A few years ago I participated in the Trialnet research program(Australia) as my daughter is T1D. I tested positive to the ICA512 autoantibodies. Ive just recently tested as pre-diabetic after watching my bgls rising. Does this mean that I am in the early stages of LADA? Will I be able to control or prevent progressing to diabetes by changing my diet and losing weight like regular pre-diabetes or is it inevitable that my beta cells are dying off and its only a matter of time to progress to full blown LADA? Have others been aware of the disease progress this early on in the process and what have you done the halt/delay the progression to LADA if anything?
Early stage LADA?
- Thread starter JellyBeanMamma
- Start Date
Hi JellyBeanMamma and welcome!
Others might disagree, but the presence of ICA512 antibodies does make it highly likely you are in the early stages of LADA which, as you know, is an autoimmune form of diabetes. It is progressive and at present, there is no way of halting that progression. It is not the same as Type 2 pre-diabetes as that can often be reversed by losing weight, changing diet and tackling insulin resistance as the body is still producing insulin but not using it effectively. In my view, you are not really pre-diabetic as such - you are in early stages of LADA which means you are diabetic - your body is producing progressively less insulin and that will one day reach a tipping point whereby it produces insufficient for your needs. Eventually insulin is inevitable. That's the bad news.
The better news is that there are measures you can take which might slow the progression and will help your body work within its available insulin production. Basically, you need to cut down as far as possible on the Carbs so that you don't need more than the insulin you have available. This will also keep your BG low which is really important because high BG - even slightly high for short periods - is toxic to beta cells, causing your ability to produce insulin to decline further. I need to be clear though, this will not reverse your condition if you have LADA because your beta cells will still be under attack by your immune system, but it will help preserve what you have.
I was diagnosed in the early stages of LADA, when my fasting BG and HbA1c were still in the non-diabetic range, but my first-phase insulin production was already badly-impaired so I was getting serious after food spikes way into the diabetic range. Unfortunately, I was misdiagnosed Type 2 and left without appropriate treatment for way too long and my condition deteriorated rapidly over the following 10 months or so. At that point I needed insulin.
I would say if you want to preserve the insulin production you have for as long as possible, it is essential that you keep your BG within the non-diabetic range - and if the only way you can do that is with insulin, then start small doses of insulin early - it gives your body a break, keeps your BG in normal levels an gives you a chance of preserving you own insulin production for longer.
It might be worth asking for a c-peptide test - this shows how much insulin you are producing and will give you an indication of how sufficient your insulin production currently is to your needs - it let's you know what you are working with - basically how far progressed you are.
I would suggest getting a copy of Dr Bernstein's 'Diabetes Solution'. Dr Bernstein is an American physician who is In his 80s and has had diabetes all his life. He advocates managing diabetes by normalising BG by eating a very low-carb diet and thereby minimising insulin requirements. He is a remarkable man and even if you don't want to follow his methods, the book is still very informative about the condition.
Stick around on the forum - there are several highly knowledgeable LADAs on here and I'm sure you will get good advice and information.
Smidge
Others might disagree, but the presence of ICA512 antibodies does make it highly likely you are in the early stages of LADA which, as you know, is an autoimmune form of diabetes. It is progressive and at present, there is no way of halting that progression. It is not the same as Type 2 pre-diabetes as that can often be reversed by losing weight, changing diet and tackling insulin resistance as the body is still producing insulin but not using it effectively. In my view, you are not really pre-diabetic as such - you are in early stages of LADA which means you are diabetic - your body is producing progressively less insulin and that will one day reach a tipping point whereby it produces insufficient for your needs. Eventually insulin is inevitable. That's the bad news.
The better news is that there are measures you can take which might slow the progression and will help your body work within its available insulin production. Basically, you need to cut down as far as possible on the Carbs so that you don't need more than the insulin you have available. This will also keep your BG low which is really important because high BG - even slightly high for short periods - is toxic to beta cells, causing your ability to produce insulin to decline further. I need to be clear though, this will not reverse your condition if you have LADA because your beta cells will still be under attack by your immune system, but it will help preserve what you have.
