Go straight to insulin?

Thanks for your reply Alicia :) I am feeling better about it and realizing that like you said it truly doesn't matter what type I am and I am going to treat it the same way regardless. I also read that there are various antibodies they test for. My test was listed as "Pancreatic islet cell AB". I wonder if that includes all of them?

Not sure maybe someone else knows. I believe I’m LADA as well. I am still not on insulin and I’ve been getting high readings and symptoms for over a month now. I still haven’t got my antibody testing back since I did a study through trialnet and the results haven’t come back yet since it gets sent to the states and I’m in Canada. The only reason why I would like to be labelled as t1 or lada would be because of insurance purposes to be able to get a pump and cgm. Otherwise I could care less about the t1/t2 classification. At this point in time the fact I’m not on insulin and don’t have an endo is ridiculous.

@Alicia, it is great that you are so on top of things and done so much research. I think you may have LADA or on your way. Why else would someone that is 24 and in great shape be prediabetic? When I was diagnosed with prediabetes I thought it be years before I became a full diabetic and a year later I was! Do you have family history of type 1 or 2?

Both but more type 2 than type 1 and I have autoimmune diseases on my moms side lol perfect storm

I will let a real expert chime in on this but that doesn't sound like the full suite of antibody tests. Also, as Alicia pointed out, sometimes the antibody tests don't show positive early on. And finally, although they are very good, the tests are not 100% perfect.

So, bottom line -- you need to manage and control it, no matter what the cause. As has been noted already.

The most important ingredient, regardless of anything else, is the right attitude -- a determination to control IT and not let IT control you. You obviously have that, and that's the key to everything. Keep it up, and let us know how you're doing!

It still takes some judgement to properly interpret these tests, and they are not definitive. Only 85-90% of T1s test positive for one or more antibodies and you were only tested for one of them (ICA). There are two others GAD and IA2 that make a complete T1 autoimmune antibody panel. And the c-peptide is also open to interpretation. If you have a high blood sugar, it is easy to interpret. High blood sugar and high c-peptide indicates insulin resistance (and T2). High blood sugar and low c-peptide indicates insulin deficiency. A normal range for c-peptide might be something like 1.4-3 ng/ml. My c-peptide recently tested at 0.4 ng/ml at a normal fasting blood sugar, bet whether I am insulin deficient or not is not clear (I am T2).

I got my results back today negative … -_-

Negative results simply means that you failed to get a specific diagnosis.

Brian, our cases are so parallel it's almost eerie . . . last c-pep came in at 0.3.

I have Kaiser and have heard and experienced all the same things. It's totally ridiculous, and you are NOT to blame. I was lucky to run across a diabetic doctor who had retired from Kaiser who clued me into the fact that they suffer from misinformation. When I asked for a c-peptide test I was told "Oh, we'd know if you weren't producing insulin." I can't get in to see an endocrinologist because my A1Cs are not low enough. Their philosophy is to just float along until things are bad, and then maybe they'll deal with them. I've decided that if I find myself getting worse, I'll pay for my own tests somewhere else and find an outside endocrinologist, then tell my doctor at Kaiser what treatment I expect from them. Good luck!

If that's what it takes to get the treatment you require, then that's what it takes, and I encourage you to pursue it that way. Sometimes the road is easy, and sometimes it's strewn with obstacles, and the obstacles usually consist of attitude and/or ignorance on the part of health care providers who are supposed to know better. Unfortunately, you have the latter situation.

As you have come to realize, it's up to you to control the care you get. Sorry that it's proving to be so much more difficult than it ought to be, but you've got the right idea. Take charge and make it happen!

AS A 30YEAR + TYPE 2; I fully agree. One has to learn as much as possible and search out cures that help you.

The amount of dis-information and nonsense out there is a disgrace. Worst yet, new excellent research from 5 years back sits trapped like relics from an Indiana Jones archelogy dig in a government warehouse. There is too much dogma and too little proper science chasing this mess.

Best wishes and good luck with your health and success getting excellent help!

They also did the GAD which was also negative. I just got the email from my Endo confirming the results and asking how the insulin was going. I told her it was going well but what am I supposed to do about my post meal highs? Here response was: You may need daytime insulin, but that is much harder to manage because of the difficult task of predicting insulin needs for food and exercise and anything else that affects blood sugar. Is it really that difficult? Isn't this something I am going to have to learn anyway?

I would do the insulin without a doubt, regardless of if you are T1 or not. Oral medication is not controlling it, and the high blood sugars(180 fasting is high) are only doing more damage the longer you wait(and killing off more beta cells if you are T1).

There really is nothing to fear with insulin as long as you maintain self control. You wont gain weight if you eat a healthy, low-carb diet and it just takes a little experimenting to figure out what you need for insulin dosing without constantly dropping low. And like you said, oral meds are constantly being found to cause cancer and other nasty stuff...insulin is about as natural as it gets.

Must agree with Shawn. I switched to a low-carb diet before starting insulin and continued it right on thru. In the process I lost about 35 lbs. I've been on insulin for a year now and the weight has stayed off.

There is nothing the least bit "inevitable" about weight gain. With or without insulin, diet and exercise are the determining factors. It would be nice if there were a shortcut, but there isn't and that's that.

so I am on humalog 3xs a day, meals, anywhere from 15 to 19 units plus 25 units of lantus at bedtime and 1kmg of metformin daily. type 2. lately my sugar has been to low, 40s and 60s when I get home from work which is maybe 3 hrs after lunch. so yesterday i decided not to take humalog and just the lantus, my score was good this morning. Will this ever make sense ? thank you.

David, since you were taking 15-19 units of humalog, I personally wouldn't suggest cutting it out altogether, but merely lowering your dose. Otherwise you will most likely go high after meals. Your fasting blood sugar which you said was good this morning has nothing to do with the humalog but is influenced by the lantus. I would try a bit less humalog and then test two hours after eating. Do you know your I:C ratio to determine mealtime dose? I highly recommend the book Using Insulin by John Walsh.

Hi Ckurpiewski: Yes, mealtime or fast-acting insulin can be difficult to learn, but if you need it you need it and you may as well start now. If you can get an excellent CDE/insulin trainer, and use books like "Think Like A Pancreas" and "Using Insulin" you will do fine. And down the road, perhaps consider an insulin pump which IMO, following some initial startup effort, is in fact easier and better and certainly made my life with diabetes better. Best of luck to you! Keep asking your great questions.

Well I picked up my fast acting insulin (humalog) yesterday! The only thing is I got no instructions! I gave myself 1 unit last night before dinner. I did have pizza though. I know it's a big no-no but it was one of those days! I had 2 slices when I usually only have one and it was 187. Not too bad! Do I just have to figure out on my own how many units I need per carb serving? I am ordering the book, "Think like a Pancreas" today.

Yes, it's pretty much trial and error. Eat a typical meal (not pizza which is more complicated to bolus for). Try starting with 1:15 - one unit of insulin for 15 carbs. Then test two hours later and see how you did. Do this for several meals until you start to see a pattern. If you consistently are high when you do this, try going to 1:14 or 1:13. if you are low, try 1:16 or 1:17. This way you will narrow it down to the ratio that most often lands you in target range two hours after eating. Oh, just to make it harder, many of us have different ratios for different times a day (mine, for example, are 1:6, 1:10 and 1:15). So do your tracking by meal.

Now that I think of it, 1:15 is a typical starting place but you might want to start more conservative based on that pizza result. Was that 187 at two hours? Two slices of pizza is like 60 or more carbs. So you might want to start with say 1:30. Then if you are significantly high for several meals you can jump down to say 1:25.