My new endo just informed me that I'm likely LADA, I tested positive on 1 out of 3 positive anti bodies. This is all very new. Where do I learn the basics, and is the treatment/control for LADA different from or similar to Type 1, insulin dependent 2?
I would like to be more informed. I may also have a multitude of food allergies/sensitivities too. For the doctors/healthcare providers, who is generally the best person to address the different concerns? It seems like my PCP wanted to send me to a GI to have an endoscopy to address my abdominal discomfort. Maybe ulcer, maybe something else. I suspect it may be gluten sensitivity. Is food sensitivity allergy for the GI or yet another specialist? It's important to maintain good health, but it doesn't make sense to go to so many different specialists. In the end, I know that we have to be our own best advocate for our health.
Not sure where you stand. Were you being treated as a type 2 and are starting insulin? Or what exactly? I understand that you are probably LADA but has your treatment changed?
If so maybe you need to get one thing down at a time. Diabetes itself can be so overwhelming. To find information DIABETES 101 (web site0 or Think like a pancreas (book) and you have some good advice on this site for newly diagnosed people.
Maybe you should (if you can ) get the diabetes thing down and then go into the the other problems...
Sorry, I'm not really sure about your post. Can you explain more?
Yes, I am new to insulin. I was considered a type 2 for many years...diet exercise alone. A1C has crept up in the past 6 years from about 6.1 to the most recent 7.2. Tried Prandin once 4 years ago, dropped my BG to 50 and I had no symptoms. I checked because I planned to exercise. Then around May and June my numbers started to go much higher with post meals more often > 180, and >200 at times. Now, I pretty much need insulin to cover any snack more than 7g of carbs. It seems like my insulin/carbohydrate ratio presently is about 1 unit/15g.
Hi lh378: Sorry to welcome you to the club, but welcome. LADA is slowly progressive Type 1 diabetes in adults. I wrote a blog of my top ten tips for the newly diagnosed adult with Type 1 diabetes that you may find useful. LADA/Type 1 diabetes is treated with exogenous insulin. I always recommend Think Like a Pancreas by Gary Scheiner as a good place to start for the basics. Best of luck to you!
Hi Melitta, Thank you. I will read Scheiner's book. I think I read somewhere on this website that you recommend a c peptide test to determine how much insulin my body is producing. With all the various tests for LADA, c peptide, is it necessary for the blood tests to be conducted while fasting?
Celiac Disease (gluten intolerance) is another autoimmune disease that is commonly linked to autoimmune thyroiditis and type 1 diabetes. Go the University of Chicago’s celiac website for a complete blood panel list needed to test for antibodies and share with your current doc or new GI. A biopsy via endoscopy is often ordered.
Keep eating gluten until all testing is complete.
Often, if you do have celiac disease that is not treated (by not eating gluten), you can develop food intolerances due to intestinal damage.
Sorry about your news for type 1 but at least you have already started on insulin so you won't go into dka and or keep trying to poorly manage things. That is great you only need very low doses now- hopefully you can keep it that way for a long time. Are you taking a basal insulin too? You will need that also at some point if not.
I'm not sure how long you've been on insulin but you may find that it will help some of your gastro symptoms. I would get tested for celiac also. I was just retested for that but I had stopped eating gluten mostly for a week again before so I wonder if it will be accurate now. Anyway, just eliminate all the foods that cause problems for you one by one and see if it helps.
I'm sure it is a little bittersweet to get an accurate diagnosis. I wouldn't wish on anyone diabetes, let alone T1/LADA. That being said, having a specific diagnosis of T1 will give you a ticket to treatment that are often just not directly available for most people with diabetes. At least now you can demand effective treatment.
As to some some of your questions. Brittle diabetes is what I consider an archaic term. It was applied to people that had wildly fluctuating blood sugars. There are some people whose blood sugar swing for no reason, but today these people use the term "labile diabetes." Unfortunately brittle diabetes was a term assigned to people who simply had poorly controlled diabetes and became attached to assignment of blame for not taking care of yourself.
On the c-peptide, the most common is the fasting c-peptide test and you do need to fast. There is another kind of c-peptide test called the stimulated c-peptide but it is rarely used.
