I was initially diagnosed as gestational 18 years ago (turning 46 in a couple of weeks) and went immediately on insulin. then went on a pump for 6 years and 2 more pregnancies, Officially considered T2. lost weight and got off insulin, tried multiple oral meds that didn’t work, back on insulin for a year. Endo finally tested, after I insisted, for just GAD, which were negative. I also have Hashi’s thyroid and PCOS, so may trend some towards insulin resistance. Completely changed diet through functional medicine, following AIP diet.
6 months ago I had my integrative med doctor run several tests after fasting (140-150) and PP keep creeping up (never higher than 275-300 with relatively quick dropping). normal weight and fit.
Original endo suspected MODY but tested negative at two different labs
IA-2 weakly positive 1.5 (<0.8), GAD/ICA/ZNT8 negative, IAA positive but that doesn’t count now
A1C is now 6.2 after 6.4 for a long time
C-Peptide 1.68 (0.8-3.85)
Fasting 147
Insulin 8.5 (2.0-19.6)
Also positive DQ8, which is associated with IA-2 and T1
I have made an appt with a different endo (at the same practice but supports integrative medicine concepts) and will ask to have these labs all re-run. veeerrrry slowly progressing LADA?
LADA just means Likely Another Diabetic, Actually.
LADAs leading characteristic is that it develops in everyone at a different rate, so is yours different than mine? Were you diagnosed as an adult?
The acronym I use is YDMV: Your diabetes may vary. It’s true in both the universal and personal sense. Everybody else’s diabetes is strange and so is yours.
This is an opinion, and nothing more (I’m a doctor, but not of people, and certainly not an endocrinologist):
With those numbers (particularly the fasting of 147 mg/dL), does it matter whether it’s a “weird” Type 2 or LADA Type 1? It seems to me that basal insulin might be useful in keeping down the fasting numbers, even if through careful diet you don’t have to take bolus.
Then again, a postprandial of 275-300, no matter how quickly it comes down, is not healthy or indicative of good beta cell function. So it seems to me that the first order of business should be getting the numbers where you want them with some combination of insulin and orals (if they work at all) and diet and exercise.
After that point, it might be worth considering. One positive antibody is certainly suggestive, and combined with symptoms (deranged fasting and postprandial Blood Glucose), is diagnostic of Type 1. Doesn’t really matter if you aren’t positive for GAD, ZNT8, or ICA. The only time multiple antibodies are important is if one is presymptomatic, in which case Type 1 (very slow onset LADA, in particular) can be diagnosed with two positive antibody tests.
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