Newly Diagnosed LADA

Type 1 and LADA
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Hello everyone. I was diagnosed with LADA about five weeks ago at age 37. I presented with the classic excessive thirst, urination, and weight loss, which I attributed to the stress of moving across country and resettling a family. My fasting glucose was 261, so my PCP ordered an AIC and GAD65, which came back with and A1C was 11.3 and very high levels of GAD antibodies.

I was immediately started on twenty units of Lantus and 500mg of Metformin (2x). My A1C came down to 8.8 in about four weeks, which is when I had my first Endo appointment. The endo added 1mg of Glimepiride to help bring down post-prandial spikes that were still happening (up to 250 after meals). It seems to be working well, as I am almost always below 180 after meals now and able to eat more carbs too. (But not too many of course.)

In my adult life, I probably went to the doctor about 12 times, usually just for antibiotics or other minor illnesses. So, it’s been weird to spend so much time at the doctor, pharmacy, reading Think Like a Pancreas and the Joslin guide and dozens of websites, testing and testing, etc. I guess more than anything, I’m annoyed at how much mental energy goes into this. I know it’s necessary and I’ll do it, but part of me is like, “why couldn’t I get something that isn’t so damn high maintenance?”

On the other hand, I’m lucky that it’s something manageable. I really like both my primary care and my endo; they have both spent lots of time answering questions and listening and they both have a sense of humor, which to me, is absolutely imperative. And after living in very remote locations for most of my life (with very poor access to doctors), I now live 25 minutes from Dartmouth hospital. So I’m trying to be thankful for how many resources I have.

I don’t really have burning questions. We haven’t done a Peptide test, but since I am already clearly LADA, there doesn’t seem to be any real reason. From what I gather, there is no way to determine how long your remaining beta cells will hang on anyway, right? You’ll just see poorer control with the same techniques as they die out? Anyway, thanks for reading.

Best,
Justin

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I’m really sorry to welcome you to the club. You seem to have a really good attitude towards this, I think for many of us being diagnosed with diabetes really bummed us out.

I have to be honest, one of the things that many of us learn is that we need to become experts on our health and take over a primary role in making medical decisions. It is good you have been given a diagnosis of T1/LADA, many people are misdiagnosed. Our fellow member @Melitta has a very good guide to getting properly diagnosed. But I have to tell you Glimepiride is considered a poor medication for type 2 and is totally inadvisable for someone with T1/LADA. Glimepiride is associated with loss of beta cell function and accelerated loss of blood sugar control. I would encourage you to ask your doctor for alternates. You should do some reading on Glimepiride (and the class of drugs called sulfonylureas) and you are entirely within your rights to refuse a medication that you think is not in your best interest.

ps. I used to live within 25 miles of Dartmouth as well.

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I strongly second Brian’s comments about Glimepiride. If you are really T1—and the evidence looks like a slam dunk—a sulfonylurea drug will be of little utility short-term and utterly useless in the long run. And that’s putting it tactfully.

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Welcome to the 24/7 job nobody wants but those who have it can’t quit. You do seem to have a good attitude and eventually this will all become second nature. Learn what works for you and advocate for your self because nobody knows you better.

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Hi. I’m 33 and in the same boat. I’m three almost four weeks in. Some days I feel okay about it…sometimes overwhelmed and pissed off about it. I never ask “why me” but at the same time…it just gets to me sometimes. I suppose that’s normal when your whole world is turned upside down. My c peptide was 1.2 fasting BG 174 and GAD was 1930.!!! Welcome. I’m newly here as well.

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Thanks for your thoughtful reply, Brian. I appreciate the link to Melitta’s article. At this point, I’m comfortable with the LADA diagnosis. Rest assured, I am not confusing you with my doctor or medical advisor, but if you have any links to studies regarding Glimepiride that you’d be willing to share, I would appreciate the reference. As you well know, there is a great deal of nonsense and opinion on the web. I have access to academic journals as well (I’m a grad student at night.) Thank you again. - Justin

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Thanks David. While tact is a trait I aspire to, my acidic tongue often gets the better of me.

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Welcome @Quigley83 (and @Justin8) to the club no one wants to join, and to TuD, which if you’ve had to join that club is a pretty decent place to hang out and get answers. I was dx’d with T1 32 years ago (they still called it “juvenile” back then), but I still remember the first couple of weeks. A lot of details from that time are still with me, but most of all I remember that it took several months before I was sticking those needles in without the accompanying thought, “I can’t believe I’m doing this.” Of course that was back before carb counting, MDI and pumping–actually before electronic BG meters for that matter–and for a guy in his 20s the idea that beer–beer!!!–was on the verboten list was perhaps the cruelest blow of all. Thank god things are better now. Glad you found this place!

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Hi Q,

Nice to meet you; it seems that we’ve jumped in to this new gang at the same time!

I know what you mean. I’ve been reading non-stop about diabetes management for the last month. Every now and then I just stop reading and say to myself, “I can do this, but I don’t want to have to f******* do this!” But it is what it is, right?

I’ve just tried to maintain a sense of humor about it. I also have a three year old son, who is absolutely fascinated by what I am doing. So, I’ve been teaching him about daddy needing to test his blood and lancets being sharp and where test strips go. He loves it! We were walking out of the grocery store this afternoon when my phone alarm went off. He asked why, and I told him that I had to test my blood. He goes, “Daddy, do you have your glue gun in the car?” Me: no, mom has the glue gun, I have the glucometer. I guess I’m trying to approach my new life with the same kind of curiosity that my three year old has about the world. I can’t change it, so I may as well embrace it with all of its absurdity.

