Prediabetes - test all the antibodies?

Type 1 and LADA
1

Hi,

TLDR: what are the tests that one is recommended to absolutely get done to rule out T1/LADA?

long version:
My blood sugar has been coming back high in lab results, suggesting prediabetes.

I’m interested in knowing if I might be at risk for T1/LADA. I don’t have insurance or a primary care, so I’m trying to research on my own.

My google tells me it’s best to test for GADA,ICA/IA-2,IAA and ZnT8, plus fasting insulin, and insulin response to glucose?

Is it necessary to get all of those? I’m trying to weigh out my options narrowed down to the following 2:

Ultalabs $300 panel:
insulin response to glucose x4 (I imagine that’s 3 hours starting with fasting?)
GADA
IA-2
and a bunch of other things I’m not concerned with right now but maybe I should be?

Request-a-test offers a $400 panel of just the 4 antibodies: GADA, ICA,IAA,ZnT8

Does one of the panels above offer enough insight to rule out T1/LADA, in conjunction with the information I already have, or if I need to buy one panel and add other tests a-la-carte.

Background:
A year ago my A1c was 5.7, BG 177 on a non-fasting blood test (which my GP who ordered it said was normal but I suspect otherwise) .
Last week I did a GTT and it came back as follows:
fasting: 85
1hour: 199
2 hour: 199
3 hour: 103

I’m 35 yo, very active, BMI <20, 5’6/120lb don’t like sweet foods, naturally eat about 100g carbs/day max. I had to really force myself to eat 150 for 3 days before my GTT and it made my stomach wonky for days afterwards.
Until this past June I was eating 3000-4000cal/day spread over about 5 meals+snacks for the past 8 years (so I bet before June I was maybe eating 300g carbs/day). Then June-Aug I raised a puppy and neglected all my eating and sleeping patterns, eating once a day and subsisting mostly on adrenaline. Since August my stomach shrank, I eat less than half what I used to (but don’t think have lost more than 5lbs, didn’t know my weight before and haven’t noticed any change in weight). No matter how much sleep I get I can’t get enough energy so I figured it was time to investigate my BG numbers from last year, which was what prompted me to do the GTT.

I got a finger pricker yesterday and have been getting readings of:
morning high 98
daytime hungry: mid 80’s
1hr post full meal 130-140
2hr post full meal 130-155
post light meal (still hungry after eating) 120’s

I’ve been combing these forums a lot and would highly appreciate any wisdom and links!

2

Sounds like classic prediabetic type 2 to me. Try cutting your carbs to under 50 per day for 3-4 weeks and make up the calorie count with good fats such as Avocados, Almonds etc. Look into Keto for a couple of months and that should resolve your BG issues. Then you can readjust your diet from there by staying on a Keto diet or modifying to something you prefer. I am similar frame to yours at 5’9" 125 lbs, eat 1 meal a day at lunch and have tons of energy on my fat adapted body diet and about 25 carbs/day. I eat in the 800 calories per day range. Avocados and nuts are your friend until you have the basics figured out, not a ton of testing. Just get a periodic A1C test from UltaLabs, maybe every 3 months to start. I think their A1C is $22, but they are running a special for $12.95 right now. That + your fingersticks will give you all the information you need.

It really sounds like you are at a stage where you can stay in perfect control with the proper diet. I don’t quite understand why you even think you may be T1

1 Like
3

I don’t. I just want to rule it out so I don’t need to worry about it.

I’ll check out the A1C special from ultalabs! thanks for the intel!

4

Nothing ever really gets ruled out in medicine. Just because you are not T1 today, does not mean you will not be T1 or have cancer or something else a few years from now. You may want to do a base Cholesterol test and if your LDL-C is increasing, then you could do an UltaLabs subfractionation test and alter your blood with diet and supplements to protect potential future heart issues as well as your pre-diabetes. Here is a pretty good set from UltaLabs:

Test Amount Status
Cardio IQ Advanced Lipid Panel Plus

Discount (20.0%)|$168.00

($33.60)|Complete|
||Cardio IQ™ hs-CRP

Discount (20.0%)|$33.00

($6.60)|Complete|
||Chemistry Panel (Comprehensive Metabolic Panel)

Discount (20.0%)|$19.95

($3.99)|Complete|
||Hemoglobin A1c with eAG

Discount (20.0%)|$22.00

($4.40)|Complete|

5

Thank you so much for putting that together!

6

I wouldn’t worry too much about ruling out type 1 at this time, especially if you’re uninsured. If you have to choose and $$$ is your driving factor, you WANT type 2 (pre)diabetes. The treatment for type 1 is a lot more expensive. There’s generally no reason to rule it out unless you don’t respond to type 2 medications, and need insulin. If you need insulin, there’s usually much better insurance coverage for delivery options if you’re type 1. Luckily most type 2 meds are on Walmart’s $4/30 days or $10/90 days drug list, and many other pharmacies have a similar option.

7

I’ve read that early start on insulin helps “save” your pancreas from working too hard, that was why I was hoping to rule out the T1 possibility.

Something else to rule out: hormonal birth control. I wonder if/hope that my nexplanon is tricking my body into gestational pre-diabetes and if that’s the case, once I remove it, everything might be back to normal. If not, well it’s contraindicated for high blood sugar so good riddance.

Another observation: Yesterday I only ran a mile in the morning and was sedentary all day and my BG went to 177 after lunch. Normally I do 2-4 hours of parkour/gymnastics/circus type training throughout the day and I wonder if that’s what’s keeping my postprandial numbers from spiking, which explains why I’m so dead tired on days I don’t train.

8

That’s great to know! I’ll keep in mind if nexplanon removal doesn’t work