I was diagnosed in the early stages of LADA, when my fasting BG and HbA1c were still in the non-diabetic range, but my first-phase insulin production was already badly-impaired so I was getting serious after food spikes way into the diabetic range. Unfortunately, I was misdiagnosed Type 2 and left without appropriate treatment for way too long and my condition deteriorated rapidly over the following 10 months or so. At that point I needed insulin.
I would say if you want to preserve the insulin production you have for as long as possible, it is essential that you keep your BG within the non-diabetic range - and if the only way you can do that is with insulin, then start small doses of insulin early - it gives your body a break, keeps your BG in normal levels an gives you a chance of preserving you own insulin production for longer.
It might be worth asking for a c-peptide test - this shows how much insulin you are producing and will give you an indication of how sufficient your insulin production currently is to your needs - it let's you know what you are working with - basically how far progressed you are.
I would suggest getting a copy of Dr Bernstein's 'Diabetes Solution'. Dr Bernstein is an American physician who is In his 80s and has had diabetes all his life. He advocates managing diabetes by normalising BG by eating a very low-carb diet and thereby minimising insulin requirements. He is a remarkable man and even if you don't want to follow his methods, the book is still very informative about the condition.
Stick around on the forum - there are several highly knowledgeable LADAs on here and I'm sure you will get good advice and information.
Smidge
Lesleywo
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Hi JellyBeanMamma
This is an interesting question. I have 2 autoimmune conditions (addisons disease and hashimoto's) and test positive to GAD 65. A year ago my GP told me to lose some weight as I was becoming insulin resistant, HbAlc 5.8. So like you I wonder, if I am early LADA. My endo just shrugs and says 'you're not diabetic' but like you I wonder as I feel if you have antibodies you have an autoimmune attack going on. I recently had a c-peptide done, reading 589 (range 280-1250) so insulin looks reasonable but I guess I just wait and see.
In the meantime I'm eating a lowish carb diet and can keep my bloods down to around 5.3 for most of the day. But I have been 'breaking out' a lot lately and have put on a bit of weight. Getting more tests done in a few weeks.
I am not sure what ICA512 autoantibodies is .. I think there are 3 antibodies related to diabetes and I believe I read recently that you need to be Gad positive to have diabetes. And the more of the antibodies you have the faster you progress to insulin.
Do you have other relatives in your family who have diabetes or autoimmune disease?
This is an interesting question. I have 2 autoimmune conditions (addisons disease and hashimoto's) and test positive to GAD 65. A year ago my GP told me to lose some weight as I was becoming insulin resistant, HbAlc 5.8. So like you I wonder, if I am early LADA. My endo just shrugs and says 'you're not diabetic' but like you I wonder as I feel if you have antibodies you have an autoimmune attack going on. I recently had a c-peptide done, reading 589 (range 280-1250) so insulin looks reasonable but I guess I just wait and see.
In the meantime I'm eating a lowish carb diet and can keep my bloods down to around 5.3 for most of the day. But I have been 'breaking out' a lot lately and have put on a bit of weight. Getting more tests done in a few weeks.
I am not sure what ICA512 autoantibodies is .. I think there are 3 antibodies related to diabetes and I believe I read recently that you need to be Gad positive to have diabetes. And the more of the antibodies you have the faster you progress to insulin.
Do you have other relatives in your family who have diabetes or autoimmune disease?
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Lesleywo
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- Messages
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- Type of diabetes
- LADA
- Treatment type
- Diet only
- Dislikes
- My addiction to carbs
My Mum was supposedly Type 2 but was only diagnosed 18 months before she died. There are 2 aunts on her side of the family that were diabetic but don't know if it was type 2 or type 1. Seems we're doomed one way or another!
Have you asked your doctor this question?
Meanwhile, @Ian DP and @LucySW are seasoned LADA's so might be able to throw some light on this for you.
Have you asked your doctor this question?
Meanwhile, @Ian DP and @LucySW are seasoned LADA's so might be able to throw some light on this for you.
My Dr doesn't seem too fussed by my results and just told me to loose weight and exercise more. I have a letter from the research people stating Im positive to the islet cell autoantibodies so I guess Ill pull that out once im formally diagnosed as diabetic. Ill be asking for a referral to an Endocrinologist too. I guess its wait and see, go low carb and keep monitoring my levels.
