Should I be worried about LADA? Please help

I’ll try to keep this short. I got pregnant with my first daughter at 22 and was diagnosed with GD. I ate a lot of fast food and sugar before diagnosis and was able to control with diet. After she was born i gained weight 160lbs and I’m 5,4" went back to eating unhealthy. Had another GD diagnosis at 25, again controlled with diet. Stayed around 165lbs then got a prediabetes diagnosis at 28, I’m 29 now. I have since lost 25lbs and test my blood sugar daily. My fastings are normal, and I’m always able to keep my pp under 120, sometimes around 135 if I eat more carbs. If I eat junk I do go high, I was at 180 after eating candy, that’s the highest I’ve gone, so my diet is pretty healthy now. Its been a year and I’ve seen no change with my sugars going higher, but my issue is hypoglycemia.

I got myself an exercise bike and if I don’t eat carbs before I use it I get low. I was at 58 after 30 minutes of a pretty rigorous workout, I didn’t eat directly before using the bike, but had a low carb meal about three hours before. Now I’m scared to exercise. I also go low if I drink alcohol, white claws are my drink of choice, but I was at 68 after four of them. I also had a margarita at a restaurant with a pretty high carb meal and got a hypo three hours later.

I do intermittent fasting and my sugar remains stable during this time, its just after exercise, alcohol, and sugary drinks.

I’m now scared I have LADA and if anyone can give me insight if this sounds like it could be it, I would appreciate it. My health anxiety is out of control and I’m terrified.

Nothing about what you’re describing sounds particularly like LADA vs T2 to me. I’d wager a guess that you’re prediabetic/early stage T2, especially if you’ve got a family history of T2. Alcohol inhibits the liver’s release of glycogen (glucose store) so if your body doesn’t alter its insulin response effectively, it could make you hypo. Same thing with exercise—if your body is over producing insulin (which it tends to with insulin resistance, i.e., Type 2), it might not dial that back enough to prevent a hypo. You can certainly ask for more tests to be done like c-peptide and antibodies, but right now, if I were you, I’d focus on learning what you need to do to keep your blood sugars in a good range (like eating a snack before exercise, eating with and testing after drinking and/or minimizing drinking) and know that however your diabetes does or doesn’t develop, that’s what it will be like—figuring what works and going with it. It will be ok no matter what!!

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Thank you so much! Idk why this response just gave me peace of mind. I appreciate it

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Having GD in the past seems to be one of the precursors/signs to getting diabetes later, but usually it’s type2. Also having hypos without taking insulin is also a sign of type 2. A lot of type 2’s have hypoglycemia before they get full blown diabetes.

Type 1’s lack insulin so they go too high and usually remain too high before they start on insulin. Although there are a few few variations of diabetes out there. To know if you are a type 1 you would need a antibody test, which if positive means you are a type 1, although there are some type 1’s out there that don’t have the antibodies but don’t make insulin. And a C-peptide that tells you how much insulin you are making. Low or low normal is a sign of type 1, high or high normal is a sign of type 2.

But what you are describing fits type 2 more. A type 1 lacks insulin and LADA is a type 1. It’s just a term used to describe slower onset type 1 . What happens with LADA/type 1 is you stop slowly making insulin over time until you completely stop. That muddies the waters and helps cause LADA/type 1’s often to be misdiagnosed. What happens with a type 2 is they still make insulin, they just don’t use it well. A type 1 loses weight because they can’t utilize the food they eat because they lack insulin to do so. A type 2 is more prone to gain weight until they get their blood sugars in better control, then they can lose weight.

It’s important as a type 2 to keep your blood sugars stable, that usually means smaller meals and watching what you eat. Proper snacks in between meals can help that. But as soon as you eat something sugary your blood sugars will shoot up because as a type 2 your insulin isn’t working well, it’s called insulin resistance. But eventually it usually does work and your blood sugars drop back down to more normal ranges.

People use exercise to help bring down their blood sugars because it helps force glucose into the cells to be used. Taking walks after you eat actually helps a lot of type 1’s and type 2’s. If you are dropping because of exercise that means exercise is being very effective in what it’s doing. So either change the timing of your exercise for right after you eat or eat a protein snack, maybe a few complex carbs a half hour or so before to help stabilize your blood sugars.

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I wouldn’t worry about whether you will be diagnosed with LADA or not. But I would aggressively pursue getting a correct diagnosis. The C-peptide and antibody tests should help clarify.

