Treatment for Early LADA

That's terrible she had that horrible low experience. I have read the SU do cause bad lows and some people get them with metformin too. I wonder if she can try Afrezza, so far most people posting here and elsewhere don't seem be having any lows which is great. I'm thinking about it myself and if my doc gives the ok, I may be the first patient at the practice to try it.

It would make sense getting antibody tests imo.

The low was from the SU and Metformin..not insulin. She had the seizure after my sister took her to the ER and before the hospital gave her insulin. Funny thing is that after the seizure she never regained her full strength and uses a walker now instead of a cane. We had to place her in Assisted Living with my father..both have serious complications from Diabetes. Her doctor is a primary care doctor so I doubt they even did a c-peptide test let alone antibody testing. Wouldn't she be fully insulin dependent after being diabetic 15 years if she was a type 1 ? She has to be making insulin else the SU wouldn't still cause lows.

That's terrible :-( I remember you mentioning that now. I wonder why they didn't just keep her on insulin? I guess 15 years is a long honeymoon, but I think some people said they have had that length. I think I had a long one from all the symptoms I was having before they got worse and then the crisis happened. So I'm sure now I had times where my bg was higher, even without the worse symptoms and it didn't show up in normal blood work.

I've had a 14 year honeymoon (no insulin for the first 13 with good control), so it is possible. It's very uncommon to go that long, though.

I consider it malpractice that antibody tests aren't given to every diabetic that may be T1.

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I get confused on what a honeymoon phase really is. Is it the time not needing insulin or the time on insulin, but not fully insulin dependent because your body still makes some- even a small amount?

The other thing is even my new endo called me pre-diabetic based on my fasting reading, which wasn't high enough for the diabetes diagnosis. He acknowledged that I was antibody positive and that he didn't know if the medicine will "reverse" it or not because of the autoimmune factor. He also listed me with a code that said abnormal glucose which allowed him to prescribe Victoza (and my insurance thankfully covered because it is expensive). Afterward, I got to thinking that if I am on meds and a healthy diet how will it be determined when I cross over to full diabetes?

I tend to blend them together. I think officially it's the time after you start insulin, your beta cells recover somewhat, especially after a dka event and then you need less insulin. I was on 30 units in the icu which then decreased a lot. Building up to dka though, I'm sure there were years where my insulin production was gradually declining bg was also fluctuating. If you're type 1 and you're making only a small amount, not enough to keep you alive and out of dka, you will need insulin, you will be totally dependent. I think the idea is the sooner you go on it the better in order to avoid further detioration.

I don't think there are specific criteria for defining the honeymoon phase, but I think it's generally used when the body is still making significant insulin.

The honeymoon could be considered over when someone starts insulin, but a period of decreased insulin needs can also be considered part of a honeymoon (as meee mentions, this often happens shortly after starting insulin).

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Christopher: was unable to access your page with your Trulicity experience. Was anxious to read about your experiences.

Unfortunately some links were broken when we went through the migration. You can find the thread here, but realize it is about byetta…

I have slow-onset type 1/LADA, diagnosed 2.5 years ago, and found this interesting. My endo just mentioned a GLP-1 receptor agonist as an option. I’m not currently taking insulin, and my A1c is in the mid-5’s with diet and exercise. She decided not to prescribe it because I’m normal weight and she didn’t think I should lose weight. @bjm2363, @Brian_BSC, have you (or anyone else) experienced a significant weight loss with Victoza? @bjm2363 are you still taking Victoza, and is working for you?

I used Byetta and Victoza. Except for an initial response for 2-3 weeks neither helped my blood sugar control and I didn’t experience any weight loss. I was on these drugs for probably two years total. I was probably what would be called a non-responder. Note that everybody is different.

Yes, I am still taking Victoza…since February 1st. My A1C went from 5.9 to 5.1 in June and I lost about 9 lbs although I wasn’t overweight before (now I am just in the middle of my weight range). It is working for me if I exercise and try to keep my carbs per meal under 40 grams and total carbs under 130 a day. I have noticed of late that my fasting readings have crept up slowly from low 80’s to upper 90’s, with an occasional over 100 again so I must be getting some post meal spikes at times.

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Yeah that sounds like it’s working well for you! I wonder if I should have pushed my endo a little more.

Interesting. Thanks for sharing!

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That is great news. I know that some people advise moving to insulin very early but I actually think that if you can use something like Victoza to really normalize your blood sugars that you can do just as well and avoid issues like hypos. And unless you see after meal numbers that are persistently higher than they normal it is unlikely that your increased fastings are due to mealtime spikes. The only way to tell is to check your levels after meals at 2 hours. If you consistently maintain post meal blood sugars that are good (say below 140 mg/dl after two hours) then it isn’t about post meal spikes.

Hey Tony:

Sorry - I haven’t been on the site for a while. I switched to Trulicity due to the sheer convenience of a once weekly shot, hoping it would give me similar results to Byetta. For the first two weeks my numbers were awesome - I was flatlining pretty consistently between 80-100. After that, the efficacy reduced significantly, but I still enjoyed the benefit of not getting hungry between meals and it does help with keeping me in range once my insulin is dialed in correctly. Net - I still see the benefit in using it and find it a valuable tool in keeping my A1c’s in the 5’s.


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@Christopher5 this was my experience. I felt “cured” for like two weeks. After that Byetta and Victoza seemed to have no positive impact on my blood sugars. Bernstein actually says that these GLP-1 drugs don’t work for very long, he suggests more like a few months. What he recommends is a constant rotation between the different drugs.

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Is this the Christopher that’s a direct patient of Bernstein?

As for early treatments, I don’t know i went straight to insulin as by the time my situation was recognized I was past the point of anything else even being discussed I think.

Just saw this thread.

The research shows NO evidence that GLP-1 drugs actually preserve beta cells. This was clear from the first studies of Byetta which showed that after a year or so on the drug people’s blood sugar started to deteriorate. Had the drug been rejuvenating them, their status should have improved, not deteriorated.

Then the autopsy study showed that these drugs appear to be growing abnormal beta cells that are arranged in pathalogical structures and which are secreting both insulin and glucagon, which is what embryonic beta cells do, but not mature ones.

It sounds like this doctor bought into the sales hype from the drug company reps and has not read the actual studies about how these drugs work.

Insulin would probably be a much better solution if you do have an slow-developing autoimmune form of diabetes. There is no evidence that any treatment can delay LADA right now, though there are a few studies going on attempting to prevent autoimmune attack in children with the genes (and family members) related to Type 1.

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