My LADA diagnosis is very recent; I haven't even it the one month mark yet. Treatment wise, I'm not doing much besides checking my blood sugar 4x/day.
Because of my low A1C at diagnosis (6.8) and healthy eating habits, my endocrinologist has decided to wait and see what my A1C does come January and think about additional treatment at that time.
So, my question is: at what point were you started on insulin after your diagnosis?
My experience wouldn't help you much as I was misdiagnosed as Type 2 and treated with oral meds which worked for 15 months before I needed insulin and then recognized I was Type 1. A 6.8 A1C, while not extreme, definitely warrants treatment. Many studies show that beginning insulin early leads to less destruction of beta cells. What kind of numbers are you seeing for fasting and 2 hours after meals?
I've only been checking blood sugars for three days (I only got my meter on Tuesday) but I've been averaging 130 fasting and I rarely go above 200 unless I eat something extremely carb loaded.
Yes, you are very new to all this, and it's important to keep records for awhile to see if there is a pattern. But if you continue with fastings around 130 (they should be under 100) and post prandials around 200 (they should be under 140) you might not want to wait until January to get started on treatment. While nothing to panic over, those are definitely numbers that should be treated in a Type 1.
You might want to read Melitta's blogs about LADA, they have lots of useful info.
I think those averages are true for non-diabetics. My diabetic educator said that if I was between 90-140 throughout the day and fasting and under 180 two hours postprandial that I was doing okay. Which is where I've been with the exception of once
It's interesting all the different ranges different doctors/educators are happy with.
I'm definitely not excited to start insulin, but if that happens sooner than later, I'll do whatever it takes to avoid complications.
Sorry to contradict, but no, those numbers are not true for non-diabetics, who generally have fastings between 80 and 90 and rarely go over 120 pp. Many of us find that doctors, backed by the ADA are content with numbers that we who have to live with this condition are not happy with. Studies show that complications start to form with significant time spent above 140, so that is the pp goal many of us use, not the 180 recommended by the ADA and some of us even use 120 as a pp goal. My suggestion is to ask questions on here (you'll get more response in the main forum), and do your own research. I highly recommend the books by John Walsh and Gary Scheiner. Also read about LADA and recommendations to start insulin earlier to preserve beta cell function. Many people dread insulin, but then when they start it are happy with how much better they feel.
I totally agree with Zoe. I would call your diabetic educator "old school." I became LADA about four and a half years ago. I'm still not on insulin, and my last A1c was 4.9. I follow Dr. Bernstein and suggest you get his book, "Diabetes Solutions." I eat very low carb and exercise religiously. It works. You look young, so you want to keep your numbers in check for the future. There are also the numbers that the American College of Endocrinology recommends. They are stricter. My Endo gave me the wag the finger thing and told me never to go over 120 post prandial. I don't go nearly that high. I cook full meals for my family complete with full carbs, but I don't eat it. I've seen what the 180 numbers can do to someone over time.
I'm 60yo and just came home from a hip-hop class and a second weight class. I just got certified to teach a fitness class a couple of weeks ago. This works.
I'm being rather stern because you have the rest of your life before you. Read the book even if you can't comply 100%. Bernstein is in his late 70s, Type 1, and no complications. He says it like it is whether you choose to eat the way he does or not.
Hi Lubdub: Personally, if I had the numbers that you are experiencing, I would ask to be put on low doses of insulin immediately. Here is some info from one of the blogs I wrote on adult-onset Type 1/LADA: "There is much debate about the timing and importance of initiation of insulin therapy in people with adult-onset autoimmune diabetes. LADA is defined as not requiring insulin for 6 months, but this is based on physicians’ clinical judgment not disease process and seems specious as Frederick Allen, before the discovery and first use of insulin on a patient with diabetes in 1922, kept Type 1 diabetics (many of them children) alive often for five years or more on a starvation (low carb) diet. Some scientists state that early insulin use has no advantages; yet patients with Type 1 report great relief in getting a correct diagnosis and insulin therapy because they feel so much better. Several published studies have shown that the misdiagnosed (Type 1s misdiagnosed as having Type 2 and not treated with insulin) have a much more rapid onset of diabetic complications. I would say if you have rapid onset Type 1 diabetes, you should initiate intensive insulin therapy as soon as possible. If you have slow-onset Type 1 diabetes, it is possible that exercise and a low carb diet can keep you in control for some time. Just be sure that you are not avoiding insulin therapy due to fear."