While I am a LADA T1D, I don’t buy into the idea that one type of diabetes is worse than another. They’re all tough to live with and if you don’t treat them well, unless you’re very lucky, long-term complications will creep in.

T1D can require closer attention to your health but that has some benefits, too. Either way, you can live a long and happy life with either form of diabetes. But you do need to take care of business and not fall into a denial trap.

In the year before I was diagnosed with T1D, I experienced several episodes of reactive hypoglycemia. They occurred following a highly processed breakfast cereal, milk and fruit breakfast. After a few hours, I went low, felt shaky, sweaty, and irritable. When I ate a candy bar, everything felt better.

This looks like a reactive hypoglycemia episode to me, compounded by your rigorous workout.

Reactive hypoglycemia is not definitive for T2D and can be a symptom of T1D with a slow onset or LADA. Many doctors miss this diagnosis and sometimes are reluctant to do the C-peptide and anti-body tests. There are several antibody tests and just because you may test negative for the most common GAD-65 antibody does not rule out T1D.

Good luck. Push to find out what kind of diabetes you’re living with, learn as much as you can about its treatment and then take action!

Another member, @Melitta, has written extensively about this issue. I recommend that you read this older post.

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I agree with Terry4. It sounds like reactive hypoglycemia. Before my LADA diagnosis in 2008 I spent years in a cycle of reactive hypos a couple hours after a high sugar / fast carb snack or meal followed by another food frenzy to to counter the lows.
I also had GD with my second pregnancy, followed the diabetes diet while I was pregnant and then spent years making up in extra carbs for the few months I ate low carb while I was pregnant. I gained about 30 lbs over the next 20 years, but I did not care at the time. When I experienced vision problems in 2005, I was misdiagnosed as a Type 2. And it took a couple more years of a low carb diet and exercise, before a sharp nurse practitioner ordered the GAD65 antibody test to diagnose LADA.
My message is to take care of yourself. Don’t give up on exercise, but always have some fast carbs / glucose tabs available if you have a hypo. Eat and drink in moderation. It may take some time before you get a correct diagnosis - if any. However, be aware that there are a plenty of doctors who do not understand LADA. Even my first endocrinologist got it wrong.
Worry and stress will likely make everything worse. Be aware of your situation and try -one day at a time- to make good (or better) decisions about diet and exercise.

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Thanks for that explanation @cardamom…explained a lot.

Those lows prob hit her hard because she’s not such a ‘hardened’ diabetic.
@cardamom, Is she a candidate for CGM or is that overkill?
I feel like a lot of ‘normal people’ react a lot harder (more intense symptoms) to those lows than many of us would. It worries me that she feels so afraid. I suspect those lows are hitting her hard.

@stefjonge, How many times are you feeling low in a week or a month or a day?
Are you checking your sugar before you drive? That would make me feel better.

I haven’t had a low in months since I stopped using my bike. Its not something I deal with daily, or even weekly. Its funny, since I started using my meter from when I had GD I check after everything, I was low after exercising, but I felt fine, albeit tired. It does make me wonder if this has happened before and I didn’t know because I didn’t test. Most days I feel fine, I fast until 12, eat a light lunch and a fulfilling dinner. My meter says I’m fine, but I do know alcohol and exercise make me go low, even if I feel okay. I tested a lot to get the hang of things…I know what I can and cannot eat, and like I said, my sugars are 99% under 120 two hours pp. I just read a lot about people with LADA having hypos and it made me afraid that maybe something else was going on

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I would get the tests for type 1 to be safe and then go from there. Gd is a precursor for both. I am type 1 and also had hypos, not reactions to carbs etc.

IMO, based on what you have written, I think there is more than a possibility that you have LADA, which of course is slowly progressive Type 1 diabetes. GDM is a common precursor to Type 1 diabetes, and reactive hypoglycemia is VERY common in early LADA. I would definitely get c-peptide and autoantibody tests if I were you. JDRF has just launched T1detect, where you can get autoantibody testing inexpensively.

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Thanks for stopping by, Melitta. I wasn’t aware of JDRF’s help with this issue. It looks like a good program. Do you know how many antibodies that they test? It seems they recognize the amount of misdiagnosis of people with T1D and the adverse effects that they suffer.

Merry Christmas!

Hi Terry: T1detect tests just three autoantibodies: GAD, IAA, and IA2. It doesn’t test ZnT8. I don’t know that JDRF has truly acknowledged the level of misdiagnosis, but this is a great tool IMO for those people whose doctors refuse to request the autoantibody tests, or for those people who need an inexpensive avenue.

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