Is it possible to have 'insulin resistance' as a LADA? I was originally diagnosed as 'pre-diabetic' with insulin resistance when my fasting blood glucose was 120.
Over the last 10 years my diabetes has become completely unmanageable, my A1C over 10 in 2012, and remained unmanageable until I was finally put on insulin last year. My A1c is now at a 6.9 (taken last week)
Just curious. Thanks in advance :)
I think we would all like to know exactly what kind of diabetes we have and how to treat it properly. In the end, diabetes is just very complicated. And the vast majority of us are given a diagnosis of T2 which isn't a specific diagnosis, rather it is a "diagnosis of exclusion." T2 really means "diabetes of unknown type." And when our doctors don't do any tests to try to determine our type, obviously we get a diagnosis of T2. But not everyone with T2 is the same. Diabetes is a complex and multispectrum condition. I was never obese and I never responded long-term to any medications (like you) and my last c-peptide was 0.4 ng/L meaning I've lost the majority of my beta cell function. So, like you, I am on insulin now.
It would be appropriate to ask your doctor for the LADA tests, but at least for now it wouldn't change your treatment.
ps. Great job getting you A1c down to 6.9%!
Hi Jesikabeth. I know how you feel! I too have been down the same path fighting diabetes.
I was 42 when I was first diagnosed with Type 2 back in 2005. I have always been very active, served in the military and maintained my weight as best as I could. My family was even perplexed of my diagnoses and so was I, since I was not obese or overweight.
Doctor started me on meds (Amaryl). The first few years I was able to control my BG with the one med, along with diet and exercise. I have been an avid mountain bike rider for years, riding up to about 50 miles a week. Maintained my A1C around upper 5's and lower 6. Then one day, BG average just kept raising now matter what I did. Doc. added another med. (metformin), BG came back down in range. After that med. increase my first doctor retired.
Started seeing my second doctor, she added Actos to my medicine cabinet. After being on Actos for awhile my weight increased no matter how hard I tried to keep it down. The second doctor told me that she thought that my pancreas was not working fully and that I could be a Type 1. The last time I saw her, she talked to me about having blood work done on my next visit to make that determination. However, she also departed her practice and she turned her patients over to another doctor in the same office.
The third doctor added tridjenta to my list of meds. The Tridjenta worked good for about a year A1C hung around in the 7's. After awhile I started to noticed that I was constantly feeling tired, weak, fatigued and having bad headaches. It got to a point that I felt like I was being runned over by a truck. It was a struggle for me to ride my bike or just to do any physical activity. People who knew me could tell that something was not right about me, my skin color was off and had no spirit about me, I felt like my life was being sucked out of me. My A1C rose up to 8.5, gained more weight. I told this to my doctor several times, he did blood work each time, nothing showed in the blood work that could be causing me to feel bad. He told me I was being a hypercondriac and wanted to get out of work! Come on Doc! Why is A1C going up! All the meds I am on are not working. Let's do something different, like insulin!
The crap finely hit the fan back in April. My health got to point I could not even go to work. My wife said "the hell with my doctor" and took me to the ER. The ER found me severely dehydrated and BG was up around 300. After the ER visit I fired that doctor! By some recommendations I found a very good Endocrinologist. He took me off the meds and started me on insulin. He also order the blood test that my second doctor wanted to run. Found out the other day that I am not at type 2 but, a type 1. He explained to me that all the meds I was on was doing more harm than good since my pancreas was not functioning. Since being on insulin my A1C has come down to 6.5, lost 30 lbs of weight, watching what I eat. With all the changes I am feeling much, much better. I feel like my old self again. My Endo also recommended for me to be on the pump. I should be on that sometime soon.
Found out just recently via a reliable source that the third doctor that gave me a hard time had lost his licensing to practice.
Congrats on making 6.9! I hope things work out for you as well.Fasting blood glucose of 120 does not in itself imply anything to do with insulin resistance.
If you are not on exogenous insulin, C-peptide tests or fasting insulin level tests are usually done to help specifically diagnose "insulin resistance". If you are on insulin, looking at the total daily dose can help identify insulin resistance, although you cannot put too fine a point on it as insulin needs can vary a lot over time or between folks.
If you never did well controlling bg's with T2-oriented drugs like metformin but do very well with small doses of insulin, the assumption of insulin resistance would be wrong.
Thanks :) It's definitely been a whirlwind! Diabetes has been a pain in the butt, quite scary sometimes, but if anything has taught me patience.
Thanks, I am going to be having a c-peptide test done for approval of the pump. T2 drugs didn't help me much, and all I did was gain weight! Now I am on a vGo (taking approx 60 U of Novolog a day) and also on 2,000mg of Glumetza a day. With that combination, my A1c has gone down to a 6.9 (from over a 10.)
Thanks! You've been quite helpful and friendly. I appreciate it :)
Oh, I forgot to say at the time of original diagnosis of 'insulin resistance' when my fasting was 120, they followed that with a 2 hour glucose tolerance test. I don't remember exactly what she said at the time (old doctor, and this was years ago) but that combined with the fasting 120, is what lead her to diagnosing me with 'pre-diabetes' (at that time I was a bit underweight (only by about 10 pounds at that point) and in recovery from an eating disorder. With that said, I'm the only diabetic in my family.
What's your insulin to carb ratio? I'd honestly say C-Peptide isn't a test to judge on with diabetes as far as type goes as you can have low cpeptide but be a type 2, get autoantibody testing , that should tell you if you're type 1 or 2 if it's not completely obvious at diagnosis.
Excellent reply Brian… You really get it that there’s so much more to it than “type 1 or type 2”
Sounds quite a bit like my journey. Diagnosed with fasting blood sugar of 126 as type 2. I am now considered type 1 (or 1.5 LADA). And yes I deal with insulin resistance dependant upon the time of the month and whenever my blood sugar goes over 190.
Insulin to carb is 1:10
I am interesting in learning if I am a true type 2. We shall see. Thanks for sharing!
I think you'd have to be using a lot more than that to be insulin resistant, but I could be wrong on this.
I take approximately 60 U of Novolog a day, and 2,000mg of Glumetza.