Do I have LADA?

Type 1 and LADA
#1

I’m new to Tudiabetes… I found you in the search for answers.

With my last 3 pregnancies at ages 31, 33, & 36 I was diagnosed with gestational diabetes. After my last son was born, the diabetes did not go away. I was then diagnosed with type 2 diabetes. I have been treating this with diet and metformin for over 6 years. At my last dr appt I asked my dr why I was so different from the typical t2. I have no family history and I am not overweight. She then told me she suspected I might be a variation between t1 & t2 referred to as t1.5. I asked if there was a test she could do to determine if I was t1.5. I was able to access my lab results online a couple days ago, but have not talked with the dr yet. I was wondering if someone here could tell me if my test results are pointing towards LADA/t1.5 as I’m assuming they do.

C-peptide 1.2 final ng/mL 1.1-4.4
Insulin, Fasting 5 final ulU/mL 2-25
Insulin Autoantibody <0.4 final U/mL <0.4

That last test really confuses me because both numbers are the same.

Any insight would be great! I go back to see my dr on the 22nd. She is an internist and I’ve been seeing her for all of my health needs for 7+ years. I also had surgery to remove most of my thyroid and my gallbladder almost 9 years ago. Earlier this year I was also diagnosed with Sjogren’s Syndrome which is an autoimmune disease along with a hiatal hernia.

Thanks!

#2

I am going through the same process now. i had my physical with my PCP in October and he referred me to an Endo. I have been a Type 2 since 2007. I was dx’d a few years after menopause and I was a little heavy, 146 pounds . Imworked out everyday fir 2-4 hours and was a vegetarian. Since going on a Low Carb diet I ammnow. 113.5 pounds. Since October I have been dx’d with 2 separate diabetic complications. My Endo ordered GAD, Insulin Assay and C-peptide. My GAD came back normal <5, normal. My c-peptide came bsck 1.1, normal. I still haven’t got the insulin Assay results back. My Endo is still treating me like a Type 2 and not looking for the reasin for my higher HgA1 c of 6.6 desoite good bgs.

#3

A good post on how to use antibody tests to diagnose LADA/T1 was written by our member @Melitta. You won’t typically be diagnosed LADA/T1 until your c-peptide is low (you need to know your blood sugar at the time of the test). The insulin autoantibody test is only one of the needed tests and yours was negative.

Technically there is no “in between” type of type 1.5. Most people consider LADA to just be adult onset T1 and that it typically will have a longer honeymoon (possibly even a decade). There are many types of diabetes (including things like MODY) and type 2 diabetes is very heterogeneous. It is appropriate to get a complete workup of all the antibodies to be clear.

I find the stereotypes of diabetes really disturbing. If you are older and even the slightest bit overweight you automatically get diagnosed as T2. Here it is, nearly a decade later and now after having complications you are finally having the medical system spend a couple of pennies and minutes actually bothering to diagnose you.

You may well have been T2 all along, but that doesn’t excuse not asking important questions. And no matter what type of diabetes we have, we have a right to proper treatment. And I’m sorry, an A1c of 6.6% isn’t normal and the fact that you now have complications suggests that you might have done better with a better diagnosis and improved control no matter what type of diabetes you have.

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#4

Hi Peggy: Many women who had gestational diabetes go on to develop Type 1/LADA. Pregnancy seems to be “the straw that broke the camel’s back” and pushes a woman over the edge into overt Type 1/LADA. Sadly, few in the medical community are aware of autoimmune gestational diabetes (and subsequent Type 1/LADA). I would suggest talking with your doctor about using exogenous insulin for your treatment; for many people, the earlier one gets on insulin, the better the health outcome.

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#5

I emailed my ENDO last night and asked about the tests in Melitta’s post. i really don’t think another type 2 drug will help me. I normally stick to 10 carbs or less a meal. If I am going to eat more carbs I do it at lunch time. It is almost impossible for me to gain weight. I have thiught about MODY but my dad and and aunt on my mom’s side are theonly diabetics in a huge family. My dad was dx’d in his late 80’s after years on prednisone. i am sure I will end up on insulin eventually, so why not try it now.

#6

I was insulin dependent during my pregnancies. Also with the last pregnancy I was diagnosed early on.

I did see in my dr’s notes on my lab results that she is planning to discuss putting me on a long acting daily insulin. My biggest fear with going back on insulin is having lows. I had a few bad lows and that is something I don’t want to do again.

#7

I also forgot to mention that my A1c came back at 7.3. :frowning:

#8

blog “Autoimmune Gestational Diabetes”

Hi Peggy: Above is a link to a blog that I wrote about autoimmune gestational diabetes that you may find interesting and hopefully useful. I have a similar blog here on TuDiabetes, but the blog in the link above is a bit more up-to-date. And yes, hypos are a concern when you are on insulin, but there are definitely ways to avoid or limit them (the best I have found is using a Dexcom continuous glucose monitor (CGM), but always having a rapid-acting glucose on hand really matters as well). Hope this helps, best of luck to you!

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