.2.

Hey Libby, thanks for the reply. Actually, I dropped about 25lb since my diagnosis (now really pretty fit) and my gluose tends to hang around the 120-135 range most of the day. Post-prandial rarely exceeds 165-170, if that. I was taking Metformin and a very small dose of glipizide (now stopped taking it) and I’m holding pretty firm. I suspect the exercise is really helping. I thought I had my bases covered by requesting the GAD and C-Peptide, but you just gave me another avenue to pursue. i appreciate that. Thanks much!

I dropped a similar amount of weight after diagnosis. I believe it was to do with reducing insulin levels in my body. Losing first phase response- in my case due to autoimmune attacks- resulted in higher post meal numbers. My body responded with a large insulin release which caused low BG at 1-2 hours. Excess insulin in the body can cause weight gain. I was thin already so losing the weight was a bit more of a problem. I’ve stabilized since but am still a bit underweight. Your numbers sound very similar to mine. I wouldn’t be a bit surprised if you turn out to have LADA. keep asking for those tests and if you come back positive, I recommend starting on basal and mealtime insulin at once. That, in combination with low carb eating and exercise will keep your remaining beta cells happy.

Libby,

You are being quite helpful. Can you tell me what your triglycerides and HDL cholesterol were at dignosis?

Thanks!

Don’t know what they were at diagnosis, but after 6 months of low carbing with a high fat diet, my numbers were great: Triglycerides under 42, HDL 64, LDL 125.

I am labeled as type-2 but went on insuln in under 2 years etc etc etc. So for almost all my dabetes years I have had to manage my BS like a t-1…

Still don’t know for sure, other than I am not a typical t-2 by a long shot.

(*&( GOMER

I just thought I would update everyone, my fasting C-Peptide came back 2.2 and my GAD65 said “less than 1” and that was the reference range. It didn’t give me a particular reading. I have made huge strides in triglycerides and cholesterol since diagnosis in late July. I guess that probably keeps me in the type 2 camp (for now).

I have lada, when I was first diagnosed they said I was type 2. I responded great to the medication for about 6 months, then they just kept going up, I have high cholesterol but not high blood pressure and have almost always had a weight problem, but when the pills stopped working I had all the tests, it was very clear that it was lada.

I thought I was LADA until I had the bloodwork. I think it was pretty conclusive that I am type 2 given the non-existence of anti-bodies and the relatively normal C-Peptide level.

I developed type 1 at the age of 43. Because I sold Glucophage at the time I knew quite a bit about diabetes. I am 5"8, 125 lbs, normal blood pressure, cholesterol, and triglycerides, no health problems. Make sure to get the C peptide and GAD. You need to find out if you’re type 1 or 2 because it obviously makes a difference in your treatment plan Take care! Colleen

If you are on insulin now it doesn’t really matter which type you have. Keeping good control of your blood sugars is your main concern. I realize you were just responding to the question. Going on insulin after two years with diabetes is not good but the best you can do is to prevent complications with good blood sugar control. Take care. Colleen

Question for the LADA folk… do the C-peptide, GAD, and islet antibody tests come back with some semblance of positive right away, or only towards the end of the honeymoon period?

The GAD 65 should come back positive now, and the c-peptice will gradually decerease overtime. I have a +GAD-65 a - IAA and my C-pep is <0.9.

Alright. Sounds like you are in fact a Type 2. The elevated liver enzymes and all that Jazz are typical. I was diagnosed 1.5 at 31. Cholesterol 166, trygicerides 66, HDL and LDL all perfect. GAD-65 = 49.25, IAA (-), cpep 0.9.
I was 6ft tall and 145lbs.
All type 1.5 is is delayed juvenile diabetes. I’d bet the farm that you are a Type 2. Type 1.5 are completel insulin dependent. Probably Diet, exercise, and some meds will do you good.

The GAD 65 enzyme is probably present for many, many, many years but 1.5’s don’t notice it until 80% of the beta cells are dead and they become Type 1 symptomatic. example: My Diagnosis Fasting Blood level was 812

The high triglycerides, slightly elevated BMI, and low HDL suggest the potential of Metabolic Syndrome. There is some indication that dietary factors (high levels of refined carbs; consumption of trans fats and high fructose corn syrup) will decrease HDL and increase LDL and triglycerides, and exacerbate issues of impaired glucose tolerance and insulin resistance.

Some factors that might help elucidate this would be the ratio of your waist measurement to your hip measurement and a percentage of body fat. If you tend to gain weight in your midsection rather than evenly all over, or in your hips and legs (waist:hip ratio > 1.0), your metabolism may be more sensitive to weight gain than someone who gains weight all over (or preferentially in the lower body). The percentage body fat indicates the true measure to which you are (or are not) overweight.

If indeed we are talking about high body fat ratio and/or a tendency towards abdominal obesity, then it is possible that attention to diet and exercise can improve your metabolic indicators, and your health overall.