Hello everyone. This is my first post and iam hoping
Someone can help me sort some of this out.
My Enzo says I have high insulin levels. Then
She says I have type 1. Arent the two in contradiction
Of each other? Im not on insulin. But Was diagnosed
With pancreatic insufficiency. I’m no dr. But she is making no
Sense. No other symptoms like thirst or etc. Might Feel low around 70
Could this be early lada stage? Thanks for your help
"High insulin levels" is very relative.
It could be high compared to ZERO, but still way below NORMAL.
C-Peptide, rather than actual insulin levels, is the most common measurement.
Language wise is it possible you or the endo is conflating "high bg" with "high insulin levels"?
Similarly... Are you in the US or somewhere else? "Pancreatic insufficiency" is not a term I've ever heard from any of my endos and I've been T1 for 30 years, I know that it has more to do with pancreatis (often as a result of CF/SDS). Pancreas makes a lot of stuff other than insulin too. Is your endo talking about that too?
Pancreatic insufficiency is a term used to more generally describe the failure of the pancreas to produce "digestive" enzymes, and as you note suggests acute pancreatitis or some other condition.
As Tim says, most people who are diagnosed with LADA have high blood sugars and are found to have some level of lowered insulin levels. Basically, your insulin production starts to fail and your body becomes less and less able to maintain normal blood sugar levels.
If you don't understand the things your doctor has said, it is always important to ask questions, so I'm glad you came here. The tests for LADA/T1 (many people consider LADA to just be slow onset T1) are to measure for autoantibodies (GAD, ICA and IAA) which detects an autoimmune problem attacking your pancreas and as Tim notes the c-peptide which suggests your insulin levels.
There are some people who suffer from acute pancreatitis who end up with a form of T1 called ideopathic T1, or T1b. But this is not the same as LADA or autoimmune T1.
Ok thank you. When I spoke to my endo to ask if I
Was type 1 or 2 she did the gad test and said I was type
1 ? My bs are always normal ( 70-100) 120 right
After eating. This is frustrating bc I’m expecting
My dr to guide me and she is scratching her head?!
She says she has never seen anyone like me?!!
Went to another endo he says maybe type 2 go
Do a glucose tolerance test. Set to have that this
Month. Just do frustrated.
Ok thank you. When I spoke to my endo to ask if I
Was type 1 or 2 she did the gad test and said I was type
1 ? My bs are always normal ( 70-100) 120 right
After eating. This is frustrating bc I’m expecting
My dr to guide me and she is scratching her head?!
She says she has never seen anyone like me?!!
Went to another endo he says maybe type 2 go
Do a glucose tolerance test. Set to have that this
Month. Just do frustrated.
Thanks tim. What is cf and sds?
Being autoimmune type 1 involves having autoantibodies "and" having problems with your blood sugar. It turns out that perhaps 20% of type 2 diabetics are also positive for antibodies, and a significant percentage of non-diabetics also test positive. I know it can be confusing, but hopefully the second endo and the additional tests will help you figure out what is going on.
Hi Linnette,
I just joined this forum too, and in the diagnosis stage of possible LADA. My insulin is very very LOW -- 3.2 out of 24. I'm also definitely NOT insulin resistant, not obese, no type 2's in the family, and the kicker is that I had another serious autoimmune disease, Graves Disease, and as a result have no thyroid left. I've been on a low carb diet (Bernstein or less) for 3 months, and before that was only a bit higher carb, but my BG shoots up to 115 or more if I have even 20 grams of carb. It takes 3-4 hours to come back down into the 80's. Also exercise jacks it up. And after taking my BG for weeks it feels like my pancreas is "sputtering," doing all kinds of weird stuff. My thyroid did the same thing before it finally burned out.
Hi,
I sent a reply to Linnette yesterday, but would be interested in your "take" on my situation while I anxiously await my antibody tests.
'shoots up to 115' that's a normal number for even non-diabetes after meals. we, as type 1's have numbers that go up into the 200's, 300's if we eat any carbs, somestimes even if we take insulin and don't match our I:CR correctly.
Mine would go up over 200 (and has) if I eat more than 15-20 carbs. If I ate the 130g recommended by the ADA it would get up there and stay there. I'm basing my concern on Bernstein's position that your sugar shouldn't go out of the 80-90 range, no matter what you eat, as this is a normal non-diabetic insulin pattern. Also, even if it could be considered "normal" to go to 115 on 15g of carb, mine doesn't come back down into the 80's for several hours, which I understand is Type I pattern, though on an early scale. I'm hoping that if I do have the antibodies and LADA I am catching it early enough to have some level of control through diet alone for awhile, at least, as Bernstein and the various websites indicate may be possible.
As a Type 1, I'm sure glad I didn't absorb the information that my blood sugar shouldn't go out of the 80-90 range, because I'd sure spend a lot of time feeling like a failure! I think I have pretty good management, but for most of us, Type 1 is about aiming for targets and correcting promptly when we inevitably go higher or lower than those ideals.
