Why Not Type 2?!?

[Scubamup]

Seriously confused now. I have diabetes, but that's as far as I've got with any certainty.
Initially I see my GP and he says type 2. This seems to make sense to me. I'm 43 and was a little overweight (just nudging the obese line on the NHS chart), have been for a while, and I have a largely desk job.
Then I see the endochrinologist who is convinced its type 1, a) because I wasn't huge b) sudden onset c) some weight loss. But as I'm 43 he thinks LADA, so I do a GAD test. This has come back negative. No antibodies. But rather than going for what I think is the more likely type 2 conclusion, I'm now sat waiting for a blood test for a genetic condition to diagnose MODY diabetes. This runs in families though, and nobody else has it. Now I accept I could be 'patient zero' in our family tree, but compared to simple type 2 this seems a long shot. I can't work out why he's so convinced I'm not a type 2 as the indicators he mentions weight loss etc aren't unique to type1/LADA/MODY.

Was hoping for a result today. Got another question instead.

Booh. :0(

 

[Daibell]

It's unusual for HCPs to assume it could be LADA. My GP and others on this forum have had real problems getting the GP to consider anything other than T2. Sounds like something other than T2 is possible and worth the endo following up. Either way, a low-carb diet and some Metformin from the Endo/GP might be the way to go for a while and see hyow the HBa1C blood test goes over the coming months. If it is LADA your blood sugar will slowly rise and more meds needed. I can't comment on other types such as MODY. Note that you can have LADA even with a negative GAD due to viruses etc.

 

[Robinredbreast]

Seriously confused now. I have diabetes, but that's as far as I've got with any certainty.
Initially I see my GP and he says type 2. This seems to make sense to me. I'm 43 and was a little overweight (just nudging the obese line on the NHS chart), have been for a while, and I have a largely desk job.
Then I see the endochrinologist who is convinced its type 1, a) because I wasn't huge b) sudden onset c) some weight loss. But as I'm 43 he thinks LADA, so I do a GAD test. This has come back negative. No antibodies. But rather than going for what I think is the more likely type 2 conclusion, I'm now sat waiting for a blood test for a genetic condition to diagnose MODY diabetes. This runs in families though, and nobody else has it. Now I accept I could be 'patient zero' in our family tree, but compared to simple type 2 this seems a long shot. I can't work out why he's so convinced I'm not a type 2 as the indicators he mentions weight loss etc aren't unique to type1/LADA/MODY.

Was hoping for a result today. Got another question instead.

Booh. :0(

Hi, did you have any other symptoms for type 1 diagnosis ,as it does sound more like type 2, but hopefully you will find out sooner, rather than later. Are you on any medication for diabetes ?

(ps My adult son had symptoms of type 2, but when I tested him it was in a good range, I told him to get to his GP asap and it turned out he had very high cholesterol levels !! )

Best wishes for a proper diagnosis very soon.

RRB

 

[catherinecherub]

Hi @Scubamup.

This site is one of the best sites for understanding MODY, Maturity-onset Diabetes of the Young.

http://www.diabetesgenes.org/content/mody

I wonder if aged 43 is too old for this diagnosis?

Whatever happens and whatever is decided by the Endo, please let us know.

 

[Scubamup]

I thought 43 was too old for MODY too.
I was on one 30mg Gliclazide MR tablet but he's just swapped me onto a single 40mg normal Gliclazide tablet. I'm a bit worried my post evening meal readings are about to go up.
I'm on ~50g carb per meal and goinf from 4.7 ish before to 6.5 ish after at the mo.
I asked about Metformin as I'd prefer that ( less hypo risk, and I want to resume scuba diving) but he said he didn't think that metformin would work. 'Wrong type of diabetes.'
Confused....

 

[Daibell]

I thought 43 was too old for MODY too.
I was on one 30mg Gliclazide MR tablet but he's just swapped me onto a single 40mg normal Gliclazide tablet. I'm a bit worried my post evening meal readings are about to go up.
I'm on ~50g carb per meal and goinf from 4.7 ish before to 6.5 ish after at the mo.
I asked about Metformin as I'd prefer that ( less hypo risk, and I want to resume scuba diving) but he said he didn't think that metformin would work. 'Wrong type of diabetes.'
Confused....

Your GP sounds quite knowledgebale. Yes, Metformin works in a different way from Glic and is most useful if you are overweight. Glic prods the pancreas to produce more insulin and sounds the right tablet

 

[phoenix]

Lada = latent autoimmune diabetes in adults.
MODY stands for maturity onset diabetes of the young This was named before they really knew what it was and before they realised that there were several versions. A better name is perhaps monogenic diabetes which reflects that it is caused by a genetic mutation. (different types have different mutations) . It is an inherited condition but as you say you could be the first, or perhaps your version doesn't show up until later and your parent was never diagnosed.(??).

I do think that a lot of weight loss seems to be more associated with T1 (LADA) than T2. MODY not so sure. I don't get the impression that many T2s are diagnosed with unintentional weight loss Your doctor is at least investigating which is good (my doc did the same but I got the LADA diagnosis)

For several types of MODY treatment with sulfs is very much better than with metformin and often only use very low doses. It's because it works by bypassing the normal signalling system to the beta cells telling them to make and release insulin. As I understand it, It is the signalling system that is deficient in some MODYs
Heres a graph showing how much better it is with MODY 3 (source Univ. Copenhagen Global Diabetes course)

 

[Scubamup]

Interesting. I wonder though if the doc is paying enough attention to my sudden change in diet. I've gone from 3-4 cans of coke, the odd flapjack n choccy bar, a day plus heaps of pasta n rice to now a 150g/day of carb diet. He's maybe thinking the gliclazide is really working, whereas I think I'm type 2 and 90% of what we're seeing is diet. The confusion would seem to be cause I wasn't obese. Doesn't mean my diet was any good though, I was just busy.