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Type 1.5/LADA Diabetes
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<blockquote data-quote="Iowaboy" data-source="post: 1606987" data-attributes="member: 445699"><p>Debated whether this was best for the Pre-diabetes forum or here, but since I think I fit into this category, decided to post here.</p><p></p><p>I have had a borderline A1c for the last 3 years, 5.7 each year (upper limit for my lab is 5.6). At the time 3 years ago, I saw endo who did GTT test which was normal. They also did c-peptide which was 0.75 (low) but was a fasting value. Fasting glucose was about 80. They basically questioned why I was there, said don't worry about it, and sent me out.</p><p></p><p>I am 6'1" and usually right around 175 pounds, and reasonable athletic shape (run 20-25 miles a week). I finally decided I wanted to do more investigation when a month ago my A1c again came back 5.7 for the 3rd year in a row. My diet was reasonably good. Water/tea only, no alcohol, felt like I ate healthy at home. However, I tended to eat larger meals at dinner, with plenty of carbs like bread, potatoes, etc. My real vice was I would go out 1-2 times a week and have a large meal or buffet. Admit I ate a lot of food during those meals - usually all you can eat sushi. To be honest, I never thought too much of it because it never affected my weight. In any case, my current fasting values are 75-80 in the morning but the A1c of 5.7 finally got to me. Once I started testing, it seems like my values peak and take a really long time to come down. For a dinner out, it would be common to peak in the 140s and still be above 100 even the next morning. Granted I was eating a large amount of food.</p><p></p><p>So I looked back at the tests I had 3 years ago and wondered if I might have LADA with the low c-peptide level and borderline A1c. I requested further testing and received the following results a few weeks ago: GAD antibody positive at 8.5 U (5 being top normal) with negative IA2, negative islet cell antibodies, and negative insulin antibodies. Fasting c-peptide recently is 0.8. </p><p></p><p>My assessment is that I likely have LADA, though we will see what the endocrinologist says in a week (haven't met with one yet). I suppose the other possibility is that I have become insulin resistant due to my diet, but that wouldn't explain the low fasting c-peptide and elevated GAD. I know that in other situations you can have positive auto-antibodies (like an ANA), and it doesn't have to be clinically relevant, but that A1c suggests otherwise. </p><p></p><p>How long can this phase last? I started a low carb diet about 3 weeks ago, trying to keep total daily carbs around 100 grams. I got rid of those all you can eat meals (I do miss sushi though). I suspect was previously eating at least 250 grams a day of carbs (if not more). New diet definitely seems to help. I know many go much lower. Now my peak 1 hour glucose is around 120 or less, with 2 hour around 95-110 (or even less if I exercise). Fasting is 75-80. My running is increasing (marathon in January), and I am struggling to maintain a weight with the new diet and increased exercise (currently about 167 pounds).</p><p></p><p>I appreciate the chance to share my story and have already learned a lot from this forum!</p></blockquote><p></p>
[QUOTE="Iowaboy, post: 1606987, member: 445699"] Debated whether this was best for the Pre-diabetes forum or here, but since I think I fit into this category, decided to post here. I have had a borderline A1c for the last 3 years, 5.7 each year (upper limit for my lab is 5.6). At the time 3 years ago, I saw endo who did GTT test which was normal. They also did c-peptide which was 0.75 (low) but was a fasting value. Fasting glucose was about 80. They basically questioned why I was there, said don't worry about it, and sent me out. I am 6'1" and usually right around 175 pounds, and reasonable athletic shape (run 20-25 miles a week). I finally decided I wanted to do more investigation when a month ago my A1c again came back 5.7 for the 3rd year in a row. My diet was reasonably good. Water/tea only, no alcohol, felt like I ate healthy at home. However, I tended to eat larger meals at dinner, with plenty of carbs like bread, potatoes, etc. My real vice was I would go out 1-2 times a week and have a large meal or buffet. Admit I ate a lot of food during those meals - usually all you can eat sushi. To be honest, I never thought too much of it because it never affected my weight. In any case, my current fasting values are 75-80 in the morning but the A1c of 5.7 finally got to me. Once I started testing, it seems like my values peak and take a really long time to come down. For a dinner out, it would be common to peak in the 140s and still be above 100 even the next morning. Granted I was eating a large amount of food. So I looked back at the tests I had 3 years ago and wondered if I might have LADA with the low c-peptide level and borderline A1c. I requested further testing and received the following results a few weeks ago: GAD antibody positive at 8.5 U (5 being top normal) with negative IA2, negative islet cell antibodies, and negative insulin antibodies. Fasting c-peptide recently is 0.8. My assessment is that I likely have LADA, though we will see what the endocrinologist says in a week (haven't met with one yet). I suppose the other possibility is that I have become insulin resistant due to my diet, but that wouldn't explain the low fasting c-peptide and elevated GAD. I know that in other situations you can have positive auto-antibodies (like an ANA), and it doesn't have to be clinically relevant, but that A1c suggests otherwise. How long can this phase last? I started a low carb diet about 3 weeks ago, trying to keep total daily carbs around 100 grams. I got rid of those all you can eat meals (I do miss sushi though). I suspect was previously eating at least 250 grams a day of carbs (if not more). New diet definitely seems to help. I know many go much lower. Now my peak 1 hour glucose is around 120 or less, with 2 hour around 95-110 (or even less if I exercise). Fasting is 75-80. My running is increasing (marathon in January), and I am struggling to maintain a weight with the new diet and increased exercise (currently about 167 pounds). I appreciate the chance to share my story and have already learned a lot from this forum! [/QUOTE]
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