There have been several studies that show that early insulin use prolongs the honeymoon, which leads to better control and reduced chance of complications.
Also, I wrote my top ten tips for the newly-diagnosed person with adult-onset Type 1 that you may find useful. I am glad that you have found TuDiabetes!
Hi! Welcome to LADA. Glad you found this website. I've found people here so helpful and understanding. I started on insulin after being misdiagnosed as type 2 for two years despite the fact that I was young, slim, active, and had a zero family history of diabetes. It took two family docs an internal medicine doc (who even then still refused to accept I was anything other than t2 because I was too "old" at age 29 to have type 1) before I went into the hospital and THEN to an endo. for diagnosis. I started on insulin immediately. Zoe and Melitta and others on here are right and they are way more knowledgeable than I am. Maybe you need a few weeks to grieve or get used to having diabetes and ALL the new routines, etc. etc. etc. (so much work!). It won't kill you to not be on any insulin until January but def. by then you should be pushing for it. The sooner the better. If you are LADA you should be on insulin. Your body doesn't make enough. Insulin keeps people alive! It isn't a sign that you are a bad diabetic. It's just what you need to stay alive.
Anyways, I'm fairly new to all of this (four years in) so trust me I still remember how overwhelming it all is in the beginning. Some days are just going to be plain hard. I'm finding more and more peace with it all, and it is getting easier. Lots of luck to you.
My primary doctor was the one that discovered I was diabetic. Because of my age and body build (I am admittedly a bit overweight, however I've lost 70 pounds in the last 4 years so I'm not anywhere near obese or anything. My height hides my weight well, too) she wanted to immediately start me on metformin. I disagreed and wanted to meet with an endo, which led to several lab draws and the diagnosis of LADA.
Even with my medical background I find this overwhelming! I never imagined having to actually check my own blood sugar or one day give myself insulin. Right now, it's definitely a surreal feeling.
My diabetic educator wants me to send my doctor a week's worth of blood sugar readings, so come this following Tuesday I'll do that and I'll ask about starting insulin. I'm all about controlling this and being as healthy as I can be, so bring on the insulin.
I have to have a check in with my endo on Tuesday about my first week of blood sugar readings and I'll definitely ask about starting insulin sooner than later.
Thanks for all the advice, and your blog links are fantastic. :)
I was Dx last March…but I was hospitalized for 5 days with DKA…my AC1 was 11 and my glucose was 700.
Looking back I had the symptoms for years but had never been muc of a carb eater…nor do I like sweets…except pie lol…I also worked in a health club teaching 2-4 classes a day so I think it helped and whenever I " felt bad" I would do what I called “walk it off” or " just drink something for a boost. I did it for years, I was suprised I had no complications.
I was GD but told it will go away…never bothered to check after birth
I was on insulin both long and fast from day three…first day they gave me Metformin but number kept rising…test results came back told Metformin won’t do you any good because your autoimmune.
Lubdubology, do you now what your C-Peptide was? Correct me if I am wrong, but doesn't that give you an indicator of how much insulin you are still producing? I asked my Endo if we needed to repeat it, but he said that we never will have to repeat that test or the antibodies.
I have asked for insulin, too, but my Endo will not give it to me until my numbers are bad. (Sorry, but I just returned from a birthday party held at guess what? - an Italian restaurant when my husband's entire family knew that I was a diabetic. I'm feeling kinda alone and tired of explaining that I am not a Type 2 and do not eat pasta.)
