Is anyone here an ottawa LADA or has lived in ottawa? I would love to know a good endo to try to be referred to that has knowledge about LADA and not just general t2/t1. I tested negative for antibodies and am kinda at my wits end. I have an appt with a GP/"internist" in june but I can't make the appt cuz its a saturday and would rather see an endo. My own GP thinks my high blood sugars are not a prob til they go over 270 (15) + and I definitely think I shouldn't be waiting until that happens. I do not enjoy frequent trips to the bathroom or going through so much water and beverages like its going out of style. Also no matter what I eat even if I try to keep it low carb I'm high...which is also hard in itself because I'm hungry so often, which is weird because I usually don't have such a big appetite.
Hey Alicia:
You're absolutely right - you should not be waiting around until you hit 270. Your GP's opinion borders on the dangerous and irresponsible.
I would recommend getting on insulin if you haven't already. Diet is only one piece of the puzzle and if this does not make a significant difference in BG control you need to consider medications.
I wouldn't worry too much about finding a "LADA" expert. Any endo who knows his way around T1/T2 well should be able to help you get your BG under control quickly. If you are LADA, the only difference between you and a full blown T1 is your ability to produce some of your own insulin - and it's probably declining at a yet to be determined rate, unfortunately.
Good luck!
Christopher
I think the reason why the OP wants a specialist in LADA is because she wants a definite diagnosis. Generally, an endocrinologist will consider someone who's antibody negative to have T2. You're right in that as long as the treatment is right the diagnosis shouldn't matter, but most endocrinologists will not go straight to insulin unless the person has type 1 or LADA.
I wonder, Alicia, if you've had a c-peptide done, and what it was? I agree with Christopher--it'll help determine your status.
Oh I know I think a lot of GPs are uneducated about proper bg limits. At least here anyway. I can get insulin apidra is pretty cheap 28 bucks a vial or 5x3mL pens but its the pen needles and syringes that are expensive for out of pocket since I can’t get an Rx.
Yes the only reason why I want a t1/lada dx vs a t2 is because pumps/cgm isn’t funded by my province for type 2s. And no I haven’t had c peptide done. When I had asked the GP that referred me to the internist (who only works weekends) to test for it along with the a1c he had no idea what c peptide was …
How high do you spike from a "low carb" meal? How many carbs is low carb? (I ask because I've been there, and my endo and I still have no idea why I supposedly have "insulin resistance".)
For me 30-35 g of carbs for lunch/dinner is low carb for me…I can’t go lower than that cuz I am still way too hungry. And even at that sometimes especially lately I’m starving all the time. I spike usually anywhere from 140-190 usually between 170-190 tho but today I had 38g of carbs for lunch and was at 178 2 hours later and wanted to check at 3 hours if I was coming down and I was at 208.
That sounds like me, but I stick up there for longer periods of time from less carbs. Even on Metformin, I've been spiking from 30-ish grams, though that's unpredictable at best. I do my best to keep it at or below 20.
I understand the being hungry bit--it took me a while to figure out what makes me satisfied. For me, it's tons of protein and salt.
There's a VERY good chance that you're hungry all the time because your insulin production is low. I get the feeling that we're both in the same boat here. 30g is respectable and you should NOT be hanging out at around 200 for hours after you eat. The longer I'm on Metformin, the more I'm realizing that it isn't working well for just that reason.
Do you ever do randon tests? How long does it usually take you to come down? And do you ever do fastings?
Hi Alicia:
I hear you and understand your rationale. However, key is getting your BG down to as close to normal levels as soon as possible. I would find a Dr. asap to get me the appropriate prescriptions and fight for the T1 diagnosis in parallel so you can get a CGM and pump covered.
