Early LADA?

Hello,

I recently posted this in the pre-diabetes forum but thought I’d get your input:

I am a fit 31 yr old with the following numbers:

03/07 A1c 5.3%
05/08 FBS 103 (ref 70-105 at this lab)
06/09 FBS 109
07/09 FBS 104 A1c 5.2%

Because of the 100+ fasting numbers I bought a meter and have had fasting numbers between 89-103 at home. I have also been testing after meals and here are the results:

after pasta dinner 1hr 155 2hr 126
after oatmeal/toast 1hr 143 1.5hr 123
after burrito with whole wheat tortilla and refried beans 1 hr 161 2 hr 147 4hr 100

But after some meals with less carbs I’ll peak at 119. These numbers seem high to me and Im concerned. My 50yr old mother is prediabetic with a FBS of 120. Could this be an early LADA or DM 1.5? Any thoughts?

It could be any number of things. T2 doesn’t require obesity, so it could be that, it could be T1, or it could be nothing at all - an A1c of 5.5 is normal at most labs.

The refried beans being so high doesn’t surprise me, as I would imagine that’s a fairly fatty meal, for which you can get a delayed peak.

To rule out LADA/T1, you’d need to get a c-peptide and assorted autoantibody tests. Your PCP can do that for you, or you might need to see an endo.

– Dov

Im just wondering if normal people have after meal glucose levels like these?

A non-diabetic A1c is under 5.0. Normal people don’t have post meal numbers that high. They may go a bit high after after a very high carb meal, but quickly drop down, not hours later. Your fasting is good, but there are people with good fasting BG who soar high after meals. This is why a glucose tolerance test is a better indicator than fasting for diagnosis.

Hi Drew: Has a doctor told you that you are pre-diabetic? If you are young and fit, and a doctor has told you that you are pre-diabetic, it is good to consider it might be early LADA. The definitive test for Type 1 autoimmune diabetes (at any age of onset) is antibody testing (glutamic acid decarboxylase antibodies (GADA), islet cell antibodies (ICA), and insulinoma-associated (IA-2) autoantibodies). A c-peptide test can also be useful. A doctor can order these tests for you. Good luck! Melitta

My doctor basically told me I am worried about nothing. I’ll have to press the issue I guess. In the meantime, it’s lowered carbs and lots of exercise for me.

I’d push the issue. The best that happens is you find out it’s nothing, and in the worst case, you’ll have a heads-up on what you need to be doing to keep things under control.

If it would give you piece of mind, go ahead and push it with your doctor.

BUT, I REALLY WOULDN’T BE CONCERNED RIGHT NOW.
Your numbers look pretty normal after those foods. I know they say non diabetics don’t go over 140, but I’ve seen several studies (and people for that matter) who go above 160 after a high carb meals like pasta. Besides, home meters are only required to be 20% accurate, which is why they won’t diagnose off a home reading/meter. Also, your A1c is pretty normal, so your not spiking too high, or it’s not lasting long enough to affect your A1c.

I’m just saying, don’t get stressed out over your numbers right now. Just keep checking them at your regular appointments to see if they change.

Thanks for for all the helpful replies. It’s good to know that if I do happen to develop diabetes, there are a lot of people out there willing to help! I’ll talk to my doctor the next time and ask for some additional testing.