I see Melitta has already responded. She is hands down among the best LADA advocates around and her information is spot-on, so no need for me to be redundant. Unfortunately, Type 1 diagnosis in adults typically only occurs after a misdiagnosis of Type 2. You are already on the right track because you know you are LADA and can start educating yourself while you still have some insulin production left. The other LADAs here on TuD helped me when I was diagnosed. LADA is really Type 1 - just with a slower onset. So any information posted for Type 1 should also be helpful to you. Type 2 information is helpful too - -particularly on diet. We can learn so much from each other. For starters -- some basics - always have glucose tablets with you for lows, figure out what works best for you for lows (e.g., skim milk works great for me), never forego testing -- test your BG each and every time you eat, consuming lots of water can help bring down a high blood glucose, moving your body - even a 30 minute walk can help bring down a high blood glucose.
Thanks everyone for all your great support, suggestions and inputs. With all the blood glucose monitoring and testing that's good and necessary(so that we know if we're hypo or hyper) how many of you use constant glucose monitoring devices? Does it not make more sense than constant pricking? Right now, I may check about 10 times daily because I'm learning about the effects of different foods, exercise,dosage, body reactions...etc. Does this seem about right for someone who is a "newbie"? (the previous endo asked as to why I check more than twice daily.)
Has it been anyone's experience whereby the glucometer reading can vary by more than 10% (~15%)? If I get a number that doesn't seem to make sense, I recheck; it could vary as much as 15%.
First, on the subject of meter accuracy, the standard they must meet is rather loose. In the US, a meter must be accurate to within +/- 20%. That's quite a range. It means that a meter reading of 100 could reflect an actual BG of 80 or 120.
That said, that is only the minimum standard meters must meet. Many of the meters on the market are considerably more accurate than that. I don't know which meter you use, but 15% is on the high side for today's meters.
As for Continuous Glucose Monitors (CGMs), they have some inherent limitations too. For one thing, you use your regular meter to calibrate the CGM, so the CGM's spot readings are never going to be more accurate than the meter you use to set it. What CGMs are really good at is showing you the trend (up or down), and sounding an audible alarm when you get too far out of range. That's where they shine.
As Brian says, I wouldn't wish any form of diabetes on anyone, BUT -- if your LADA diagnosis is confirmed, it will help in one respect. It will make it easier to justify a CGM to your insurance company. For T2s such as myself, it's very, very difficult to persuade an insurance company to spring for a CGM unless you are able to demonstrate a documented history of severe lows.
Unfortunately, some of us T1s face incredibly difficult obstacles to CGM coverage as well. I'm paying out-of-pocket, but I don't know how long I'll be able to swing it.
I'm sorry you're having trouble getting one covered, why? I remember someone who is late onset saying her insurance wouldn't cover one because she had never gone below 50.
There is no way you can test only 2x per day if you're on insulin. I would just test as much as you feel you need to and buy extra strips/meter from walmart if need be. I'm going to be trying a dexcomb again soon and I hope it will be accurate for me this time. Last time I had terrible accuracy and pain/rash/swelling. I tested out a sensor and I had some minor irritation but I think I can tolerate it and I really need it at the moment. I'm hoping it will maybe help me figure out what is going on with some crazy readings I've been having and dp and lows. Some people find it is so accurate that they can treat off a dex reading. My CDE said her son does that even though officially you're not supposed to. The bare minimum is to calibrate 2x per day with a cgm.
I forgot to mention that if you fill out a form at jdrf, your local jdrf rep will contact you and send you a type 1 adult care kit with various items & relevant info of people in your area with jdrf who can help you. They have an adult type 1 mentoring program if you're interested in that.
Here are the current ADA guidelines for testing for insulin users. Your prior endo was not up to date.
Be sure to get your endo to write your strip prescription for testing 10 x a day. You will get much better insurance coverage that way. Keep your records of BG, insulin dose, carbs in meal, post meal BY, etc. Will help when you decide to try for a CGM and or a pump.
It is also necessary to determine insulin to carb ratios, correction factors, duration of insulin, and basal doses.
Have you read Think like a Pancreas, or Using Insulin yet. They will help you get up to speed and understand how things work.
The term "brittle" has never been used by the endo but frequently by nurses. I have wondered about that.
As for control ---don't think I will ever have it - so I have started referring to my LADA as management of a chronic disease. I was diagnosed 4 1/2 years ago at the age of 80 and I assumed I would have this under control shortly ----well, all of you know the story. vpg
