Hello. I would love to share my story and hear any advice you guys are willing to pass along. In October 2010 while pregnant with my first child I was diagnosed with gestational diabetes. This came as a big surprise to me as no one in my family has diabetes so it just wasn’t even on my radar. I made it through the pregnancy fine on diet and exercise alone and gave birth to a 7 pound 8 ounce little girl. She was born a day before my birthday so on my birthday I celebrated by eating a big piece of chocolate cake. Just for fun I checked my sugar and my bg was around 156. This was high for me and concerned me but my husband (who thinks I worry to much) took my monitor away and told me to move past it. Well along comes my 6 week follow up with the 3 hour Glucose tolerance test which I fail. Fasting was fine but 1 hour was in the 200’s with the 2 hour being a little lower and the 3 hour being a little lower as well. My Endo at the time said “well you might have diabetes. Follow the low GI diet and check back in 6 months”. This was not good enough for me so I sought out a second opinion. The next Endo said I most likely had a sluggish pancreas but based on A1C she thought I was good to go but to follow up in 6 months. Well I moved to a new state and six months turned into a year and before I was able to meet with my new Endo, I was pregnant again. On my first meeting they checked my A1C and it was 5.4. She said that wasn’t bad but to keep my eye on it and wanted to see me back in a month. During that month I had to work to keep my numbers low so when I went back the NP I was seeing decided to run an antibody test on me to see if anything was up. Well low and behold I test positive for GAD antibodies (my level was 10). I was still able to get through the pregnancy with diet and exercise alone. She also checked my c-peptide which was 1.3. So I am now 3 months post pregnancy and I have once again failed my glucose tolerance. 1 hour was 210. 2 hour was 115 and 3 hour was 49. It seems to me that most people who are diagnosed with LADA are already hitting numbers in the 300’s. I do not get those numbers. My fasting bg is 80 and If I keep it low carb my 2 hour meals are below 100. So it seems to me that this has been caught really early on. My question is what should I do. I think if I started insulin to preserve beta function I would go really low. Should I just keep low carbing it as long as I can? I just want to make sure I am doing every thing I can. My last a1c was 4.8 with c-peptide at 1.4.
No info from anyone?
Wait a bit, Jenny and the replies will drift in! Meanwhile you might want to read Melitta's blogs about LADA and check into the LADA group.
Yes, it does sound like you caught it early. The belief is that insulin use early can prevent beta cell death, but, on the other hand, dealing with lows is no piece of cake! You are still making enough of your own insulin that you can manage with low carb - which is a great habit to develop! If I were you I would just test regularly and keep doing what I'm doing until it stops working as well. Others may disagree. I've never been pregnant but from what I hear about dealing with pregnancy when you are fully Type 1 it's hard, hard, hard. So you are lucky you've had your children before it advanced too much. Hang in there and you've come to the right place for answers! (Btw I was LADA, misdiagnosed as Type 2 as I was 58 at the time!)
Hi Jenny: I wrote a blog about autoimmune gestational diabetes that might be useful for you. I agree with Zoe, you definitely have caught this early (which is great), but you definitely have Type 1 autoimmune diabetes (GAD positive). One TuD member, LilMaMa, was also diagnosed with pregnancy. Initially, she was using just 3 units per day of long acting insulin (Lantus I believe). Even that might be helpful for preserving beta cells, but preventing lows.
I actually am not minding the low carb at the moment. I am in the midst of reading Dr. Bernstein's Diabetic Solutions book and while I do not think I can be as strict as he wants a person to me, I have made some huge alterations. I am eating omlettes for breakfast with cheese or a Wasa crisp and lite cracker with cream cheese and am staying around 84 2 hours post. For lunch usually a salad with chicken or a sandwhich on really thin bread. This keeps me around 115 2 hours post. For dinner a protein with steamed veggies and I am under 100 2 hours post. My indulgence every day is one No Sugar Added Klondike Bar around 9:00 p.m. It has about 22 carbs and 4 fibers. I am usually around 115 2 hours post. As long as I am good my numbers are good. I cheat and they are bad. On a road trip I had 3 hard tacos from taco bell and was at 145 2 hours post. I know that isn't horrible but I could do that easily when I was pregnant and get good numbers. Food I relied on during pregnancy I can't touch now. For example I would eat a P&B sandwhich for breakfast while pregnant and had no problems. I can just see it slowly getting worse already and wondering how fast the decline will be.
Hi Jenny, I'm glad to hear that you're doing so well on diet and exercise alone. My story has some similarities to yours, except that my Type 1 developed rapidly. You're doing the right thing by testing frequently and eating foods that work for your meter. With your numbers right now, I would tread carefully with insulin as your insulin requirements would probably be minute.
I was originally diagnosed 25 years ago as Gestational while pregnant with my daughter. The glucose tolerance test showed me so high that they knew right away that I would be put on insulin. After about 2 months, I was put on insulin but I can't remember now which insulin it was (one of the older insulins). I had frequent lows, particularly right before meal times because of the peaking of those older insulins.
Once I delivered my daughter, my blood sugar levels immediately went back to normal levels and I was told I would be more at risk for developing Type 2 as I aged.
About 6 months after delivery, I began to have all the symptoms - unquenchable thirst, constant urination, extreme fatigue, weight loss - and my primary care doc at the time (an internist) diagnosed me as Type 2 (at the age of 27). I was put on oral meds that did nothing to help me as I got sicker. I was begging to be put back on insulin.
On the advice of the doc who delivered my daughter, I went to an endo that he recommended. The endo diagnosed me as Type 1 and immediately put me on insulin. He told me that I was probably misdiagnosed because I was honeymooning.
Sounds like my current situation is similar to yours. Recently diagnosed LADA/Type 1. GAD positive. I have good fasting and other bg numbers if I stay very low carb. Insulin now or not? I don't know, either.
I'll post a separate topic so I'm not hijacking your question!
If you want to look through LiL MaMa's posts just type in LiL MaMa in the forum search box. Her experience may help you figure out a path forward.
LiL MaMa also posted extensively in the Bernstein Group when she was trying to figure out what was going on, reading her posts there may be helpful too.
Welcome to the LADA family. I was originally diagnosed type 2 because of my age and was able to control my bg's very well for a couple of months. Then everything started to fall apart. Went on oral meds, same pattern. Finally had Gad testing and turned out positive. I'm now on insulin, Levemir and Novolog. They have been a great help, but I wish the low-carb diet would have worked longer. I still eat relatively low carb (30-60) because of the law of low numbers.
I liken having LADA to having a slow leak in your car tire. You can keep on eye on it and keep it running well for awhile, but eventually you will need a new tire. When? No one really knows. So enjoy the time of no insulin and then embrace the insulin when your body needs it. Life is good!
Welcome! Me telling you my story would be to ditto everything you just said, except that my GD was diagnosed during my last pregnancy, and my LADA was caught two years after I gave birth to my daughter. I commend your OB for administering a glucose test after you gave birth. Mine never did. I caught it myself a year later after having some nasty symptoms and then I was diagnosed as a type 2 for two years. I am the first in my family to have diabetes and it came out of left field. I have really appreciated all the helpfulness and kindness of people here. It helps to have others share this journey! I feel like they are very knowledgeable too. I still am struggling to keep up with the acronyms and the math! Oh the math! Carb counting, and administering insulin, and keep track of my blood sugar #'s does not come easy to me. Hang in there. It sounds like you are doing great! I have three girls and it is no picnic. I do worry about going low when they are so small. Actually, I've taught my 9 and 5 year old what to do if pass out, but I mostly hang with my two year old who won't be much help in a low situation.