Getting tested

Wanted to introduce myself. Although the profile says I have T2DM, that is not quite right. I really don’t know how to classify myself yet. In 2001 I was given an OGTT. The one hour was 202 and the 2 hour result was 158. I was told this was not a problem and all I had was insulin resistance and not diabetes. Like a fool, I believed the doctors. I have had a fasting blood sugar done once more and it was 101 - again I was told not to be concerned.

Recently I started testing my own blood sugars and have found that my pp readings are elevated. How high I am not sure as three different meters give me three different answers with a range of 30-40points difference. I am not sure what to think.

I did a A1C and it was 6 - again my PCP told me “this is normal and you do not need treatment” He did not ask about my diet. I don’t eat a typical, high carb diet. I am gluten free and don’t eat many grain products at all. I feel better without all grains and sugars.

I have found a new PCP and because of the OGTT, two sisters with T1DM and history of heart disease - had bypass 8 yrs ago - he is willing to test me for LADA and explore the possibiltiy that I do indeed have diabetes. I will take my meters with me to find out which one I can trust - if any.

So I wanted to say “Hi” and I may have questions for you as I go though testing.

Hi, Anne,
Good luck with your testing, and good for you to take this seriously. Fasting numbers of 100 and high PP readings are NOT normal. I had a similar experience with the GTT. I had a one and a half hour of 175 and two hour of 112 and was told that was completely normal. I did have the antibody tests and was barely positive for just one (Islet cells). I was lucky to have a nurse practitioner who didn’t think it was right to call me pre-diabetic. I take very small amounts of insulin with meals, and can keep almost completely normal BG levels and eat a bit more balanced diet- including small amounts of fruit and dairy but still very low-carb. Let us know how things go.

My fasting c-peptide and GAD antibodies were “normal” so I don’t have LADA. I have been on a low carb diet since my original post and my BG has come down nicely. The meter with the lower reading is the one that agreed with the doctor’s meter and a glucose drawn from my vein. As long as I don’t eat anything with high carbs, I can keep below 120. Sure do miss rice and potatoes.

It seems that limiting my carbs has brought about a slow decline in my BG. Normal diet fasting readings in the mornining were as high as 120-130. When I started eating low carb they dropped to 90-100 and now they are 80-90. I was surprised they continued to drop over the past month.

My insulin level was 7, which is under the "goal of <10. How quickly does a low carb diet impact insulin level? This was drawn about a month after I started eating low carb.



A low carb diet works within a few days when a person’s blood sugars are elevated into the range you reported for yours.

Fasting insulin is a tricky measurement, too, as it doesn’t tell you anything about your post-meal insulin secretion. The pattern in which diabetes develops in most people is one where fasting insulin stays normal until years after post-meal secretion has failed.

Hi, Anne,
Glad to hear you are doing well with low-carb. I am curious about your test results. Did you have the full range of antibody tests or just GAD? This IS the most common, but I am negative for GAD and positive (just barely) for Islet cell antibodies. There are 3 or 4 other tests. Also, my C-peptide was normal because I am still in the early, early stages of LADA. It is possible you are too and perhaps you should have some more tests done in the future. I am wondering what your actual numbers were. Sometimes you can fall in the normal range but be on the borderline. It might be helpful to find out. My result was 5 and that is the cut off for positive. If I had 4.9 I am sure the lab would have recorded the result as normal.

Libby and Jennifer - thanks for the replies.

C-peptide was 2.2ng/mL (range 1.1 - 5.0)
GAD-65 antibodies was <1 U/mL (range 0.0 - 1.5)

It is interesting to me to find out that getting tested thoroughly for DM is much more complicated than I had realized. This should not come as a surprise to me as it is the similar to getting tested for gluten sensitivity/celiac disease. Doctors tell patients that “simple” tests will diagnose these diseases. The truth is, all too often,“simple” tests will diagnose only after there is significant damage.

I am thrilled that my BG has responded so well to a low carb diet. I don’t mind giving up grains. My biggest frustration is that I have antibodies to both egg white and casein, so many low carb recipes are off limits for me.

So did you have the other antibody tests or just GAD? You can have antibodies to insulin and/or islet cells as well. If you have antibodies to egg white and casein, chances are you could have autoimmune diabetes. (Type 1)

I did not have any other insulin or islet cell antibody tests done. What are the name of the tests? My new PCP seems to be fairly open to exploring this with me.

Right now since my BG seems to be fairly well controlled with diet alone, I am not sure that testing will change what I am doing. If my BG starts to rise again, then I can see more testing. I will ask for another A1C in a few months to be sure it has dropped from 6.

I have antibodies not only to egg white and casein, but also to soy and gluten.

Diabetes Mellitus Type 1 Autoantibody Evaluation:
Islet Cell Autoantiboies F
Islet Cell IgG
Insulin Antibodies

Here is an update. With the low carb diet my A1C fell to 5.5 Is that low enough? I am not without risk as I already have had heart bypass. My meter seems to range from 85 - 120 and an occasional jump to 140.

Eating low carb is not easy and it will be much more difficult when I attend a national meeting of Gluten Intolerance Group. I will have to resist all the vendors with their carb laden gluten free goodies.

Hi :slight_smile:

Hi, Anne,
5.5% sounds great. Did you ever have the other antibody tests done? The thing is, if you do have LADA and are insulin sensitive you could do small amounts of insulin and not have to give up so much. I have a friend with celiac disease and we compare diets. I think she has it easier than I do because she can eat rice and other grains. I can’t even imagine how hard it is to have both. I can manage with diet and exercise alone, but insulin allows me to eat fruit and dairy and that makes a big difference.

Yeah, rice and potatoes were a main staple for me. Getting down to 5.5 has not been easy. I see my doctor in August and we will talk more. Is good to add insulin so I can eat more carbs??? Or is it best to just stay low carb??? I can tolerate small amounts of fruit. I do best with berries and canteloupe.


Hi Anne, I am “kind of” in the same boat as you. I’m on the border of everything. Its more likely mine is just garden variety T2 rather than LADA or T1.5 though, since I do have weight issues and have had 3 gestational diabetic pregnancies of increasing severity.

Anyway, don’t have a lot to add yet but I do hope you get the answer you need.

I think its frustrating how much different meters will read. I have collected, over time, a plethora of different meters, all given to me or the most recent one which I had full free coupon for, and I always wonder what to trust.

My A1c was 5.8, so I am in that “cuspy” zone, too. I was told anything under 6.0 is non diabetic, but I also know that for the first 1.5 months (roughly) of the time the A1c would cover, I was still nursing and that was keeping my blood sugars low, so what I am thinking is that without some action, my A1c will be higher the next time around.

Good luck and welcome!