Yeah, the phrase "shoot up to 115" gives me a definite chuckle. Since I'm LADA, I spent my first 15 months doing fine on oral meds until my numbers started to climb and I realized I'd been misdiagnosed. So I never experienced a honeymoon in the classic sense. If I'm 115 two hours after eating I am very happy.
well, in what world, ha! a continual 80 - 90 range for a type 1 diabetic is nearly impossible to achieve w/out constant lows and corrections, i.e., lows. we are manually having to manage our blood sugars and inject insulin, which in no way even absorbs the same way one's pancreas would and does deliver insulin. Most of us aim for 70 - 130, 80 - 120, and we try to have a blood sugar of 140 or below 2 hours after meals, some try for tighter control, it depends on the 'lows'. But I can pretty much guarantee you, it's very tough and takes a huge amount of work and a lot of correction shots.
LADA is just type 1 diabetes. There's no such diagnosis, really, as LADA, it's just type 1 diabetes. Many children have a slow onset, still produce insulin, just like an adult may have, the autoimmune attack can happen very rapidly (DKA) or a gradual process. If you test positive for the antibodies and have a low cpeptide, indicating you're producing very little insulin, you many have caught it early, it's called a honeymoon stage". Initially some still produce insulin and their fasting numbers aren't effected yet..,that's the last phase to go. Most are put on a small dose of insulin (basal, bolus or both) to preserve any remaining beta cells they may still have. Orals typically don't work. Thyroid issues (autoimmune) often do go hand in hand with type 1 diabetes...
Good luck!
ha, me too...i would have freaked out and would have made myself scary low, especially when first starting out.
also, many t1's do low carb and advocate for Dr. Bernstein, many (most) do not..i do low carb (only about 40grams/day). i don't know why really cause I need to gain weight. i find no diffence if I eat more carbs and take more insulin (and taking MORE insulin has NOT caused me to gain 1 pound, not one..it's a myth that insulin causes weight gain too, we ALL need, use and have insulin in our bodies, one way or the other), but i just (still) need to get the 'dosing' correct. Which I have not mastered yet, hoping a pump will help. Example, I had a terrible weekend, 'low carbing', same food I eat everyday, corrections all weekend. Right now I'm at a nice 85...after 2 days of corrections (for NO reason)..but, I have to eat again, breathe, move, be active..so, it ain't gonna stay there.
There actually is a diagnosis of LADA, Type1Gal, (Latent Autoimmune Diagnosis in Adults), though you are absolutely right that it is Type 1. The difference is most notable at onset, which is much slower than "regular"type 1. Today, I just tell people I'm Type 1, because for all intents and purposes my management is the same today as any other Type 1. But 5 years ago, being diagnosed as LADA would have been very useful for me. Instead I was misdiagnosed Type 2, because of my age (58) and because I didn't meet the usual picture of sudden onset/DKA, etc. If people had known about the possibility of a slower onset version of Type 1 that typically happens to people in adulthood or older, I would not have been misdiagnosed. And yes, oral meds worked for me for 15 months with very good blood sugars. Generally LADAs can go anywhere from a couple months to 4 years without needing insulin, much longer than a typical Type 1 honeymoon, although you are correct, many people believe LADAs should be started earlier on insulin to preserve beta cells.
I'm soooo sorry to come across as a smart-■■■, or whatever. I just read Bernstein's book, and he is of course a life-long juvenile Type 1, and says that he and his patients maintain 80-90 with diet (admittedly harsh) and minimal insulin. He doesn't really go into the LADA issues, except for one paragraph in the new edition. Since I've been able to stay under 100 most of the time with just strict diet I'm hoping for the best, but frankly expecting the worst from everything I'm reading. I see that you are struggling, and I again apologize for seeming flip about this. This is all new, and I obviously have a lot to learn, while trying to come to terms with the possibility (probability I think) of having diabetes at age 67.
well, not really. i'm referring to a diagnosis code, none exists for LADA, it's just type 1 diabetes. Nor for 1.5 diabetes, none exists (my Endos laugh at that). LADA is more for the patient, to help him/her understand. But, my Endo (none of them) has never used that term on me, just type 1 diabetes. What we forget is there are many children who present in the same way, catch it early, do not present DKA, have a very long honeymoon, go off a basal - bolus insulin after initial diagnosis, etc..it's the same disease. Just like adults can present in DKA with a very rapid onset or a very slow onset. It makes no difference. If it's confirmed it's a positive autoimmune disease, it's the same thing whether one's 5, 12, or 80 years old.
Children can present in the exact same way...I would imagine if they too were given orals initially, when their type 1 was caught early, it may work too....most just start low carbing anyway, early in the diagnosis which can help a bit while the destruction takes place. We've read many stories on here where young children needed very little insulin, once starting out..because they too have some beta cells left, some pancreas function..same as you. It's just a term used, for some reason, because many medical providers are ignorant to diabetes, especially type 1, and don't even realize adults can get type 1.
No, you are right, there is no diagnosis code for LADA, but it is an important distinction for the reasons I explained above.According to John Walsh in Using Insulin, LADA's are approximately 15% of all Diabetics more than even "traditional type 1's"who make up 10%. Many of us would have had a lot easier time of it if more people knew about LADA.