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Type 1.5/LADA Diabetes
GAD positive but confused
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<blockquote data-quote="smidge" data-source="post: 862031" data-attributes="member: 29301"><p>Hi Nybrid,</p><p></p><p>A lot of questions there.</p><p></p><p>1. A lot of LADAs don't need insulin at first - it absolutely doesn't make them Type 2s. It is believed to be a slow onset form of Type 1. It tends to be diagnosed by the GAD antibody test. The presence of antibodies almost always means LADA and the NHS will classify that as Type 1 - they only really recognise Types 1 and 2 so LADAs get shoved in with Type 1s.</p><p></p><p>2. A c-peptide test would be useful for a couple of reasons; firstly it gives you a prognosis - if it's really low, you'll probably move onto insulin more quickly whereas if it's not too bad, you might go several years without needing to inject; secondly it gives you a baseline for measuring your condition's progression - but that involves getting your consultant to agree to doing them every year or so, which is highly unlikely; thirdly, it helps rule out Type 2 if there is still any doubt - a high c-peptide is indicative of Type 2 whereas a low c-peptide is indicative of Type1/1.5. As you've already tested positive to GAD antibodies, there isn't much doubt about your diagnosis, so your consultant will probably not want to spend the money on a c-peptide test for you.</p><p></p><p>3. Red wine is notorious for lowering BG. You're not on any BG lowering medications so there is really nothing to worry about. 3.8 is normal BG. Doctors are very ignorant in general around the issue of hypos. Even on insulin I like to see occasional 3.8s - even the DAFNE course doesn't classify a hypo until below 3.5 and clinically, a hypo is below 2.2. Medics tend to say 4 to build in a margin of error for insulin users - but you shouldn't need that margin with metformin.</p><p></p><p>4. I doubt the metformin is doing much for an LADA although I do know several Type 1s and LADAs who take it as they say it helps control the after food spikes and means they can use less insulin. Personally, if I was on it I'd probably stay on it. It is widely believed to be a benign drug that does more good than harm and has several protective benefits. I have no evidence of this though.</p><p></p><p>5. My advice would be to avoid dieticians!</p><p></p><p>Smidge</p></blockquote><p></p>
[QUOTE="smidge, post: 862031, member: 29301"] Hi Nybrid, A lot of questions there. 1. A lot of LADAs don't need insulin at first - it absolutely doesn't make them Type 2s. It is believed to be a slow onset form of Type 1. It tends to be diagnosed by the GAD antibody test. The presence of antibodies almost always means LADA and the NHS will classify that as Type 1 - they only really recognise Types 1 and 2 so LADAs get shoved in with Type 1s. 2. A c-peptide test would be useful for a couple of reasons; firstly it gives you a prognosis - if it's really low, you'll probably move onto insulin more quickly whereas if it's not too bad, you might go several years without needing to inject; secondly it gives you a baseline for measuring your condition's progression - but that involves getting your consultant to agree to doing them every year or so, which is highly unlikely; thirdly, it helps rule out Type 2 if there is still any doubt - a high c-peptide is indicative of Type 2 whereas a low c-peptide is indicative of Type1/1.5. As you've already tested positive to GAD antibodies, there isn't much doubt about your diagnosis, so your consultant will probably not want to spend the money on a c-peptide test for you. 3. Red wine is notorious for lowering BG. You're not on any BG lowering medications so there is really nothing to worry about. 3.8 is normal BG. Doctors are very ignorant in general around the issue of hypos. Even on insulin I like to see occasional 3.8s - even the DAFNE course doesn't classify a hypo until below 3.5 and clinically, a hypo is below 2.2. Medics tend to say 4 to build in a margin of error for insulin users - but you shouldn't need that margin with metformin. 4. I doubt the metformin is doing much for an LADA although I do know several Type 1s and LADAs who take it as they say it helps control the after food spikes and means they can use less insulin. Personally, if I was on it I'd probably stay on it. It is widely believed to be a benign drug that does more good than harm and has several protective benefits. I have no evidence of this though. 5. My advice would be to avoid dieticians! Smidge [/QUOTE]
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