Ian DP
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Hi jellybeanmaa
Smidges advice is spot on, in my opinion. I was diagnosed T2 18 months ago, then T1 in the honeymoon period / LADA 15 months ago through a GAD test. Since then I have very low carbed and am keeping my BG levels normalised. A number of experts, including Dr Bernstein say normal means 4.6 fasting and 5.6 two hours after eating. Dr Bernstein says if you are LADA and can keep your BG levels within this range you can stay LADA for years, he says he has seen 10 years plus. It's working for me, but I have only been low carbing for a year. My BG levels are low enough now for me to be even out of the pre diabetic range.... But I am diabetic, and it's only diet that keeps my BG levels low. At some point in time I will be on insulin. It sounds very much like you will be to. If you are LADA you definitely will be at some point in time. Like me your beta cells are gradually diminishing. The only way you may be able to reduce this is to keep your BG levels at normal levels.
Smidges advice is spot on, in my opinion. I was diagnosed T2 18 months ago, then T1 in the honeymoon period / LADA 15 months ago through a GAD test. Since then I have very low carbed and am keeping my BG levels normalised. A number of experts, including Dr Bernstein say normal means 4.6 fasting and 5.6 two hours after eating. Dr Bernstein says if you are LADA and can keep your BG levels within this range you can stay LADA for years, he says he has seen 10 years plus. It's working for me, but I have only been low carbing for a year. My BG levels are low enough now for me to be even out of the pre diabetic range.... But I am diabetic, and it's only diet that keeps my BG levels low. At some point in time I will be on insulin. It sounds very much like you will be to. If you are LADA you definitely will be at some point in time. Like me your beta cells are gradually diminishing. The only way you may be able to reduce this is to keep your BG levels at normal levels.
One indication that your LADA is progressing is unexpected loss of wieght as the body stops being able to use the carbs you eat and your BS keeps going up.
LucySW
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Doesn't matter. Any time you unaccountably start to lose weight. But that's usually high BG. I don't really know, but would guess over 12 mmol/L.
You don't say anything about weight loss, though, so I assume this hasn't happened to you. It would eventually, if your BG rose and rose and you didn't do anything about it.
In the meantime, as Smidge and Ian say, all you can use to slow BG rises if you are indeed LADA is to control carb intake and/or add insulin.
Ian managed it with carb control alone; I didn't.
Edit: some useful links. Ian's story is here; mine is here and here. I think both our pathways are quite typical of the progression of LADA. Smidge's story is at posts ## 15 and 18 of this thread.
On maintaining the Bernstein 30g carb/day program, this might be useful.
Lucy
You don't say anything about weight loss, though, so I assume this hasn't happened to you. It would eventually, if your BG rose and rose and you didn't do anything about it.
In the meantime, as Smidge and Ian say, all you can use to slow BG rises if you are indeed LADA is to control carb intake and/or add insulin.
Ian managed it with carb control alone; I didn't.
Edit: some useful links. Ian's story is here; mine is here and here. I think both our pathways are quite typical of the progression of LADA. Smidge's story is at posts ## 15 and 18 of this thread.
On maintaining the Bernstein 30g carb/day program, this might be useful.
Lucy
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Hi. As Lucy says, when bloods go into the teens then some action is needed. This may be up to three tablet types over time and when these fail as they did for me even on max dose then the time for insulin has arrived. The NICE Diabetes Pathways doc (Google it) gives some guidance on HBA1C levels and appropriate treatment. There is also a new NICE Diabetes Draft Guidleines DEC 2014 doc. What a shame some GPs don't read these docs; they're quite good.
LucySW
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There's a certain argument for skipping tablets, unless they're going to help preserve beta-cell function, and going straight to insulin once BGs rise. I was glad I was never offered tablets, apart from Metformin, which I keep going on about because I think it's a wonderful, safe, simple drug if you can tolerate it, used preferably in conjunction with insulin. Because it increases insulin sensitivity, and therefore lowers the amount of insulin you need to take. Which I think can only be a good thing.
That's Dr Bernstein's recommendation, too. Which is a big plus for me, as he is such a wonderful clinician. He may not have published research, but he's a fantastically thorough and successful physician.
That's Dr Bernstein's recommendation, too. Which is a big plus for me, as he is such a wonderful clinician. He may not have published research, but he's a fantastically thorough and successful physician.