I saw from one of your posts that you’re a backpacker! Me too. My wife and I are both park rangers, though we tend to be behind desks now rather than out in the field. Are you still taking your trip later this month? Where are you going? (I’m jealous already.) That was one of my first thoughts: so, will I have to put insulin in a bear can or will I need to put it in my sleeping bag to prevent freezing? What if I have a low and my glucose tablets are in the bear can 100 yards away? So many new routines to figure out.

Take care!

-Justin

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Hi Justin. It seems you may have a stressful environment like me. I’m done with school but have kiddos and a stressful job and everything else that is busy. My kids aren’t educated yet about my disease because I’m still mad about it. I’ve said before that I find it as a weakness as I never had the need to go to the doc before. But I admire how your approach and I know I’ll do the same.

We aren’t technically backpackers…we just like to be outdoors a lot (fish hunt backpack hike etc). Very cool that you guys are park rangers. You’ll have to keep me update f on how (if any) this affects your job. I read about an Olympic swimmer diagnosed and went onto win a gold medal. If he can do that I’m sure there is a way to enjoy everything in life. :relaxed:

We are going for a hike and camp on the continental divide. Can’t wait! I think I’ll do better with reflection once I’m able to get out of dodge for awhile.

Congrats on grad school. That’s a feat it itself. I can say I feel sooooo much better after insulin and I don’t ever want to go back to how I felt before. I also went shopping and picked out better food choices for my family and I. So there are things to consider. Thanks for taking the time to respond.

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Hi Justin: I concur with Brian and David–sulfonylureas are detrimental to people with Type 1/LADA. LADA researchers in Japan (Kobayashi et al, 2002) have conclusively demonstrated that better preservation of beta cell function occurs with exogenous insulin compared to sulfonylureas, and that sulfonylureas hasten beta cell destruction. Other studies have demonstrated the negative effects of sulfonylureas as well. Fast-acting insulin is really the way to go, to cover mealtime carbs and quickly bring down highs. Also, I wrote a blog for those newly diagnosed, my top ten tips, that you and @Quigley83 may find useful.

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:smile: Diabetes has many facets. On the down-side, it’s relentless; the silver lining is that it usually responds well to knowledge, curiosity, and tenacity. I’m not aware of any diseases that lets you “steer” like diabetes does.

I’m 32 years down this road, diagnosed T1D (probably LADA) at the age of 30. I’m a data nerd and watching my blood glucose trends not only works well but keeps me engaged in my health in a good way. Good luck.

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Justin…how you doing this week? I seem to have some ups and downs. I am now at 145 and gained a whole pound! People are asking at work what diet I’m on…if they only knew.

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Not too bad, aside from the family cold that we can’t seem to shake. Ah, the joys of a child in daycare. I met with my CDE for the first time and went over all the information about diet and exercise. Most of it I had already read over the last six weeks, but I suppose it never hurts to have one more person to talk to about it. We eat pretty healthy already, so for me it’s mostly just re-adjusting portions to eat less carbs and less snacking. My numbers are pretty close to target of less than 150 two hours after meals; I’ve had a few between 150 - 180, but nothing over. And I started using a Verio Flex monitor, which has Bluetooth connectivity and syncs readings to my iPhone app. Seems pretty handy. How about you?

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Doing pretty good. I hear you on snacking. I was starving so had a little bit of granola. Disnt do any insulin and it shot up pretty good. We eat pretty healthy too and I’ve been really low carb since I was diagnosed. Just to get my body used to this whole ordeal. I can say I do feel more energetic and my mind feels sharper.

I hear you about daycare. It’s a Petri dish! School isn’t any better …trust me!

I find finally talk to my kids about diabetes and they are so bright. They asked alt of questions and so worried about me when I showed them how I tested (blood mom? You okay?)

So each day gets better for me. I follow up with my PCP next week. Just living the dream. Sounds like you’re doing well. My appt with a nutritionist the end of the month.

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I hope you’ll be seeing a RD, registered dietician. anyone can call themselves a nutritionist, an RD must go through a rigorous certification process. bring lots of questions and maybe at least a few days worth of logs showing what you’ve been eating. let us know how it goes!

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:joy: :joy: :joy:
you are too funny :smiley:
How many times have i thought that to myself?
I celebrate my 12 year diaversary today, and i totally agree with you, diabetes is a high-maintenance diva.
Keep your humorous approach, it will help you a lot!

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Happy Diaversary, swisschocolate, and congratulations on kicking the big D’s butt for 12 years!:thumbsup:

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Happy D-Day. :slight_smile:

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And always keep your glue gun handy! Great story, Justin. I’ve been T1 for 33 years and frankly I don’t remember too much about what my daughter’s reaction was (I was 28 when dx’d). But my granddaughters have been pretty curious about why I’m poking my finger and what that insulin pump thing is. Funny thing: on one of our visits they were watching the “Caillou” show, and the episode was about a kid in Caillou’s class with an insulin pump. “Hey that’s what Grampa has!” Yup. it’s been kind of useful as a point of reference when questions have come up about it.

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