My C-peptide was 1.96 and you're correct. I only tested positive for the GAD antibodies; my islet cell antibodies were negative as well as my insulin autoantibodies.
Gee, that sounds like me four and a half years ago. I was 1 something, but I remember it as being lower. I had the advantage of suspecting that I was LADA from the get go. Two of my dds have to eat a gluten free diet to feel well, I'm of Irish decent - with a high incidence of Celiac among Irish, and knew that the same gene that causes Celiac causes LADA. I tested positive for the gene. Even though I had an A1c of 5.5 and fasting bg in the 90s, I became severely thirsty with dry skin. That thirst happened immediately after eating carbs. I argued with my Endo, but he tested me. I had four times the GAD antibodies above normal.
The good news is that I had read about resting the pancreas by going low carb, and it seems to have worked for me. I will perfectly honest - I really do not ever cheat on my regimen. I found out I was diabetic soon after I had surgery for an adrenal tumor. I couldn't fight the adrenal tumor. I can work with my diabetes.
Bernstein's diet is severe, but I'd rather do this. I don't do it perfectly, but I only eat slow delivering carbohydrates, no carbos in the am when cortisol is higher, most of my carbs at night or a couple of hours after exercise.
I was very fortunate in that a nurse on the Cushing's boards told me about "Diabetes Solutions" by Richard Bernstein, M.D. My husband and I took turns reading it the first week I was dxed. Prior to the dx, I told my Endo that I didn't believe him that I wasn't diabetic and went low carb anyway, but not uber low carb, as I am now.
What works for me, may not work for someone else. If you have a biology background, study the diurnal rhythms of cortisol and eat most of your vegetables in the PM. I was/am a great cook. I have cooked every meal from scratch for over 40 years. However, now I never taste what I cook and use my sense of smell to guide me. My husband and family still give me rave reviews, though they may have to add salt.
Last week, was the only time I have been in trouble. I had a colonocopy scheduled. I dropped rapidly soon after I started drinking the prep solution. I had to drink a half gallon in about 90 min. after a day of diet pop and chicken broth. I dropped to 46. I will never attempt to have this test again without a solid plan including insulin. My theory is that I diluted my blood volume.
Hi, As I and Gerri mentioned in your other post, an A1c of 6.8 isn't good,you need to maintain 6 and below to hopefully avoid complications- there are people who do go higher but it isn't something I would generally recommend. I personally go for the 5 range. Has your doctor done the full round of testing on you, antibody and c peptide testing to see how much insulin you're producing? I definitely would not wait till January and I would find a new endo if he/she won't put you on insulin immediately. I just don't think you're getting good advice from your team at all. 130 fasting is bad, you need to be waking up at 80-100 most of the time not 130 all the time. This shows that you need to be on basal insulin. If you're going to eat high carb meals you need to be on fast acting insulin to bolus for that- I would say you need it anyway for whatever you eat.
As far as testing goes: test when you wake up for fasting, test before meals, 2 hours after meals, before bed, and any time you feel weird. It is not ok to be 180 2 hours after a meal and you want to avoid 200 as much as possible.
Since you're in the early phases of this, and by that I mean you haven't dkaed yet or something liked that, with insulin, diet and exercise, you can probably get yourself back to normal ranges and slow down the beta cell destruction that has probably been going on for quite a while to get you to these bad bg ranges. Remember that you're type 1, lada is type 1, you're body is shutting down insulin production and you need to supplement that in order to start managing your bg.
The discussion is right on. You should keep your average BG below 150 so that your A1C is under 7.0. Many do better than that but the studies clearly show that you are pretty safe from long term complications with an A1C under 7.0. Don't be fooled by a post prendial glucose of 200. You may be above 200 for several hours before you remaining natural insulin is sufficient to being it back down. While you still have significant natural insulin production you fasting levels will always be good. It gets harder without natural insulin.