Christopher
Takes me 3-4 hours to come down. I do fastings and those for now are usually not too bad usually between 90-130 I’ve had a few high ones here and there had a 9.3 fasting bg at the drs and then they referred me to the internist but can’t make the appt in June cuz it’s on a Saturday and I work. For now it seems to mostly be the meals that are my problems not as much my basal …but then again I don’t see all my bg’s either. Wish I had a cgm for this reason … Sigh
You need an endocrinologist, definitely not a GP. And from what I've heard/read, most people find that mealtime insulin is first to go because the body is so busy dealing with fasting that it can't keep up with the demand for extra insulin at meals.
It's funny, because I also wanted a CGM a while ago to keep track of the highs even more than the lows and I still thought I had reactive hypoglycemia then! (Though the random 50's I didn't feel scared me.)
haha I'm trying! Really hard for the dr thing ...I've gone to a few that just don't care because "I'm too young to be diabetic" or "No sorry your bg's aren't high enough to be concerning yet". I had one dr tell me he thinks I'm diabetic he didn't know what to do with me so referred me to an internist. When I got the appt letter I tried calling to reschedule because I couldn't make the appt which was on a saturday. The internist they referred me to ONLY works saturdays and sundays. Both of which I can't make appts to. Why can't they make appts during the week?! Pretty stupid if you ask me. So I'm going to try bringing the letter saying I'm being referred with me to a diff clinic and asking for a referral for an endo and not an internist who really is just a GP with a swanky title.
I'm constantly stunned by the difficulties we go through in trying to get even the most basic care. I've seen too many posts where others express similar frustrations. I wish I had a recommendation in your area. My endo is about a 7hr drive from you, unfortunately.
You're absolutely right - you need to see an endo, and I can't believe you're getting the runaround you're describing. I wish you all the best of luck in finding a good one in your area soon!
Thanks Christopher :) It would be easier if I didn't need a referral. Even my pharmacist gave me a brochure for a good CDE program near me and they don't take type 1s without a referral but they will take type 2s...makes no sense.
If you're not on insulin, then couldn't you tell them you have T2?
Well when they initially took my info they asked what type etc and I said type one then they told me after that I had to get a referral. I didn't know this until after I got more info since the brochure didn't state that..-_- I could try calling back and saying I made a mistake I'm not a type 1 but I doubt it would work...
Very simple: you're antibody negative. Tell them you aren't type 1.
I'm in Ottawa but I am a Type 1 not a Type 1.5. I'm somewhat confused. I thought you said you had pre-Diabetes. Who tested you for and what test(s) did they use to diagnose you as a LADA? He must be a good Dr. to know about such tests. I'm surprised that he can't treat you for it though.
I'm sure you know that every country is lacking in Doctors, especially Specialists such as Endos because of the rampant Diabetes rise, as is here. They are overbooked and overworked and as I mentioned to Marie, patients come from hundreds of miles away just to see an Endo or other Specialists in our city since they have no Specialists in the many of their areas. Thus your GP referred you to an Internist. Internists can ask Endos for info and advice about their patients. You can (kindly) make suggestions which he may agree with.
Having an Internist is your foot in the door to a future Endo for yourself but you should be patient and flexible.
Is this the place you were referred to? If so, say you are pre-diabetic and they can help you out with some stuff. Keep your avenues open. It's a long ride.
I do not know what part of Ottawa that you are in but this diabetes program has many locations. Ask them to advise you of more programs for Diabetics.
I don't know your job but it's illegal to not allow an employee a few hours off of work
to go to an appointment.
I have my Endo appointment this week. I know what he'll say since I've already asked for 2 other ladies in the recent past. I'll give it a shot for you. Good luck in your future efforts.
Okay, that makes more sense. You are a pre-Diabetic. I just popped in for a break during some work before, so I didn't read the other posts.
I'll have to renege on the Endo offer then. They only accept dxd. Diabetics(by Dr. referral), if they have a space. I'd hop on that Internist, work or not, if I was in your shoes.
I work 2 days a week so no thats not an option. I'm only part time. Also I don't think I'm "prediabetic" thats what my GP said but other tests and symptoms have proved otherwise.